Gastro IV ( Hepatitis)

Question 1

Indications for Tissue Transglutaminase (tTG) IgA and IgG Antibodies?

Answer 1

Monitoring celiac disease:

Will be negative in a pt on gluten-free diet (IgG decreases over 6-12 months

**first test you do when looking for celiacs disease , and it has to be active disease to find the ABS *

Question 2

Antibodies test explanation?

Answer 2

Gliadin and gluten are proteins found in wheat

Cause direct mucosal damage when ingested by pt with celiac

**they induce an autoimmune reaction in the bowel and you get a smooth bowel wall creating problems *

Question 3

Indication for lactose intolerance test?

Answer 3

Used to identify pts with lactose intolerance caused by:

Lactase insufficiency
Intestinal malabsorption
Maldigestion
Bacterial overgrowth in the small intestine

**can break down lactose cause they do not have the lactase enzyme ( lactase insufficiency)*

Question 4

lactose is broken up into what by what enzyme?

Answer 4

galactose and glucose by lactase

Question 5

Test explanation lactose intolerance?

Answer 5

Lactose load is given

Serum glucose levels are checked at 30,60, and 120 minutes after lactose PO

Question 6

lactose intolerance test abnormal ?

Answer 6

No rise in glucose

Question 7

lactose intolerance test normal ?

Answer 7

Rise in glucose levels by >20 mg/dL

**if they break down lactose then we should see a rise in glucose ( check at 30, 60, 120 min)
*

Question 8

Uncommon Hepatitis ?

Answer 8

D , E

Question 9

Common Hepatitis?

Answer 9

A, B, C

Question 10

Hep A incubation period?

Answer 10

2-6 weeks

Question 11

Hep A transmission?

Answer 11

fecal oral

Question 12

Hep A. testing: HAV RNA?

Answer 12

direct detection ( directly detect the virus)

Question 13

Hep A. testing: HAV-Ab/IgM appears?

Answer 13

4-6 wks

Question 14

Hep A. testing: HAV-Ab/IgG appears?

Answer 14

8-12 wks

Question 15

Hep A. testing: HAV-Ab/IgG gone?

Answer 15

10 yrs

Question 16

Hep A. testing: HAV-Ab/IgM gone?

Answer 16

3-4 mo

Question 17

Hep C is what type of pathogen?

Answer 17

blood borne

Question 18

Hep C incubation period?

Answer 18

2-12 wks

Question 19

Hep C is chronic in what percentage of patients?

Answer 19

60%

Question 20

Hep C testing: HCV-Ab/IgG appears?

Answer 20

3-4 mo

Question 21

Hep C testing: HCV-Ab/IgG gone?

Answer 21

2 yrs

Question 22

Hep C testing: HCV RNA?

Answer 22

direct detection

monitor tx.

Question 23

Hep D causes _____ hepatitis?

Answer 23

delta

Question 24

Hep D need what to enter liver and be infective?

Answer 24

Hep BV

Question 25

Hep D testing: HDV-Ag?

Answer 25

directly after infection or use: HDV-Ab/IgM

Question 26

What is the testing with Hep. E?

Answer 26

no testing

Question 27

Hep B incubation period?

Answer 27

5wks-6mo

Question 28

Transmission of Hep B?

Answer 28

blood transfusion bodily fluids

Question 29

Hep B antigens?

Answer 29

HBsAg HBeAg ``` ** c - core antigen e- enveloping antigen s- surface antigen * ```

Question 30

Hep B antibodies?

Answer 30

HBsAb HBcAb/IgM HBcAb/Total HBeAb

Question 31

What Hep B test indicate a active infection?

Answer 31

HBsAg

Question 32

What is the most common Hep B test?

Answer 32

HBsAg

Question 33

HBsAg for Hep B appears?

Answer 33

4-12 wks

Question 34

HBsAg for Hep B gone in?

Answer 34

1-3 mo

Question 35

What Hep B testing indicates the end of acute infection?

Answer 35

HBsAb

Question 36

HBsAb signifies ________ to subsequent infection

Answer 36

immunnity

Question 37

HBsAb appears in?

Answer 37

3-10 mo

Question 38

HBsAb is gone in?

Answer 38

6-10 yrs

Question 39

What Hep B test correlates with early and active infection and is an index of infectivity?

Answer 39

HBeAg **its an index of infectivity - the more infective the person is - the first few weeks they are more infective ( contagious)*

Question 40

HBeAg appears ?

Answer 40

1-3 wks **This si what we look for early on in disease, and it shows up before the SA *

Question 41

HBeAg is gone?

Answer 41

in 6-8 wks

Question 42

HBeAb indicates that acute infection is _____ and that infectivity is ______?

Answer 42

over lower

Question 43

HBeAb appears in?

Answer 43

4-6 wks

Question 44

HBeAb is gone in?

Answer 44

4-6 years

Question 45

HBcAb is the only detectable sign of HBV during the ____ _______

Answer 45

core window present with chronic hep. ** core window - between the detection of the antigen and the response of the ABS and stays elevated in chronic infection*

Question 46

What is the test for HBV viral loads?

Answer 46

HBV-DNA, RT---PCR

Question 47

what is the number that indicates a inactive infection ?

Answer 47

viral load of <300 copies/ml ** always want to get out patients with chronic infections down to a undetectable viral load *

Question 48

EGD uses?

Answer 48

Infectious esophagitis shallow ulcers or deep ulcers Mallory-Weiss Tear linear tear with bleeding Esophageal varices - band / cauterize it Barret’s - salmon/orange colored mucosa Adenocarcinoma ulcerated with heaped borders Gastritis - inflammation of stomach lining PUD - look at lesions or bx. Gastroparesis - use other test ——scintograophy or gastric emptying study Gastric outlet obstruction

Question 49

Barium swallow is used for?

Answer 49

Achalasia parrot’s beak Esophageal spasm corkscrew/ rosary bead Esophageal stenosis filling defect/narrowing ( where stenotic area is) Zenker’s diverticulum see pouch Adenocarcinoma filling defect Gastroparesis gastrinoma - check gastrin levels

Question 50

ECRP uses?

Answer 50

Acute cholangitis Primary sclerosing cholangitis