Hepatology Flashcards
AST is elevated in? Where is it found?
Acute conditions; found in liver, muscle, kidney, and heart
ALT is elevated in?
Chronic conditions
Which type of bilirubin is water soluble?
Conjugated (direct)
High indirect bilirubin means?
The disorder is pre hepatic; Hemolysis of RBCs and impaired hepatocyte function
High direct bilirubin means?
Obstruction fo excretion of bilirubin = CHOLELITHIASIS
What is the most common hereditary cause of increased bilirubin?
Gilbert’s disease
NASH ALT:AST ratio
ALT greater than AST
Treatment for hemochromatosis?
Phlebotomy
The Kayser-Fleischer ring is pathognomonic for?
Wilson’s disease
Alcoholic hepatitis ALT:AST ratio
AST greater than ALT
What do you use to treat a Tylenol overdose?
N-acetylcysteine
What do you need to make an autoimmune hepatitis diagnosis?
Biopsy necessary for diagnosis
Which two Hepatitis viruses are DNA?
Hep B and D (easy to remember, they co-infect!)
When is the greatest shedding of the Hep A virus?
During anicteric prodrome (14-21d)
80% of hepatocellular carcinomas are linked to?
Hepatitis B
Who is the only patient who will have a positive hepatitis B surface antibody?
Vaccinated individuals, HBsAg = Immunity
What is the most common chronic blood-borne infection in the US?
Hepatitis C
Everyone born between ____ and ____ should be tested for HCV
1945 to 1965
___% of people infected with HCV go on to a chronic state
80%
How do you diagnose cirrhosis?
Abdominal US with doppler, liver biopsy
Hepatocellular carcinoma is associated with?
Cirrhosis
How do you diagnose HCC?
AFP (Alpha fetoprotein) tumor marker
What is the most common neoplasm of the liver?
Metastatic liver lesions
Where do metastatic liver lesions typically metastasize from?
lung, colon, breast, prostate, pancreas, stomach
