Hepatitis Flashcards
What are the positive serology markers for acute infection with Hepatitis?
HBsAg +
Anti-HBc (ab) IgM +
HBeAg +
HBV DNA +
What are the positive serology markers for prior hepatitis infection?
Anti-HBs +
Anti-HBc (ab) IgG +
Anti-HBe (ab) +/-
What is the serology for a chronic hepatitis carrier without active infection?
HBsAg+
Anti-HBc (ab) IgG +
Anti-HBe (ab) +
HBV DNA +
What is the serology for a chronic infection with active infection and replication?
HBsAg + Anti-HBc IgM +/- Anti-HBc IgG + HBeAg+ HBV DNA +
What is the serology for immunization against hepatitis?
Anti-HBs +
What is the most common cause of Ascites?
Portal HTN from chronic liver disease.
Risk factors-> ETOH, transusions, tattoos, IVDU, Viral hep
What are the findings in NAFLD
- Mild RUQ discomfort, HSM.
- Normal to slightly elevated transaminases and ALKP
- obesity, DM, hypertri, metabolic syn
What is the histology for NAFLD
Macrovesicular steatosis
What test do you do to check the ascitic fluid in a severely malnourished patient?
adenosine deaminase to R/O/I TB
What does a SAAG score tell you
Etiology of the ascites
What does a SAAG score >1.1 indicate
underlying portal HTN.
Less than 1.1 is non-portal HTN
How do you calculate SAAG score
Serum albumin- Ascitic fluid albumin
What must always be ruled out when a patient initially presents to the hospital with ascites
spontaneous bacteria peritonitis
What is a risk factor for developing HEV?
treatment with tacrolimus for immunosuppression
What causes very high tranaminiases
acetaminophen toxicity
What serology markers are positive in autoimmune hepatitis
+ANA and or smooth muscle ABs.
What are patient with autoimmune hepatitis at risk for?
Cirrhosis and HCC
What are some physical signs of CLD or Cirrhosis
Palmar erythema, spider angioma, gynecomastia, muscle wasting, jaundice, dupuytren’s contracture.
What are some lab findings in cirrhotic patients?
Macrocytic anemia, dec WBCs, thrombocytopenia, prolonged PT time
What lab do you need to calculate a patients child-pugh score?
CMP
How does Primary Biliary Cirrhosis present
- W>M
- isolated elevated alkaline phosphatase
- AMA
- increased IgM
Associated with Sjogrens, scleroderma, Raynauds
What are the risk factors for PBC?
- h/o UTI
- smoking
- HRT
- Hair dye
Where is the increased iron absorption occurring in patients with Hemochromatosis?
Duodenum
What is the etiology of hemochromatosis?
AR disorder, HFE mutation on chromosome 6 C282Y.
