Hepatitis

Question 1

What are the positive serology markers for acute infection with Hepatitis?

Answer 1

HBsAg +
Anti-HBc (ab) IgM +
HBeAg +
HBV DNA +

Question 2

What are the positive serology markers for prior hepatitis infection?

Answer 2

Anti-HBs +
Anti-HBc (ab) IgG +
Anti-HBe (ab) +/-

Question 3

What is the serology for a chronic hepatitis carrier without active infection?

Answer 3

HBsAg+
Anti-HBc (ab) IgG +
Anti-HBe (ab) +
HBV DNA +

Question 4

What is the serology for a chronic infection with active infection and replication?

Answer 4

HBsAg +
Anti-HBc IgM +/-
Anti-HBc IgG +
HBeAg+
HBV DNA +

Question 5

What is the serology for immunization against hepatitis?

Answer 5

Anti-HBs +

Question 6

What is the most common cause of Ascites?

Answer 6

Portal HTN from chronic liver disease.

Risk factors-> ETOH, transusions, tattoos, IVDU, Viral hep

Question 7

What are the findings in NAFLD

Answer 7

• Mild RUQ discomfort, HSM.
• Normal to slightly elevated transaminases and ALKP
• obesity, DM, hypertri, metabolic syn

Question 8

What is the histology for NAFLD

Answer 8

Macrovesicular steatosis

Question 9

What test do you do to check the ascitic fluid in a severely malnourished patient?

Answer 9

adenosine deaminase to R/O/I TB

Question 10

What does a SAAG score tell you

Answer 10

Etiology of the ascites

Question 11

What does a SAAG score >1.1 indicate

Answer 11

underlying portal HTN.

Less than 1.1 is non-portal HTN

Question 12

How do you calculate SAAG score

Answer 12

Serum albumin- Ascitic fluid albumin

Question 13

What must always be ruled out when a patient initially presents to the hospital with ascites

Answer 13

spontaneous bacteria peritonitis

Question 14

What is a risk factor for developing HEV?

Answer 14

treatment with tacrolimus for immunosuppression

Question 15

What causes very high tranaminiases

Answer 15

acetaminophen toxicity

Question 16

What serology markers are positive in autoimmune hepatitis

Answer 16

+ANA and or smooth muscle ABs.

Question 17

What are patient with autoimmune hepatitis at risk for?

Answer 17

Cirrhosis and HCC

Question 18

What are some physical signs of CLD or Cirrhosis

Answer 18

Palmar erythema, spider angioma, gynecomastia, muscle wasting, jaundice, dupuytren’s contracture.

Question 19

What are some lab findings in cirrhotic patients?

Answer 19

Macrocytic anemia, dec WBCs, thrombocytopenia, prolonged PT time

Question 20

What lab do you need to calculate a patients child-pugh score?

Answer 20

CMP

Question 21

How does Primary Biliary Cirrhosis present

Answer 21

• W>M
• isolated elevated alkaline phosphatase
• AMA
• increased IgM

Associated with Sjogrens, scleroderma, Raynauds

Question 22

What are the risk factors for PBC?

Answer 22

• h/o UTI
• smoking
• HRT
• Hair dye

Question 23

Where is the increased iron absorption occurring in patients with Hemochromatosis?

Answer 23

Duodenum

Question 24

What is the etiology of hemochromatosis?

Answer 24

AR disorder, HFE mutation on chromosome 6 C282Y.

Question 25

What is the etiology of Wilson’s disease

Answer 25

AR disorder, chromosome 13, affects ATP7B

Question 26

What is Budd-Chiari syndrome?

Answer 26

Occulsion of flow to hepatic vein or IVC

Hypercoagulable state, that can be complicated by HCC.

Question 27

What is alpha-1 antitrypsin deficiency?

Answer 27

Defective alpha 1 antitrypsin which accumulates in the hepatocytes and causes liver damage and low serum levels of protease inhibitor.

• panacinar emphysema also present
• Lungs and Liver