GI

Question 1

How do you treat autoimmune pancreatitis with biliary obstruction?

Answer 1

not with stent. do steroids.

Question 2

What antibody do PSC, PBC, and autoimmune hepatitis share?

Answer 2

anti-smooth muscle

Question 3

Which antibody is positive in PBC? anti-smooth muscle or anti-mitochondrial antibody?

Answer 3

anti-mitochondrial antibody

Question 4

What condition is associated with alk phos elevated to 1.5 x ULN + positive anti-mitochondrial antibody?

Answer 4

PBC

Question 5

What is the clinical presentation of PBC?

Answer 5

usually asymptomatic but may have pruritis and fatigue, elevated alk phos, then elevated anti-mitochondrial antibody

Question 6

what is the treatment for PBC?

Answer 6

ursodeoxycholic acid

*hydrophilic bile salt, which stabilizes hepatocyte membranes against toxic bile salts and inhibits apoptosis and fibrosis.

Question 7

Why is the reason to avoid ACE/ARBs in certain people with cirrhosis?

Answer 7

can worsen ascites if present

Question 8

Why avoid NSAIDs in cirrhosis?

Answer 8

can worsen azotemia and Na retention

Question 9

what are the 4 phases of Chronic Hep C?

Answer 9

immune tolerant/active/control and reactivation

Question 10

Of the 4 phases of chronic Hep B, which involves seroconversion of HBsAg from neg to pos and rising viral DNA levels?
1) Immune tolerant
2) Immune active
3) Immune control
4) Reactivation

Answer 10

Reactivation

Question 11

Of the 4 phases of chronic Hep B, which involves vertical transmission, +HBeAg without e Ab, DVA >1 million, and normal ALT?
1) Immune tolerant
2) Immune active
3) Immune control
4) Reactivation

Answer 11

Immune tolerant (hep c is going crazy but liver is okay)

*no treatment needed in this phase

Question 12

Of the 4 phases of chronic Hep B, which has moderate levels of viral DNA with high ALT?
1) Immune tolerant
2) Immune active
3) Immune control
4) Reactivation

Answer 12

Immune active

*treatment is needed here because liver is actually being damaged