Gastro IV ( Hepatitis) Flashcards
Indications for Tissue Transglutaminase (tTG) IgA and IgG Antibodies?
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 *
Antibodies test explanation?
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 *
Indication for lactose intolerance test?
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)*
lactose is broken up into what by what enzyme?
galactose and glucose by lactase
Test explanation lactose intolerance?
Lactose load is given
Serum glucose levels are checked at 30,60, and 120 minutes after lactose PO
lactose intolerance test abnormal ?
No rise in glucose
lactose intolerance test normal ?
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)
*
Uncommon Hepatitis ?
D , E
Common Hepatitis?
A, B, C
Hep A incubation period?
2-6 weeks
Hep A transmission?
fecal oral
Hep A. testing: HAV RNA?
direct detection ( directly detect the virus)
Hep A. testing: HAV-Ab/IgM appears?
4-6 wks
Hep A. testing: HAV-Ab/IgG appears?
8-12 wks
Hep A. testing: HAV-Ab/IgG gone?
10 yrs
Hep A. testing: HAV-Ab/IgM gone?
3-4 mo
Hep C is what type of pathogen?
blood borne
Hep C incubation period?
2-12 wks
Hep C is chronic in what percentage of patients?
60%
Hep C testing: HCV-Ab/IgG appears?
3-4 mo
Hep C testing: HCV-Ab/IgG gone?
2 yrs
Hep C testing: HCV RNA?
direct detection
monitor tx.
Hep D causes _____ hepatitis?
delta
Hep D need what to enter liver and be infective?
Hep BV
Hep D testing: HDV-Ag?
directly after infection
or use:
HDV-Ab/IgM
What is the testing with Hep. E?
no testing
Hep B incubation period?
5wks-6mo
Transmission of Hep B?
blood transfusion
bodily fluids
Hep B antigens?
HBsAg
HBeAg
** c - core antigen e- enveloping antigen s- surface antigen *
Hep B antibodies?
HBsAb
HBcAb/IgM
HBcAb/Total
HBeAb
What Hep B test indicate a active infection?
HBsAg
What is the most common Hep B test?
HBsAg
HBsAg for Hep B appears?
4-12 wks
HBsAg for Hep B gone in?
1-3 mo
What Hep B testing indicates the end of acute infection?
HBsAb
HBsAb signifies ________ to subsequent infection
immunnity
HBsAb appears in?
3-10 mo
HBsAb is gone in?
6-10 yrs
What Hep B test correlates with early and active infection and is an index of infectivity?
HBeAg
**its an index of infectivity - the more infective the person is - the first few weeks they are more infective ( contagious)*
HBeAg appears ?
1-3 wks
**This si what we look for early on in disease, and it shows up before the SA
*
HBeAg is gone?
in 6-8 wks
HBeAb indicates that acute infection is _____ and that infectivity is ______?
over
lower
HBeAb appears in?
4-6 wks
HBeAb is gone in?
4-6 years
HBcAb is the only detectable sign of HBV during the ____ _______
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*
What is the test for HBV viral loads?
HBV-DNA, RT—PCR
what is the number that indicates a inactive infection ?
viral load of <300 copies/ml
** always want to get out patients with chronic infections down to a undetectable viral load *
EGD uses?
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
Barium swallow is used for?
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
ECRP uses?
Acute cholangitis
Primary sclerosing cholangitis
