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AMC MCQ > Hepatology > Flashcards

Hepatology Flashcards

1
Q

Mode of transmission of HAV, HEV?

A

feco-oral (food transmitted)

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2
Q

Mode of transmission of HBV, HCV?

A

blood derived.

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3
Q

Pt with +ve anti-HBs and -ve all other HBV serology»>

A

Vaccination

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4
Q

Pt with +ve anti-HBs, anti-HBc and -ve all other HBV serology»>

A

Chronic HBV Inf

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5
Q

First marker appears in the blood»>

A

surface antigen

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6
Q

Marker detected only by liver biopsy»>

A

Hbc-Ag

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7
Q

Marker of highly infectivity»>

A

e-Antigen

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8
Q

How to follow u Hepatitis infection?

A

PCR

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9
Q

Acute cases hepatitis?

A

NO TTT

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10
Q

CHRONIC HEPATITIS:

A

More than 6 months with +ve serology.

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11
Q

TTT of chronic HBV?

A

lamivudin, interferon.

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12
Q

Post- exposure prophylaxis of HBV:

History of previous vaccination?

A

reassure

Wash hand is the 1st step if needle puncture

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13
Q

First step:

If history of vaccination?

A

reassure

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14
Q 
If not vaccinated?
If Hep (+) for antibodies?
If (-) for antibodies = susceptible?
A

check immune status
reassure
vaccine and IVIG

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15
Q

If in the exam no option for checking the immune status?

A

go for vaccine and IVIG

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16
Q

Baby born to HBV mother what to do with baby?

A

Vaccine and IVIG immediately to the newly born.

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17
Q

Chronicity of hepatitis B in adult in how many percent?

A

10-15%

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18
Q

Chronicity of hepatitis B in newly born is how many percent?

A

over 75 %

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19
Q

TTT of hepatitis B?

A

INTERFERON AND LAMIVUDINE

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20
Q

Main SE of interferon?

A

depression and fatigue

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21
Q

If depression occurred in Hep B tx, what to do?

A

stop interferon

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22
Q

Post- exposure prophylaxis of Hepatitis C:
First step?
Second step?

A

check base line immune status

serial labs for 6 months

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23
Q

If (+) for HCV antibodies?

IF HCV RNA (+)?

A

NEXT STEP HCV RNA

start ttt

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24
Q

TTT of hepatitis C?

A

interferon and ribavirin

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25
Q

Chronicity of hepatitis C?

A

over 75%

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26
Q

Counseling Q for pts with HCV inf:

Vaginal delivery?

A

Available

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27
Q

Lactation in Hep C?

A

Available

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28
Q

Sex in Hep C

A

Available but preferred to use condom.

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29
Q

Best way to avoid hepatitis C?

A

avoid sharing razors.. imp

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30
Q

Alcoholic + gynaecomastia + bilateral parotid swelling+ scrotal swelling?

A

= Alcoholic liver disease

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31
Q

Best way to avoid neonatal Hep C infection ?

A

avoid scalp electrodes

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32
Q

when to screen for hepatitis C in neonate?

A

18 months ( antibody)

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33
Q

Pt returned from Thailand presents with fever, jaundice, RUQ abdominal pain. His lab shows increase in ALT, AST, normal AP… Dx:

A

HAV infection.

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34
Q

Pt returned from Thailand presents with fever, jaundice, RUQ abdominal pain. His lab shows increase in ALT, AST, marked increase AP… Dx:

A

acute cholangitis.

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35
Q

Pt returned from Thailand presents with fever, RUQ abdominal pain. His lab shows ++WBCs& normal ALT, AST, AP… Dx:

A

acute cholecystitis.

36
Q

Prophylaxis against HAV:

A

inactivated vaccine “4 Ws before travel”

37
Q

Most effective measure to control HAV epidemic at school?

A

control of food source

And vaccination

38
Q

Pt with liver cirrhosis, ascites develops abdominal pain, fever… Dx:

A

SPB.

39
Q

Inv of choice for SBP?

A

paracentesis (++ WBCs, >250 neutrophil)

40
Q

TTT of choice SBP?

A

IV cefotaxime

41
Q

Prevention of recurrence SBP?

A

TMP-SMX.

42
Q

Most accurate test of 1ry biliary cirrhosis?

