Hepatology

Question 1

What is the Child-Pugh classification used for?

Answer 1

Grading the severity of liver cirrhosis

Question 2

What are the factors which are used in the Child-Pugh classification?

Answer 2

Bilirubin levels
Albumin levels
Prothombin time (how much it is prolonged)
Ascites
Encephalopathy

Question 3

What is Wilson’s disease?

Answer 3

Autosomal recessive disorder where there is excessive copper depostion in tissues, such as the liver, brain and cornea.

• Increased copper absorption
• Decreased copper excretion

Question 4

How would you diagnose Wilson’s disease?

Answer 4

Reduced caeruloplasmin

Increased 24 hr urinary copper excretion

Question 5

What is the treatment for Wilson’s disease?

Answer 5

Penicillamine - chelates the copper

Question 6

Describe hepatitis B

Answer 6

Viral infection of the liver, spread by contamination of blood or bodily fluids.

Question 7

What are the main symptoms of hepatitis B?

Answer 7

Fever
Jaundice
Elevated liver transaminases

Question 8

How would you define chronic hepatitis B?

Answer 8

Persistent levels of HBsAg in the serum after 6 months

Question 9

What antigen present in hepatitis B makes a person more likely to be infectious?

Answer 9

HBeAg

Question 10

How is hepatitis B treated?

Answer 10

Pegylated interferon-alpha
Also, antiviral medications are being used moe commonly
e.g. tenofovir

Question 11

How is chronic hepatitis C treated?

Answer 11

A combination of:

• pegylated interferon-alpha
• ribavirin
• protease inhibitor (e.g. boceprevir, simprevir and telaprevir)

Question 12

What is the common presentations of someone with viral hepattis?

Answer 12

Nausea, vomiting, anorexia
Malaise/lethargy
Myalgia
RUQ pain 
Recent history of travel