Hep

Question 1

acute liver disease

Answer 1

widespread cellular damage - possibly leading to failure

Question 2

chronic may be ………. or ………

Answer 2

persistent or active

Question 3

Chronic is the result of……..

Answer 3

cirrhotic changes

Question 4

persistent chronic liver disease is

Answer 4

minimal degree of inflammation
follows benign course
becomes infective to others

Question 5

chronic active liver disease is

Answer 5

continual destruction of hepatocytes

Question 6

liver disease affects ……….% of the global population

Answer 6

3%

Question 7

Cirrhosis is

Answer 7

permanent structural damage (inflammation >6 months)

Question 8

What accumulates between cells in cirrhosis

Answer 8

large fat droplets

collagen fibre network near venules

Question 9

How are the portal tracts destroyed

Answer 9

venules become obliterated and a fibrous band develops

cells regenerate between - leads to haphazard cell division and nodules

Question 10

liver disease produces ……………. hypertension

Answer 10

portal

Question 11

Compensated

Answer 11

replacement of dead tissue sufficient to restore funciton

Question 12

Decompensated

Answer 12

the damage is too great and the liver can no longer restore normal function

Question 13

Antibodies to HVC take up to ……….. months post infection

Answer 13

3 months

Question 14

What sort of virus is HVC

Answer 14

ssRNA Flaviviridae family

Question 15

How many genotypes?

Whis is more prevalent in UK?

Answer 15

6

1

Question 16

3 checks before biopsy

Answer 16

• platelet and clotting
• vit K
• fibroscan

Question 17

Why not oral vit K?

Answer 17

malabsorption of fats - poor absorption of fat soluble vitamins
Also the water soluble form (menadione) needs to be converted in the liver which may also be impaired

Question 18

What is ribavarin?

Answer 18

broad spec antiviral (teratogenic)

Question 19

Main treatments for HPC

Answer 19

PEG interferon alpha 2a or 2b
and
ribavirin

Question 20

IFNalpha treatment requires paracetamol and hydration because

Answer 20

pro-inflammatory

Question 21

Monitoring in HVC virus

Answer 21

neutrophil
platelet
thyroid function
LFT
FBC
anaphylaxis

Question 22

antidepressant of choice in HPC

Answer 22

citalopram - minimal effects on liver enzymes

TCA: imipramine