A

AMA.

43
Q

Definitive TTT of 1ry biliary cirrhosis?

A

liver transplant.

44
Q

Pt with cirrhosis, choriform movement, personality changes: Dx:

A

wilson’s disease

45
Q

Best initial test of Wilsons?

A

– ceruplasmin level& slit lamp exam of eye (kayser flischer ring)

46
Q

Most accurate test Wilsons?

A

liver biopsy

47
Q

TTT of choice wilsons?

A

penicillamine

48
Q

Best initial test of hemochromatosis?

A

trans-ferritin level or ferritin level… If both found in choice: transferritin level.

49
Q

If ferritin or transferrin high in hemochromatosis?

A

next step is gene analysis …vvvvvv imp

50
Q

Most accurate test in hemochromatosis?

A

liver biopsy.

51
Q

TTT of hemochromatosis

A

phlebotomy.

52
Q

Screening of hemochromatosis:
Normal population:
1st step?
2nd step?

A

serum ferritin or better transferrin

if any of the above high do gene analysis

53
Q

Who to screen for hemochromatosis:

A

those with 1st degree relative with hemochromatosis.

54
Q

1st step of screening those that are predisposed?

A

HFE gene mutation

55
Q

When to test kids for hemochromatosis: ???

A

If both parents are carrier

56
Q

Pt with hemochromatosis known to have cirrhosis came with fever, abdominal pain… Dx:

A

SBP.

57
Q

Pt with obesity, DM, hyperlipidemia develops hepatomegaly… Dx:

A

NASH.

58
Q

Young non-smoker with emphysema, liver cirrhosis… Dx:

A

A1AT deficiency.

59
Q

Young non-smoker with pan-acinar emphysema:

A

U must survey his liver.

60
Q

Cause of hepatic encephalopathy in pt with cirhhosis:

A

increase ammonia level……next step is lactulose and enema

61
Q

MCC of liver cirrhosis in Australia:

A

alcoholic liver disease.

62
Q

TTT of emphysematous cholecystitis:

A

IV fluid, abs & emergent surgery.

63
Q

VVV imp notes:

Common cause of cirrhosis in Australia:

A

Alcohol

64
Q

Most common virus causing chronicity in adult?

A

C

65
Q

Most common virus causing chronicity in kids?

A

B

66
Q

Most common virus causing liver cancer?

A

B

67
Q

Most common virus to be transmitted after needle abrasion?

A

B

68
Q

Most common virus transmitted by food?

A

A

69
Q

Virus that can kill adult while very benign in kids?

A

A

70
Q

Viruses transmitted by food?

A

A and E

71
Q

Virus that can kill pregnant women?

A

E

72
Q

Virus that is associated with hepatitis B?

A

D

73
Q

MC route of HBV transmission?

A

Perinatal

74
Q

Best inv of chronic hepatitis?

A

liver biopsy.

75
Q

MCC for the need of liver transplantation:

A

cirrhosis

76
Q

MCC disease cause need of liver transplant in Australia:?

A

alcoholic liver disease

77
Q

Pt on list for transplant, MCC that this pt may not be given the liver?

A

pt say he can’t stop drinking.

78
Q

HBV Vaccine

A

vaccine available & post- exposure prophylaxis also available.

79
Q

HCV Vaccine

A

NO vaccine available& NO post- exposure prophylaxis.

80
Q

Take care:

Most common virus causing Hepatic cancer?

A

B

81
Q

Most common toxin causing hepatic cancer?

A

aflatoxin

82
Q

Most common cause of hepatic cancer over all?

A

cirrhosis

83
Q

If bleeding varices:

. VARICEAL BLEEDING MANAGEMENT:
. The 1st step?

A

RESUSCITATION (normal saline )

84
Q

If you need blood:VARICEAL BLEEDING

A

packed RBC’s ( O- RH- low hemolysis),

1st step to control bleeding………sengstaken tube

85
Q

Definitive ttt of VARICEAL BLEEDING

If failed?

A

band ligation

TIPS

86
Q

Pain in RT upper quadrant area, fever, jaundice + air fluid level in the biliary tree:
Next step?

A

clostridium cholecystitis

iv fluid and antibiotics

87
Q

Definitive ttt cholecystitis

A

surgery

AMC MCQ (14 decks)

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