FLT's 2 Flashcards
Hep B
goal of tx is antigen to antibody seroconversion
dont treat if they have no antigen
Tx- antigen in blood for greater than 6 mo\
- serum HBV DNA > 10^5 copies /mL
- persistent or intermittent elevation in ALT and AST
- –>interferon for 1 year-flu like symptoms
- —>nucleoside analogs, fewer s/e
if u have normal ALT u are not a candidate for tx due to low likelihood of seroconversion, unless u have cirrhosis
Hep C
defined as presence of HCV rna in blood for >6 months after infection
goal of tx is to clear hcv rna such that remain HCV rna negative 12 wks after stopping therapy
nearly 100% coin flips
Hemochromatosis
goal is lower serum ferritin
HFE gene
Autoimmune hep
immune suppression azothioprine
50% chance of relapse after tx
*Primary biliary cirrhosis
intrahepatic small bile ducts
alk phos elevation, AMA strongly positive
Therapy- UDCA (ursodeoxycolic acid)
check for osteoporosis
Primary sclerosing cholangitis
large bile ducts–> no effective medical therapy
risk of cholangiocarcinoma
ast alt mildly elvated alk phos moderately elevated
bilirubin high direct,
wilsons
AR,
Tx- chelate with D penicillamine and trientine
AST ALT mildly elevated, alk phos mildly elevated, low platelts INR mildly elevated, splenomegaly, cirrhosis
has kayser fleisher rings in her eyes
non-alcoholic steatohepatitis (NASH)
presence of hepatic staeatosis and inflammation with hepatocyte injury (balloning w/ or w/o fibrosis
risk factors- obesity, dm, hyperlipidemia
Tx- modify risk factor
HbsAG
hep B surface antigen marker of active infection, if present for greater than 6 mo than its a chronic hepatitis B infection
HbsAb
antibody to hep B antigen marker of immunity
HbcAB
hep B core antibody, marker of active or pprior infection
HbeAg
hep B E antigen, surrogate marker of high viral load
HbEAb
antibody to hep e antigen associated with lower viral load
HBV DNA
presence means active viral replication
