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Clin Med 2 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What is acute hepatitis

A

inflammation of the liver

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2
Q

What is the cause of acute hepatitis

A 
infectious
- Hep B and C
non-infectious
- alcohol
- drugs
-autoimmune
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3
Q

Clinical acute hepatitis

A
  • fatigue/maliase
  • anorexia
  • N/V
  • fever
  • enlarged tender liver
  • jaundice
  • normal/low WBC
  • elevated aminotransferase (>1000U/L)
  • hyperbilirubinemia
  • increase PT/INR (>1.5)
  • encephalopathy
  • viral has viral sickness included
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4
Q

Transmission of hep a

A

fecal-oral route due to crowding and poor sanitation

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5
Q

Is there a vaccine for hep A

A

yes

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6
Q

Dx hep A

A

anti-HAV appears early (IgM= active, IgG= previous exposure)

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7
Q

Tx hep A

A

symptomatic

recovery in 3 mo and no chronic liver dz

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8
Q

Transmission Hep B

A

infected blood products, sexual contact, delivery by HBV+ mother

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9
Q

Do adults or infants develop acute hepatitis infection from HBV

A

infants

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10
Q

Is there a vaccine for Hep B

A

yes

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11
Q

If mother is HBV+ and delivers baby, what do we give baby? What could we give mother in 3rd trimester?

A
  • vaginal delivery give baby HBIG and HBV vaccine within 12 hrs of birth
  • give mother antiviral therapy in 3rd trimester is high viral load
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12
Q

HbSAg

A
  • first evidence of infection

- persistent for more than 6 months–> chronic infection

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13
Q

HBV DNA

A

active viral replication; viral core

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14
Q

Anti-HBc

A

IgM indicating acute hepatitis infection and IgG indicated chronic or recovered infection

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15
Q

Anti-HBs

A

after successful vaccination or recovery from HBV infection

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16
Q

Transmission of Hep C

A 
IVDA
body piercing
tattooing
hemodialysis
pre-1992 blood transfusion
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17
Q

Do people usually develop chronic HCV

A

yes

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18
Q

Dx HCV

A

anti-HCV ELISA

HCV RNA PCR serology for confirmation (do if ELISA positive)

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19
Q

Tx HCV

A

8-12 weeks Ledipasvir/sofosbuvir (Harvoni)

Recover in 3-6mo

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20
Q

Hep D is only associated with what and only present when?

A

Associated with HBV and HBsAg has to be present

21
Q

Transmission Hep D

A

blood- percutaneous exposure

22
Q

Dx Hep D

A

anti-HDV

23
Q

Transmission Hep E

A

fecal oral- waterborne

consuming undercooked pig meat or if pet a pig

24
Q

Who gets autoimmune hepatitis

A

young to middle aged women

25
Q

When is autoimmune hepatitis common

A

following viral illness or drug exposure

26
Q

Labs autoimmune hepatitis

A

aminotransferace>1000
positive ANA and/or smooth muscle Ab most common
IgG increase

27
Q

Dx autoimmune hepatitis

A

liver biopsy

28
Q

Tx autoimmune hepatitis

A

corticosteriods

azathioprine

29
Q

How much alcohol consumed to produce cirrhosis

A

over 50g alcohol/day for 10 yrs

30
Q

What preceded alcoholic hepatitis

A

recent period of heavy drinking

31
Q

Sign of alcoholic hepatitis

A

fatty liver

32
Q

Lab alcoholic hepatitis

A

macrocytic anemia
thrombocytopenia
AST/ALT ratio 2:1 and mildly elevated
PT/INR elevated

33
Q

Imaging alcoholic hepatitis

A

CT/MRI: mod-severe steatosis

34
Q

Tx alcoholic hepatitis

A 
Emergent
- steroids: methylpredisone if MELD over 18
- pentoxiphylline if steriods C/I
General
- stop alcohol
- correct folate, thiamine, and zinc def
- abstinence 
- liver transplant if abstinent for 6mo
35
Q

Drugs that cause direct hepatotoxicity and are dose related

A 
APAP
ALcohol
niacin
tetracycline
valproic acid
vitamin a
36
Q

Drugs that cause direct hepatotoxicity and are not dose related and an allergy at times

A 
amiodarone
aspirin
diclofenac
fluoroquinolones
phenytoin
methyldopa
37
Q

Non-inflammatory drug induced cholestasis

A

azathioprine
estrogen
anabolic steriod
diclofenac

38
Q

Inflammatory drug induced cholestasis

A 
augmentin
azithromycin
erythromycin
macrobid- nitrofurytoin
cephalosporin
azathriprine
39
Q

How much of world infected with HBV

A

1/3

40
Q

What is the dominant cause of cirrhosis and HCC

A

chronic HBV

41
Q

What is a predictor of cirrhosis and HCC

A

High HBV DNA

42
Q

chronic HBV labs

A

HbSAg and anti-HBc IgG

43
Q

Imaging chronic HBV

A

US/CT/MRI- coarse nodular echogenic appearance

44
Q

TX HBV

A

entecavir and tenofovir

45
Q

Clinical active chronic HBV

A

elevated transaminase more than 3-6mo
HBV DNA elevated
cirrhosis (ugly liver F2-F4)
acute liver failure

46
Q

Most cases chronic HCV

A

Africa, C. America, E. Asia

47
Q

Who has an increased risk of developing cirrhosis with chronic HCV

A

chronic alcohol ingestion
male
hcv>40yo
co-infection with HIV/HBV

48
Q

Prevent Chronic HCV

A

needle exchange for IVDA
tx substance abuse
blood donor screening
universal precautions

49
Q

Tx Chronic HCV

A

12 wks w/o cirrhosis and 24wks w/ cirrhosis

Ledipasvir/sofosbuvir (harvoni)

Clin Med 2 (25 decks)

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