GI Flashcards
Hepatitis B: Immunized
Anti-HBs
Hepatitis B: Acute Infection
+HBsAg
+ Anti-HBc IgM
+ HBeAg
Hepatitis B: Resolved Infection
Anti-HBs
+ Anti-HBc IgG
+/- Anti-HBe
Hepatitis B Treatment
Entecavir or tenofovir
Hepatitis B Phases
Immune tolerant
immune active
immune control/carrier
Reactivation
Hepatitis C Treatment Cure (lab)
no HCV RNA in blood 12 weeks after completion of treatment
Autoimmune Hepatitis Antibodies
Type 1 - Antismooth muscle, ANA, elevated IgG
Type 2 - Anti-LKM and ALC
Alpha 1 AntiTrpysin Genotype
ZZ = severe disease
MZ or SZ = disease only in setting of other liver disease
Initial Testing for Hereditary Hemochromatosis
Elevated transferrin saturation
Wilson Disease Screening
low ceruloplasmin, high urinary copper
Wilson Disease, typical age for presentation
5-40
Treatment of Wilson Disease
Trientine > pencillamine
Zinc supplementation
Primary Biliary Cholangitis Labs
elevated ALP
+ antimitochondrial Ab
Primary Biliary Cholangitis Screening
yearly TSH for AI thyroid disease
Diagnosis of Primary Sclerosing Cholangitis
MRCP w/ colonoscopy at diagnosis
beading seen on ERCP
Diuretic Ratio for Cirrhosis/Ascites
Furosemide 20 : Spironolactone 50
Ascites Studies consistent with Cirrhosis
SAAG >1.1
Low ascetic protein (<2.5)
SBP Diagnosis
PMN >250
When to consider albumin co-administration for SBP
Renal Dysfunction, Cr >1, BUN >30
TB >4
Gallbladder polyps - when to intervene
size >1cm, symptoms, increasing in size
Cholangitis - Tetrad and Pentad
Charcot: Fever, jaundice RUQ Pain
Reynolds: hypotension, AMS
Hep A pre exposure prophylaxis
most - Hep A Vaccine
consider IG if immunocompromised OR endemic region in 2 weeks + unvaccinated
liver disease + traveling + unvaccinated: vaccine + IG w/in 2 weeks
Hep B Extrahepatic manifestations
arthritis
polyarteritis nodose
MN
cyroglobulienmias
Hepatitis C Extrahepatic manifestations
cryoglobulienic vasculitis, MPGN, porphyea cutanea tardia
alcoholic hepatitis DF score for treatment
32! –> prednisolone
avoid if active infection, GI bleed, pancreatitis
