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NAPLEX Prep > Hepatitis and Liver Disease > Flashcards

Hepatitis and Liver Disease Flashcards

Hep A B & C, Hep C tx, Hep B tx, liver disease & cirrhosis, alcohol-induced liver disease, cirrhosis complications, key counseling points

1
Q

there are vaccines for Hepatitis

A. A
B. B
C. C

A

A. A
B. B

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2
Q

Hep A is transferred via

A

fecal-oral route

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3
Q

Hep B is transferred via

A

bodily fluids/blood

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4
Q

Hep C is transferred via

A

bodily fluids/blood

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5
Q

there are treatment options for Hepatitis

A. A
B. B
C. C

A

B. B
C. C

Hep A treatment is supportive tx

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6
Q

what are the treatment options for Hep B? Which are preferred?

A

TDF*
TAF*
entecavir*
lamivudine

*preferred

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7
Q

TDF has more _________ compared to TAF

A

TDF has more renal toxicities and decreased MBD than TAF

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8
Q

TAF is CI at a CrCl of ______

A

</= 15

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9
Q

TDF and entecavir are CI at a CrCl of

A

</=50

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10
Q

treatments for Hep B are part of the __________________ drug class

A

NRTI

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11
Q

TDF brand name

A

Baraclude

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12
Q

TAF brand name

A

Vemlidy

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13
Q

TDF and TAF should not be used with

A

p-gp inducers
(green team)

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14
Q

Hep C treatment options (brand and generic)

A

Mavyret (glecaprevir/pibrentasvir)
Epclusa (sofosbuvir/velpatasvir)

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15
Q

what 3 drugs classes are part of Hep C tx options

A

NS3/4A PIs
NS5A replication complex inhibitors
NS5B polymerase-i

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16
Q

what are the BBW for all Hep C treatment options

A

Hep B reactivation (test first!)
lactic acidosis and severe hepatomegaly with steatosis
sofosbuvir DDI with amiodarone

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17
Q

Mavyret
generic
CI
dosing

A

glecaprevir/pibrentasvir
CI with Child Pugh Class B or C, 3A4 inducers or ethinyl estradiol, statins

3 tab po qd with food

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18
Q

Epclusa
generic
CI
dosing

A

sofosbuvir/velpatasvir
CI with acid suppressors PPI, H2RA, 3A4 inducers, statins

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19
Q

what genotypes do Mavyret (glecaprevir/pibrentasvir) and Epclusa (sofosbuvir/valpetasvir) cover

A

all 6 genotypes

20
Q

what are the top causes for liver disease in the US

A

Hep C and alcohol

21
Q

acute liver disease LTFs

22
Q

chronic liver disease LFTs and lab values

A

inc ALP, tbili
inc PT, INR
dec platelets, albumin
inc LDH

23
Q

which child pugh score is class A

24
Q

which Child Pugh Score is Class B

25
Q

which Child Pugh Score is Class C

26
Q

which score is used to estimate mortality for liver disease

A

MELD Score

27
Q

DILI possible medications

A

APAP
amiodarone
isoniazid
PO ketoconazole
MTX
NRTIs
PTU
VPA

28
Q

R factor : what value indicates hepatocellular injury

29
Q

R factor : what value indicates hepatocellular-cholestatic mixed injury

30
Q

R factor : what value indicates cholestatic injury

31
Q

R factor equation

32
Q

first line tx for hepatic encehpalopathy

33
Q

patient is to receive lactulose for hepatic encephalopathy. what dose should they receive? What are the monitoring parameters?

A

30-45mL hourly until stool evacuation then 30-45mL 3-4x/day until 2-3 stools a day

34
Q

what is a second line option for hepatic encephalopathy? What is the dosing?

A

rifaximin (Xifaxan)

400mg po q8h x4-10 days

35
Q

rifaximin hepatic encephalopathy ppx dosing

A

550mg PO BID

36
Q

what are pharmacologic treatment options for ascites

A

spironolactone and furosemide dual treatment

37
Q

is a spironolactone 50mg : furosemide 100mg dosing regimen ok for ascites?

A

no, ration has to be 2:5 spirono : furosemide mg

should be 50mg : 125mg or 40mg : 100mg

38
Q

why is there a 2:5 spirono mg : lasix mg in ascites

A

to maintain potassium balance

39
Q

what is the target weight loss for 2:5 treatment of ascites

40
Q

when is albumin given in ascites

A

when over 1 Liter of fluid is removed during paracentesis

41
Q

albumin dosing if given after paracentesis

A

6-8 g / L of fluid removed

42
Q

SBP treatment

A

CTX x5-7 days +/- albumin

43
Q

is furosemide monotherapy appropriate for ascites

A

no, furosemide monotherapy is ineffective

44
Q

portal HTN first line treatment

A

non-selective BB
propranolol 20mg PO BID
nadolol 40mg PO Q

45
Q

a SAAG over _______ indicates portal HTN

46
Q

what is a unique MOA medication for portal HTN? dosing?

A

octreotide
25-100mcg IV

NAPLEX Prep (57 decks)

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