Hepatitis Flashcards
This hepatitis has the highest mortality in pregnant women
Hepatitis E
This liver test is a measure of vitamin K dependent clotting factors
Prothrombin time/INR
Liver biopsy shows piecemeal necrosis with lymphocyte infiltration, what might this patient have?
Autoimmune hepatitis
Serology test to determine severity of hepatitis B
HBeAg - presence indicates that virus is replicating and the infected person has high levels of HBV
Anti-HBe - hepatitis B e antibody, indicates lower levels of HBV
Most people with this type of hepatitis don’t know they’re infected
Hepatitis B
Sign of alcoholic hepatitis
Severely elevated bilirubin, bad jaundice
ALT and AST are enzymes found in hepatocytes. When are they released into the blood?
Both released when liver cells damaged
ALT: specific for liver injury
AST: less specific, also found in skeletal and cardiac muscle
(if AST up but not ALT, may not be liver issue)
Name the two autosomal recessive and one autosomal dominant genetic liver conditions
Auto recessive: hemochromatosis and Wilson’s
Auto dominant: alpha 1 antitrypsin deficiency
Treatment for hepatitis A
Supportive care only
99% get better in six months on their own
Differentiate between cholestatic and hepatocellular patterns
Cholestatic: Disproportionate ALP and bilirubin elevation
Hepatocellular: Disproportionate AST/ALT (transaminases) elevation
Textbook patient for primary biliary cirrhosis
Middle-aged woman
Which liver test, albumin or prothrombin time/INR, is more reflective of short-term changes in liver function?
Prothrombin time/INR
(albumin has 21 day half life so does not drop acutely)
Does infection of hepatitis C always confer immunity?
No
Most common causes of drug-induced liver failure
Tylenol most common intentional cause
Antimicrobials/antibiotics most common unintentional cause
Transmission of hepatitis B
Can be horizontal or vertical
Transmission of hepatitis E
Fecal-oral
Animal vectors
Maternal-infant (often fatal)
Definition of hepatitis
Inflammation of the liver
Manifested by elevations of AST/ALT
Symptoms of hemochromatosis
Similar to diabetes (bronze diabetes)
Which hepatitis variants have no potential for chronic infection?
A and E
Differentiate between acute and chronic hepatitis
Acute: less than six months
Chronic: more than six months
Most common cause of liver cirrhosis
NASH/MASH
NASH/MASH is caused by this syndrome
Metabolic syndrome
(obesity, lipids, diabetes)
A patient infected with hepatitis B would have this on serology
HBsAg - surface antigen
Core antibody
(IgM anti-HBc if acute)
A patient who has recovered from hepatitis B and is immune would have this on serology
Anti-HBc - core antibody
Anti-HBs - surface antibody
Two actual tests of liver function
Prothrombin time/INR
Albumin
Will hepatic diseases cause elevated conjugated or unconjugated bilirubin?
Both unconjugated and conjugated increased equally
Wilson’s disease causes a buildup of this in the blood, leading to these symptoms
Copper
Neurologic symptoms (psychosis, seizures, retardation)
This genetic liver disease most commonly presents with respiratory issues
Alpha 1 antitrypsin deficiency
A patient who was vaccinated for hepatitis B would have this on serology
Anti-HBs - surface antibody
Incidence of this hepatitis is increasing due to the opioid epidemic
Hepatitis C
Treatment for Tylenol induced acute liver failure
N-acetylcysteine within 8 hours
NAC ‘em!
This hepatitis needs a patient to be infected with this hepatitis to survive
Hep D needs Hep B (coinfection)
Will posthepatic diseases (gallstones) cause elevated conjugated or unconjugated bilirubin?
Conjugated (dark urine and pale stool)
Transmission of hepatitis A
Close personal contact
Fecal-oral contamination of food or water
Will prehepatic diseases (hemolytic anemia) cause elevated conjugated or unconjugated bilirubin?
Unconjugated
Factors that affect fibrosis risk in hepatitis C
Alcohol use
Duration of infection
Male more risk than female
Gold standard for assessing treatment effectiveness in hepatitis B
Anti-HBe antibody presence
