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Gastroenterology > Hepatitis and Cirrhosis > Flashcards

Hepatitis and Cirrhosis Flashcards

1
Q

Autoimmune hepatitis

A

Type 1 and 2
Occur in women
Often have other autoimmune dz

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2
Q

Autoimmune hepatitis tx

A

Corticosteroids

Azathioprine 2nd line

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3
Q

Hemochromatosis

A

Mostly in caucasians
Iron overload form increased absorption
Leads to cirrhosis, cardiomyopathy, diabetes, hypogonadism.

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4
Q

How much iron does it take for hemochromatosis to manifest symptomatically?

A

around age 40 OR when iron stores reach 15-40 grams.

Females have delayed sx

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5
Q

Classic hemochromatosis S/S

A

Cutaneous hyperpigmentation (bronzing)
Diabetes
Cirrhosis

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6
Q

Gold standard for hemochromatosis dx

A

Liver biopsy

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7
Q

Hemochromatosis tx

A

Phlebotomy every 2-4 months

Avoid alcohol, red meat, iron

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8
Q

Wilson’s dz

A 
Hepatolenticular degeneration
Autosomal recessive
Affects copper metabolism
Copper build up in liver and brain.
Easily treated if diagnosed early
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9
Q

Wilsons Dz presentation

A

Presents btw 1st and 3rd decade.
Liver dz of young child
Neuropsych sx

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10
Q

Kayser-Fleischer rings

A

Copper ring Iin eyes

For dx of wilsons dz

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11
Q

Wilsons dz tx

A

If not treated, fatal

Chelate for tx

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12
Q

3 stages of alcoholic liver dz

A

Fatty liver
Alcoholic hepatitis
Fibrosis and cirrhosis

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13
Q

Fatty liver

A

Mostly asymptomatic
Can occur within hrs of binge
Tender hepatomegaly
May occur in obesity and preg

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14
Q

Alcoholic hepatitis

A

Asymptomatic to very ill
Anorexia, weight loss, abd pain
Jaundice
Fever

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15
Q

ALcoholic hepatitis physical findings

A 
Spider angiomas
Palmar erythema
gyenecomastia
Parotid enlargement
testicular atrophy
ascites
encephalopathy
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16
Q

Alcoholic hepatitis lab findings

A

AST:ALT ratio greater than 2
Anemia
Hyperbilirubinemia

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17
Q

Is alcoholic hepatitis reversible?

A

Usually, but may progress

18
Q

Most common cause of liver failure in the US?

A

Drug-induced Liver Injury

19
Q

DILI

A

Drug-induced liver injury

APAP, Abx

20
Q

How to tx APAP OD?

A

N-acetylcysteine

21
Q

S/S of Viral Hepatitis

A 
Can be asymptomatic
Malaise and fatigue
Anorexia, N/V
Myalgias
Pale stools, dark urine
Jaundice
RUQ pain
22
Q

Viral hepatitis tx?

A

Supportive

Manage sx

23
Q

Does HAV cause a chronic infection?

A

No

24
Q

HAV route of transmission

A

Fecal oral mostly

Close contact, sex, food, blood

25
Q

HBV route of infection?

A 
Sexual contact
Perinatal
Breaks in skin, injectables
Organ transplant
Transfusions (RARE)
26
Q

HBV post-exposure tx

A

Vaccine and

HBIG in different body site

27
Q

Extrahepatic HBV manifestations

A 
Fever
Rash
Arthralgias
Polyarteritis nodosa
Glomerular dz
28
Q

HbsAg

A

Hepatitis B surface antigen
Appears prior to onset of sx
Persistence past 6 mo indicated chronic infection
dissapears within 4-6 months in infection

29
Q

HbcAg

A

HBV CORE antigen

Indicates acute infection

30
Q

Anti-HBsAg

A

Follows disappearance of HBsAg.
Persists for life
*Just presence of this means immunity by vaccination.
*Presence of this AND HBsAg indicated HBV carrier.

31
Q

Chronic HBV Tx

A

Interferon

But not in pts w/ decompensated cirrhosis

32
Q

Majority of liver transplants in the US are from?

A

HCV

33
Q

Risk for HCV transmission

A

IVDU
Sex
Jail, blood transfusion

34
Q

which cancer does HCV lead to?

A

HCC

35
Q

HCV serology

A

80-100% of pts remain HCV RNA positive

60-80% have persistent liver enzyme elevation.

36
Q

HCV Tx

A

Peginterferon

Ribavirin

37
Q

HDV

A

Required HBV for replication
Parenteral, close contact transmission
Low risk of chronic infxn
High risk of superinfection

38
Q

HEV

A

Waterbourne RNA virus
No chronic form
Spread by fecally contaminated water

39
Q

HGV

A

Does not cause hepatitis in humans.

Protective in HIV patients

40
Q

Cirrhosis

A

Development of fibrosis of liver
Nodules
Impairment of function

41
Q

Tx of hepatic encephelopathy

A

Lower ammonia levels by:
Lactulose
Enemas

Gastroenterology (14 decks)

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