Hepatitis Flashcards
Inflammatory disease of unknown cause commonly affecting young and middle-aged women?
Autoimmune hepatitis
Presentation of autoimmune hepatitis?
Acute hepatitis (e.g. fever + jaundice)
Insidious- signs of chronic liver disease
Other features: malaise, rash, arthralgia, amenorrhoea
Types of AIH, according to antibodies
a) type I
b) type II
c) type III
a) ANA, anti smooth muscle (ASMA)
b) LKM1
c) soluble liver-kidney antigen
Which type of AIH affects only:
a) children
b) middle aged
a) II
b) III
Diagnostic tests in AIH?
a) blood/serology (3)
b) biopsy
a) elevated LFTs, hypergammaglobulinaemia, +ve antibodies
b) necrosis/fibrosis/cirrhosis
Management of AIH? (3)
High dose steroids to induce remission then maintenance dose
AZT as a steroid sparing agent
Liver transplantation
Inherited disorder with toxic accumulation of copper (Cu) in the liver and CNS?
Wilson’s disease
How do children/adults usually present with Wilson’s disease?
Children- hepatitis, cirrhosis, fulminant liver failure
Adults: CNS/psychiatric signs
Pathognomonic sign in Wilson’s disease?
Kayser-Fleischer rings (copper deposits in the iris)
Diagnostic tests for Wilson’s disease? (2)
High 24hr urinary copper excretion
Low serum copper and caeruloplasmin
Management of Wilson’s disease? (3)
Avoidance of foods with high Cu content (e.g. chocolate, shellfish)
Lifelong penicillamine
Liver transplantation
Important adverse effects of penicillamine? (4)
Lymphopenia, thrombocytopenia, anaemia. membranous nephropathy
CNS signs in Wilsons disease? (2)
Basal ganglia degeneration
Speech and behavioural problems
Commonest cause of an acute hepatitis?
Hepatitis A
What is the risk of progression to cirrhosis in Hepatitis A?
None
