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Gastrointestinal > Hepatitis Pathophys > Flashcards

Hepatitis Pathophys Flashcards

1
Q

What is the sequence of events in viral hepatitis?

A

1) Acute Hepatitis
2) Acute Liver Failure
3) Chronic Hepatitis

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2
Q

Once you get chronic hepatitis what happens

A

you get cirrhosis, liver failure, and/or hepatocellular carcinoma

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3
Q

Hepatitis A and E mostly cause what

A

Acute hepatitis

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4
Q

HBV mostly causes what

A

Acute hepatitis like A and E. The difference is that there is a greater chance that B can lead to fulminant liver failure.

A small percentage of HBV causes chronic hepatitis. This is mostly in the presence of Hep D

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5
Q

HCV causes what

A

chronic hep

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6
Q

hepatits pts will, of course, have an acute rise in liver enzymes (AST and ALT)

A

ok

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7
Q

Constitutional symptoms of acute hepatitis?

A

fever, fatigue, abdominal pain

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8
Q

High AST/ALT is what levels?

A

1,000 - 5,000….usually doesnt exceed 5,000

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9
Q

Most serious complication of acute viral hepatitis

A

Fulminant liver failure

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10
Q

Presentation of fulminant liver failure

A

altered mental status in pt with acute hepatitis.
The altered mental status is due to the hepatic encephalopathy

Fulminant liver failure mortality rate is close to 90%

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11
Q

Key test for Hepatitis A diagnosis?

A

IgM anti-HAV antibody

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12
Q

Key test for HEV

A

IgM anti-HEV antibody

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13
Q

Chronic HBV represents a vital public health problem for which part of the american population

A

Asian Americans…HBV is endemic to many parts of Asia

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14
Q

Positive HBsAg means what?

A

Active infection

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15
Q

Positive HBsAg antibody means what?

A

resolved infection or prior vaccination

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16
Q

Positive HBc antibody means what?

A

Definitely have been infected in the past…this does not show up with a vaccination

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17
Q

Positive HBe antigen means what?

A

Active replication and highly infectious

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18
Q

In patients with chronic HBV, what serological (plasma or serum) markers are detectable for life?

A

HBsAG and IgG for HBc

19
Q

When is it appropriate to start treating chronic HBV?

A

When there is evidence of liver injury….meaning high ALT

20
Q

What are the treatment goals of chronic HBV tx?

A

Decrease replication and minimize liver injury.
Reduce the risk of Hepatocellular carcinoma

Unfortunately, chronic HBV can only be cured in approximately 5-10% of pts.

21
Q

All HIV fts should be tested for HBV. There chance of natural clearance is lower

A

ok….the good news is that some anti-HIV drugs, like Tenofovir, are also anti-HBV.

22
Q

HBD is transmitted parenterally or enterically>

A

Parenterally…Needs the HBsAG to infect

23
Q

Super-infection

A

When a person with CHRONIC HBV becomes infected with HDV

24
Q

Co-infection

A

Just acute HBV and HDV infection occuring simultaneously

25
Q

New CDC recommendation for HCV screening?

A

Anyone born between 1945 and 1965

26
Q

Regarding HCV serotypes, the most prevalent in the US is

A

HCV 1

27
Q

HCV 2 where

A

Developed countries (US included)

28
Q

HCV 3

A

IV drug users

29
Q

HCV 4

A

Middle East and North Africa

30
Q

HCV 5

A

South Africa

31
Q

HCV 6

A

Asia

32
Q

Goal of HCV tx

A

Eradicate teh HCV…it is curable with treatment

33
Q

Hepatocellular carcinoma is actually the most common cancer worldwide.

A

ok

34
Q

What are the major risk factors for Hepatocellular carcinoma?

A

Chronic Hepatitis (either B or C)

35
Q

Hepatitis C viruse causes cancer only in the setting of

A

Cirrhosis

36
Q

Which of the hep viruses can cause HCC without even entering into a stage of cirrhossis?

A

HBV

37
Q

Proteinuria of unknown cause calls for

A

Screen for HCV

38
Q

CMV hepatitis in mmunocompromised pts. Become suspicious when you see what symptoms

A

Fever, diarrhea, increase in liver enzymes

39
Q

Gold standard test for CMV?

A

Tissue Biopsy

40
Q

Gold standard treatment for CMV hep

A

Ganciclovir

41
Q

Hepatitis E causes what type of infection and is more severe in who?

A

AcutE, More severe in pregnant women and the elderly…KNOW

42
Q

Hep A and B vaccines should be given to who

A

anyone with any type of liver disease

43
Q

Which genotype of HCV has the lowest cure rate?

A

1

44
Q

All HBV pts should be screeened for HCC, whereas HCV pts should only be screened if…

A

They have Cirrhosis

Gastrointestinal (58 decks)

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