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Internal Medicine EORE > GI and Nutrition > Flashcards

GI and Nutrition Flashcards

12% of EORE Blueprint

1
Q

What are the acute symptoms associated with Hepatitis A?

How is Hepatitis A transmitted?

A
  • Fatigue
  • Malaise
  • Vomiting
  • Anorexia
  • Fever
  • RUQ pain

Fecal-oral route

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2
Q

A positive IgG anti-HAV suggests what?

What serum level will be positive with an acute hepatitis A infection?

A

Previous infection with hepatitis A or acquired immunity

IgM anti-HAV

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3
Q

Is there a vaccine available for hepatits A?

A

Yes, it is an inactivated vaccine given in 2 doses. Recommended to start at age 1. Recommended also for high risk travelers and lab workers.

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4
Q

What are the clinical manifestations of acute viral hepatitis?

The phases

A
  • Prodromal Phase: malaise, arthralgia, fatigue, URI sx, decreased desire to smoke, n/v, abdominal pain, loss of appetite, acholic stools (HAV is associated with fever)
  • Icteric Phase: jaundice (most don’t develop this phase)
  • Fulminant Phase: encephalopathy, coagulopathy, hepatomegaly, jaundice, edema, ascitis, asterixis
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5
Q

What is the most common cause of fluminant hepatitis in the U.S.?

A

Acetaminophen Toxicity

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6
Q

What is the name of the syndrome that is defined as fulminant hepatitis in children after receiving aspirin with a viral illness?

A

Reye’s Syndrome

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7
Q

When is the hepatits B vaccine given?

A
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8
Q

What viral hepatitis strains are reportable diseases?

A

Hepatitis A, B, and C

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9
Q

What are the chronic forms of viral hepatitis?

A

Hepatitis B, C, and D

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10
Q

What is the incubation period for Hepatitis A?

A

2 weeks - 6 months (average 30 days)

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11
Q

What is a specific symptom in hepatitis A?

A

Aversion to smoking

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12
Q

What can be some positives on physical exam with Hepatitis A?

A
  • Low grade fever
  • Hepatomegaly
  • Splenomegaly
  • Lymphadenopathy
  • +/- Jaundice
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13
Q

Will AST/ALT be elevated in Hepatitis A?

A

Yes

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14
Q

What is the treatment for Hepatitis A?

A
  • Self limited with improvement in 2-3 weeks
  • Frequent hand washing to prevent spread
  • Symptomatic treatment
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15
Q

How is Hepatitis E transmitted?

A

Fecal-oral transmission

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16
Q

What populations are at risk for Hepatitis E?

A
  • Pregnant women
  • Underlying liver disease
  • HIV
  • Immunosuppressed
17
Q

What are some extra-hepatic manifestations of Hepatitis E?

A
  • Arthritis
  • Pancreatitis
  • Thrombocytopenia
  • Guillain-Barre
  • Peripheral neuropathy
18
Q

What is the treatment for Hepatitis E?

A
  • Self-limited
  • Symptomatic treatment (rest, fluids, avoid ETOH)
19
Q

How is Hepatitis B transmitted?

A

Blood borne

20
Q

Hepatitis B fomites can remain on surfaces for how long?

21
Q

Can Hepatitis B be vertically transmitted?

22
Q

What is the incubation period of Hepatitis B?

A

6 weeks to 6 months (average 12-14 weeks)

23
Q

How is chronic Hepatitis B defined?

A
  • Infection persisting longer than 3-6 months (3-6 months of AST/ALT elevations)

*High rates of chronic hep B in infants who receive via vertical transmission

24
Q

What is the treatment for chronic hepatitis B?

A

Treatment is only indicated if the individual is actively replicating the virus –> antivirals

25
Q

What are the preferred antiviral treatments for chronic hepatitis B?

A

Entecavir and Tenfovir

26
Q

What Hepatitis strain is Hepatitis D a co-infection of?

A

Hepatitis B

27
Q

Hepatitis C is commonly co-infected with what other virus?

28
Q

Who should be periodically screened for Hepatitis C?

A
  • IVDU
  • Dialysis patients
  • High risk co-morbidities (HIV)
29
Q

What is the treatment for acute Hepatitis C?

A
  • None
  • Consider PEG interferon +/- ribavirin if no spontaneous clearance by 3 months
30
Q

What are the first line antivirals for chronic hepatitis C?

A

Ledipasivir and Sofosbuvir (Harvoni)

*Response is dependent on genotype

31
Q

What serum antibody is present when there is immunity against HBV?

32
Q

What is the most sensitive imaging for diagnosing chronic pancreatitis?

33
Q

List the osmotic laxatives

A
  • polyethylene glycol
  • magnesium citrate
  • lactulose
  • sorbitol

They work by drawing water into the intestine, which increases the frequency of bowel movements and improves the consistency of the stool.

34
Q

A 36-year-old man returns to the office for follow-up evaluation. He recently completed an antibiotic course of clarithromycin, amoxicillin, and omeprazole for acute gastritis. What would you expect to learn from his history based on this information?

A. A recent colonoscopy revealed transmural involvement with skip lesions

B. He had a biopsy revealing eosinophilic inclusions

C. He had a positive urea breath test

D. He was overusing NSAIDs for chronic back pain

A

He had a positive urea breath test

35
Q

Chronic use of what medications other than metformin may lead to vitamin B12 deficiency?

A
  • PPI’s
  • Antacids
  • H2 Blockers

Medications that reduce gastric acids

Internal Medicine EORE (10 decks)

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