Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

(OMS2) GI II Exam 2 > DSA 5: Approach to the Hepatobiliary Patient (Acute Hepatitis / Liver Disease) > Flashcards

DSA 5: Approach to the Hepatobiliary Patient (Acute Hepatitis / Liver Disease) Flashcards

1
Q

How does acute (fulminant) liver failure (ALF) present?

A

1) Massive hepatic necrosis
2) Impaired consciousness
3) Occurs within 8 weeks of onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the primary etiology of acute (fulminant) liver failure?

A

Acetaminophen overdose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can cause AST/ALT elevations but rarely cause true hepatitis or ALF?

A

Statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the leading causes of death associated with ALF?

A

Cerebral edema (brainstem compression) and sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes the deep coma associated with ALF?

A

Hepatic encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens to the liver during ALF?

What happens to bilirubin levels?

What happens to PT?

A

1) Shrinks
2) Rises
3) Prolongs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What occurs when ALF presents with an INR of greater than 1.5?

A

Life threatening coagulation abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How should ALF be treated?

A

1) Liver transfer

2) N-Acetylcysteine (NAC) in Acetaminophen OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the main causes of acute hepatitis?

A

1) Viral
2) Drugs
3) Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is seen on PE for acute hepatitis?

A

1) RUQ due to tenderness over liver
2) Jaundice
3) Stools may be acholic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of virus is hepatitis A?

A

Single-stranded RNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the duration of HAV?

A

Acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common risk factor for HAV?

A

International travel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the route of transmission for HAV?

A

Fecal-oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What labs are elevated for HAV?

A

1) AST/ALT

2) Bilirubin and Alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What forms of anti-HAV are detectable in serum soon after onset?

A

IgM and IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Detection of IgM anti-HAV is an excellent test for diagnosing?

IgG anti-HAV (in the absence of IgM anti-HAV) indicates?

A

1) Ongoing acute hepatitis A

2) Previous exposure to HAV and immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Can HAV become chronic?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of virus is HBV?

A

Partially double-stranded DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

HBV may be associated with what cutaneous symtom?

A

Polyarteritis nodosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are routes of transmission for HBV?

A

1) IV drug use
2) Sexual contact
3) Perinatal (mother to baby)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Perinatal transmission of HBV is endemic in what areas of the world?

A

1) Sub-Saharan Africa

2) Southeast Asia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When may HBsAg-positive mothers transmit HBV?

There is a risk as high as 90% of what occuring in these infants?

A

1) At delivery

2) Chronic infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What labs are seen markedly elevated early in the course (higher than HAV infection)?

A

AST/ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Can HBV become chroinc?

A

Yes, 5-10% of cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What complications can arise from HBV?

A

1) Cirrhosis (especially if HDV superinfection)

2) Hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is HBV prevented before exposure?

A

3 doses of vaccine

28
Q

What is the window period of acute HBV infection between?

A

HBsAg disappearing and HBsAb appearing

29
Q

In terms of serology, what is present during the window period of HBV?

A

HBcAb IgM

30
Q

In terms of serology, what is present during acute infection of HBV?

A

1) HBsAg
2) HBcAb IgM
3) HbeAg
4) HBV DNA

31
Q

In terms of serology, what is present during prior infection of HBV?

A

1) HBsAb

2) HBcAb IgG

32
Q

In terms of serology, what is present during chronic inactive infection of HBV?

A

1) HBsAg

2) HBcAb IgG

33
Q

In terms of serology, what is present during chronic active infection of HBV?

A

1) HBsAg
2) HBcAb IgM
3) HBcAb IgG
4) HBeAg
5) HBV DNA

34
Q

In terms of serology, what is present during when a person is immunized for HBV?

A

HBsAb

35
Q

What type of virus is hepatitis D?

A

Defective RNA virus that requires HBV

36
Q

What is the relationship that HDV has with HBV?

A

Either co-infects with HBV or superinfects a chronic HBV carrier

37
Q

What is seen on labs for HDV?

A

HDV RNA (PCR)

38
Q

How is HDV prevented?

A

Hepatitis B vaccine

39
Q

What type of virus is hepatitis C?

A

Single stranded RNA

40
Q

What form of HCV is most common?

A

Chronic

41
Q

What are some risk factors for HCV?

A

1) Transfusions
2) IV drug use
3) Intranasal drug use (cocaine)

42
Q

Coinfection with HCV is found in at least 30% of?

A

HIV-infected persons

43
Q

Covert transmission of HCV during what activity has been reported?

A

Bloody fisticuffs

44
Q

What is found on labs for HCV?

Which is the most sensitive indicator of HCV infection?

A

1) HCV Ab in serum

2) HCV RNA (most sensitive)

45
Q

What indicates recovery from prior HCV infection especially in people with genotype CC?

A

Anti-HCV in serum without HCV RNA

46
Q

What vaccine is used for HCV?

A

There is no vaccine to HCV but patients with chronic liver disease should be vaccinated against HAV and HBV

47
Q

What are potential complications of HCV?

A

1) Cirrhosis
2) Hepatocellular carcinoma
3) HIV co-infections
4) Mixed cryoglobulinemia

48
Q

What is the recommended screening for HCV?

A

Everyone over the age of 18 should be screened for it at least once in their lifetime

49
Q

What type of virus is hepatitis E?

A

ssRNA hepevirus

50
Q

What is the risk factor for HEV?

A

Immunocompromised patients

51
Q

How is HEV transmitted?

A

1) Fecal oral
2) Waterborne epidemic
3) Spread by swine

52
Q

What labs are seen with HEV?

A

1) IgM or IgG HEV Ab

2) PCR for HEV RNA

53
Q

Does it present as acute or chronic?

A

Acute

54
Q

While HEV does not have a carrier state, in what patients have there been instances of chronic HEV with progessrion to cirrhosis?

A

Transplant patients treated with tacrolimus

55
Q

What population does HEV have the highest mortatliy rate in?

A

Pregnant women

56
Q

What is the most common drug that causes toxic hepatitis?

A

Acetaminophen

57
Q

What do you use to treat acetaminophen OD?

What is the critical amount of time you should administer the treatment?

A

1) N-acetylcysteine aka NAC

2) Within 8 hours of ingestion

58
Q

Occlusion of flow to hepatic vein leads to what condition?

A

Budd-Chiari syndrome

59
Q

What factors predispose patients to hepatic vein obstruction?

A

Hypercoagulable states such as polycythemia vera

60
Q

What is the screening test of choice for Budd-Chiari syndrome?

What can be seen on imaging?

A direct venography will show?

Liver biopsy will show?

A

1) Contrast enhanced US
2) Prominent caudate liver lobe
3) IVC webs
4) Nutmeg liver

61
Q

What is a potential complication of Budd Chiari Syndrome?

A

Hepatocellular carcinoma

62
Q

What is the most common cause of jaundice in pregancy?

A

Viral hepatitis

63
Q

What condition may be life threatening for pregnancy women and is characterized by hyperreflexia and convulsions?

A

Eclampsia

64
Q

Subclinical hepatic disease may be the primary manifestation of preeclampsia, as part of what syndrome?

A

HELLP syndrome:

Hemolysis, Elevated Liver enzymes, and Low Platelets

65
Q

What is characterized by the onset of pruritus in the third trimester?

A

Cholestasis of pregnancy

(OMS2) GI II Exam 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions