Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NAPLEX Prep > Hepatitis and Liver Disease > Flashcards

Hepatitis and Liver Disease Flashcards

1
Q

Transmission of HAV

A

Fecal-oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Transmission of HBV

A

Blood and body fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Transmission of HCV

A

Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hepatitis vaccines?

A

Hep A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

First line for HBV

A

PEG-IFN
NRTI (Tenofovir or entecavir)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

First line of HCV

A

Direct-acting antiviral combos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the treatment of HCV

A

2-3 DAAs with different mechanism x 8-12 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Medications for all genotypes of HCV

A

Mavyret (Glecaprevir/pibrentasvir) x 8wks

Epclusa (Sofobuvir/velpatasvir) x 12 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are you NS3/4A PI

A

Glecapravir
Grazoprevir
Voxilaprevir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the NS5A replication complex inhibitors

A

Elbasvir
Ledipasvir
Pibrentasvir
Velpatasvir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the NS5B polymerase inhibitors

A

Sofosbuvir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to take PI

A

Take with food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BBW of all DAA

A

Risk of HBV reactivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Glecaprevir/Pibrentasvir

A

Mavyret

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sofosbuvir/velpatasvir

A

Epclusa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sofobusvir/ledipasvir

A

Harvoni

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CI of MAvyret

A

Child Pugh B-C or hepatic decompinsation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Warning with Sofobusvir products

A

Avid amiodarone → symptomatic bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

HCV drugs that must be dispensed in OG containers?

A

Solvaldi
Epclusa
Harvoni
Vosevi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

HCV drugs that you should avoid acid suppression therapy

A

Epclusa
Harvoni
Vosevi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

BBW of ribavirin

A

Teratogenic

Not as effective as a monotherapy

Hemolytic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Notes wen initiating ribavirin

A

Avoid pregnancy in female and 6-9 months after completion, 2 reliable forms of birth control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Drugs for HCV

A

TDF
TAF
Entecavir
Lamivudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

TDF

A

Viread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
TAF
Vemlidy
26
Entecavir
Baraclude
27
Lamivudine
Epivir
28
Warnings of HBV NRTIS
CrCl <50 (CI) BBW: lactic acidosis and hepatomegaly with steatosis Exacerbations with HBV upon discontinuation
29
Warnings of tenofovir
1. Renal tox 2. ↓ bone mineral densiy 3. Fanconi syndrome N/D, lipid abs Dispense in OG container
30
Counseling on entecavir
Take on empty stomach Ascites, LFTs, hematuria, nephrotox
31
BBW of lamivudine
Don't use Epivir HBV to treat HIV ADR: HA, N/V/D
32
BBW of adefovir
Renal impairment, avoid NSAID or nephrotoxic drugs
33
How to administer NRTIs for HBV
1. Test for HIV 2. HIV and HBV connected are recommended 2 NRTIs (avid abefovir and tenofovir combinations)
34
What is Peg-IFN-alfa used for
HBV monotherapy
35
BBW of Pegasys
Exacerbate neuropsychiatric, autoimmune, ischemic, or infectious disorders
36
Warnings and ADRs of Pegasys
Myelosuppression, CNS effects (fatigue, dizziness), GI upset, LFTs Flu like symptoms (pretreat with APAP and an antihistamine)
37
What is the difference between Acute liver tox vs chronic liver disease
Acute: ↑ AST/ALT Chronic: ↑ AST/ALT, Alk phos, Tbili, LDH, PT/INR and decreased albumin
38
Labs to ID alcoholic liver disease
↑ AST > ALT (AST will be double the ALT), ↑ GGT
39
What is in a hepatic liver panel
AST, ALT, Tbili, Alkphos
40
Natural products for hepatic disease
Milk thistle
41
Natural products that are hepatotoxins
Kava and comfrey
42
What are the child pugh scores
A <7 B 7-9 C 10-15
43
When should hepatotoxic drugs be discontinued
LFTs are 3x the ULN
44
Drugs that can cause liver damag
APAP Amiodarone Isoniazid Ketoconazole MTX Nefazodone Nevirapine PTU Valproic acid Zidovudine
45
What is steotosis
Fatty liver due to fat deposits in the hepatocytes
46
What is secreted due to chronic consumption of alcohol
Pro-inflammatory cytokines (TNF-alpha, IL6, and IL8) oxidative stress Lipid per oxidation Acetaldehyde toxicity
47
What drugs are used for alcohol cessation?
BZD Gabapentin and carbamazepine Naltrexone, acamprosate, disulfiram (prevent relapse)
48
Vitamin crucial for alcoholics
Thiamine (B1) to prevent werniicke-korsakoff syndrome that can lead to brain damage
49
What causes portal HTN?
Increased BP in portal vein from firbo tictissue → stenosis and resistance to blood flow
50
What causes esophageal varices
Blood backs up and flow in smaller blood vessels causing herniation → increased risk for bleeding
51
How do you stop or prevent esophageal bleeding?
1. Band ligation 3. Sclerotherapy
52
What medication is used for active esophageal bleeding?
Vasoconstrict the splanchnic circulation - Octreotide is selective for splanchnic vessels - Vasopressin in non-selective
53
ABX prophylaxis for surgical interventions for varicies
Ceftriaxone or Cipro for 7 days
54
Octreotide
Sandostatin
55
ADR and Dosing of octreotide
Bradycardia, cholelithiasis, biliary sludge Bolus: 25-100 mcg IV can repeat in 1 hr
56
Why do we use beta blockers for portal HTN
Using nonselective: ↓ cardiac outputted cause splanchnic vasoconstriction → reduce port venous inflow and blood pressure
57
Goal of NSBB for portal HTN
HR 55-60 BPM SBP ≥90 mmHg Continued indefinitely
58
BB indicated for variceal bleeding
Nadolol (primary and secondary) Propranolol (primary and secondary) Carvedilol (primary due to addition alpha-blocking → vasodilation in intrahepatic circulation decreasing vascular resistance)
59
BBW of NSBB
Do not DC abruptly, taper over 1-2 weeks
60
ADR of NSBB
1. Mask hypoglycemia and except sweating 2. Caution in asthma and COPD 3. Caution in Raynaud's ADR: bradycardia, CNS effects (fatigue, dz, depression), hypotension Propranolol is lipophilic and may have more CNS ADRs
61
Counseling when taking Coreg
Take with food
62
Sx of hepatic encephalopathy
Musty odor of the breath and urine, changes in thinking, confusion, forgetfulness, flapping hands (asterixis)
63
What causes HE
Accumulation of gut-derived nitrogenous waste in the blood(ammonia) that is normally cleared by the liver
64
How can we reduce ammonia levels via diet?
Reduce animal protein
65
MOA of lactulose
Converts ammonia to ammonium that is polar and can easily diffuse into the blood → enhances the diffusion of ammonia into the colon for excretion
66
MOA of rifaxamin
Inhibit the activity of urease-producing bacteria → decreasing ammonia production (add-on)
67
ADR of lactulose
Farts, diarrhea, dyspepsia, ab discomfort Monitor: bowel movements, ammonia
68
ABX that can be used for HE
Rifaximin or Neomycin
69
Rifaximin
Xifaxan
70
ADR of Rifaximin
Peripheral edema, DZ, Fatigue, Nausea, ascites, HA
71
ADR of neomycin
Neurotoxicity, GI upset
72
What is ascites
Fluid accumulation in the peritoneal space → HRS or SBP
73
All patients with cirrhosis and ascites should consider ___
liver transplant
74
Counseling patients on ascites
Sodium restriction (<2g/d)
75
Medications of ascites
Furosemide by itself is ineffective + Spironolactone mono or combo 50-100 mg titrated to 400 Furosemide 40: Spirmolactone100 mg to maintain potassium balance
76
What is the difference between Carospir and Aldactone
Carospir oral suspension: edema associated with cirrhosis 75 mg Not equivalent to PO
77
What is a direct removal of peritoneal fluid
Paracentesis Large-volume paragenesis (>5L) associated with fluid shifts, and addition albumin is recommended (6-8 g/L of fluid removed) to prevent paracentesis-induced circulatory dysfunction and HRS
78
ABX used for SBP and dose
Strep and GNP: Ceftriaxone (or equivalent 3rd gen) 5-7 days + Albumin Secondary prophylaxis: Cipro or Bactrim
79
What is HRS
Renal failure in advanced cirrhosis due to renal vasoconstriction mediated by RAAS activation and SNS via the hepatorenal reflx
80
What is used to treat HRS
Vasoconstrictors: terlipressin or NE in combo with albumin If VC are not possible due to lack of close monitoring octreotide and mid-drone + albumin can be used

NAPLEX Prep (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions