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IM > Hepatology > Flashcards

Hepatology Flashcards

1
Q

What are the physical exam findings of liver disease?

A

ascites, anorexia, jaundice, spider angiomas, palmar erythema, caput medusae

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2
Q

What are the syndromes that must be considered with highly elevated AST/ALT?

A

viral hepatitis, autoimmune hepatitis, hemochromatosis, ischemic hepatitis, alcoholic hepatitis

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3
Q

What syndromes must be considered with Normal AST ALT

A

dubin johnson syndrome, rotor’s

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4
Q

What syndromes must be considered with elevated alk phos?

A

cholestasis, malignancy, PBC, PSC, gall stones

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5
Q

What are the manifestations of chronic hepatitis C?

A

heme: mixed cryoglobinuria, renal: membranoproliferative glomerulonephritis, skin: porphyria cutanea tarda, lichen planus
endocrine: increased risk of diabetes

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6
Q

Symptoms of amebic abscess

A

RUQ pain, endemic area travel, elevated alk phos, diarrhea, tender liver mass

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7
Q

What are the treatment options for patients who are gallstone symptomatic but poor surgical candidates?

A

ursodeoxycholic acid

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8
Q

What are the treatment options for asymptomatic gallstone patients?

A

don’t treat! (unless malignancy risk)

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9
Q

What are (and are not) the indications for ERCP?

A

ARE: ampullary tumors, early intervention in pancreatitis, chronic pancreatitis, exploration of bile ducts
ARE NOT: after acute pancreatitis attack has resolved

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10
Q

Who are the patients that should be treated for Hepatitis B?

A

acute liver failure, complications of cirrhosis, advanced cirrhosis with high HBV DNA

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11
Q

What drug can cause a mild hepatitis?

A

INH

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12
Q

What is the mechanism of non alcoholic fatty liver disease?

A

insulin resistance leading to increased lipolysis, triglyceride synthesis and hepatic uptake of fatty acids

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13
Q

What are the various causes of elevated AST/ALTs?

A

Autoimmune hepatitis, Hep B, Hep C, Drugs, Ethanol, fatty liver, growths, hemodynamic disorders, iron

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14
Q

What is the cause of acute cholecystitis?

A

stone obstructing bile duct

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15
Q

What are the symptoms associated?

A

RUQ pain, fever, nausea, vomiting

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16
Q

Describe HEP E

A

can progress to fulm. hepatitis in pregnant women during 3rd trimester; spread fecal orally; rare in US

17
Q

What is fulm hepatitis?

A

hepatic encephalopathy that develops within 8 weeks of acute liver failure

18
Q

What is tx of pancreatitc pseudocyst?

A

drainage only if perists or gets infected

19
Q

What is hemorrhagic pancreatitis?

A

retroperitoneal bleeding and hemorrhagic pancreas - presents with Grey Turner or Cullen sign

20
Q

What are the contraindications for Hep C treatment?

A

uncontrolled depression, ongoing alcohol use

21
Q

What lab values might indicate a progression to fulm hepatitis?

A

increasing PTT, decreases transaminases

22
Q

What are the symptoms of PBC?

A

pruritis, fatigue, xanthomas, steatorrhea, portal hypertension

23
Q

How is PBC treated?

A

ursodeoxycholic acid

24
Q

What are causes of markedly elevated transaminases?

A

ischemic, drugs, viral hepatitis

25
Q 
What is the purpose of the following markers? 
HbsAg
HbeAg
HbcAg
AntiHbsAg
AntiHbcAg
A

acute infectivity - precedes symptoms (acute infection)

infectivity, active virus

undetectable

indicates immunity, clearing infection (non-infectivity)

IgM - acute phase; IgG - recovery phase

26
Q

What is rotor’s syndrome?

A

benign defect in hepatic storage of conjugated bilirubin

27
Q

Gilbert’s syndrome

A

mild unconjugated hyperbilirubinemia caused by fasting, illness, etc.

28
Q

Dubin Johnson syndrome

A

benign condition of conjugated hyperbilirubinemia and black liver

29
Q

What does a hyatid cyst look like?

A

well defined cyst with egg shell calcifications

30
Q

What causes hyatid cysts?

A

Echinococcus infections - spread by contact with dogs

31
Q

What is the test for Wilson’s disease?

A

Ceruloplasmin levels

32
Q

What is the test for autoimmune hepatitis?

A

Anti smooth muscle antibody Titer

33
Q

Describe the substrates for gluconeogenesis

A

alanine (converted to pyruvate), G3P from adipose, lactate

34
Q

What are the infectious risks for patients with hemochromatosis?

A

listeria monocytogenes and other siderophilic organisms

35
Q

What serotypes of hepatits are most responsive to therapy?

A

2 and 3

IM (24 decks)

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