Hep Flashcards
acute liver disease
widespread cellular damage - possibly leading to failure
chronic may be ………. or ………
persistent or active
Chronic is the result of……..
cirrhotic changes
persistent chronic liver disease is
minimal degree of inflammation
follows benign course
becomes infective to others
chronic active liver disease is
continual destruction of hepatocytes
liver disease affects ……….% of the global population
3%
Cirrhosis is
permanent structural damage (inflammation >6 months)
What accumulates between cells in cirrhosis
large fat droplets
collagen fibre network near venules
How are the portal tracts destroyed
venules become obliterated and a fibrous band develops
cells regenerate between - leads to haphazard cell division and nodules
liver disease produces ……………. hypertension
portal
Compensated
replacement of dead tissue sufficient to restore funciton
Decompensated
the damage is too great and the liver can no longer restore normal function
Antibodies to HVC take up to ……….. months post infection
3 months
What sort of virus is HVC
ssRNA Flaviviridae family
How many genotypes?
Whis is more prevalent in UK?
6
1
3 checks before biopsy
- platelet and clotting
- vit K
- fibroscan
Why not oral vit K?
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
What is ribavarin?
broad spec antiviral (teratogenic)
Main treatments for HPC
PEG interferon alpha 2a or 2b
and
ribavirin
IFNalpha treatment requires paracetamol and hydration because
pro-inflammatory
Monitoring in HVC virus
neutrophil platelet thyroid function LFT FBC anaphylaxis
antidepressant of choice in HPC
citalopram - minimal effects on liver enzymes
TCA: imipramine
