Friday morning CIS Flashcards
Differential of liver mass in 13 year old?
hepatic adenoma hepatoblastoma in young kids, pretty unusual past 2-4 years old hepatocellular cancer focal nodular hyperplasia hemangioma
A 45 year old man with ulcerative colitis presented with jaundice. differential? tests?
primary sclerosing cholangitis
alcohol
hepatitis
biochemical panel, seriologies
cholestasis without liver involvement possibilitities
primary sclerosing cholangitis (onion skin fibrosis, beading/ strictures)
obstruction at ducts from neoplasia
stones
primary biliary sclerosis
do ERCP (look at ducts) and MRI cholangiography
high alk phos, alt and ast
mixed hepatocellular and cholestatic
usually hepatitises would have higher transaminases, although could be autoimmune
drugs could cause this
(minocycline, e.g.)
you find the hep c antibody, does this mean that person has chronic hep c?
not necessarily; some seroconvert and cure
check PCR for viral RNA
thrombocytopenia with cirrhosis means?
portal hypertension
hint of possible decompensation
chronic hep C infection, what should we make sure to do?
give hep A vaccine
mexico ate food, what viruses do you think of?
Hep A (food borne) Hep E
alcohol and transaminases
alcohol uses vitamin B and your transaminases are unlikely to be higher than 1,000
things that can cause transaminases that are super high
hepatitis viruses
drugs
hepatic ischemia
autoimmune
(EBV, CMV, alcohol)
lower elevated transaminases
lot of overlap between cirrhosis and chronic hepatitis
NAFLD
HBe antigen tells you what?
viral replication going on
15-year old hypertensive, thrombocytopenia, elevated unconjugated bilirubin
could be Gilberts or hemolytic
minocycline is associated with
autoimmune hepatitis
