Hepatology and Biliary Tract Diseases Flashcards by Diego Luis Carrillo Pérez

Diagnosis suggested by elevated alkaline phosphatase and positive antimitochondrial antibody

PBC

MKSAP 20

PBC stands for Primary Biliary Cholangitis.

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Mandatory test in patients with cirrhosis with new-onset ascites

Diagnostic paracentesis

MKSAP 20

This procedure helps to evaluate the cause of ascites.

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HCV-associated extrahepatic diseases

Non-Hodgkin lymphoma, membranoproliferative glomerulonephritis, mixed cryoglobulinemia, porphyria cutanea tarda

MKSAP 20

These are conditions that can occur outside the liver due to hepatitis C.

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Recommended hepatitis C pretreatment assessment

Cirrhosis assessment with serologic biomarkers and/or elastography

MKSAP 20

This assessment is critical to determine the extent of liver disease before starting treatment.

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Ascites leukocyte count diagnostic for SBP

≥250/µL

MKSAP 20

SBP stands for spontaneous bacterial peritonitis.

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Most common causes of drug-induced liver injury

Acetaminophen, amoxicillin-clavulanate, phenytoin, valproate

MKSAP 20

These medications are frequently associated with liver toxicity.

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Treatment for liver disease and iron overload secondary to hereditary hemochromatosis

Phlebotomy

MKSAP 20

This treatment helps to reduce iron levels in the body.

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HCC screening in at-risk patients with hepatitis B and no cirrhosis

Ultrasonography and AFP measurement every 6 months

MKSAP 20

HCC stands for hepatocellular carcinoma, and AFP is alpha-fetoprotein.

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Most common cause of abnormal liver test results

MASLD

MKSAP 20

MASLD stands for Metabolic Associated Steatotic Liver Disease.

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Amebic liver abscess diagnostic tests

Liver imaging, E. histolytica serologic testing

MKSAP 20

E. histolytica is the causative agent of amebic liver abscess.

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Diagnosis characterized by cirrhosis-related orthodeoxia and platypnea

Hepatopulmonary syndrome

MKSAP 20

This syndrome involves respiratory complications due to liver disease.

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Alcoholic hepatitis indications for prednisolone

MELD score >20

MKSAP 20

MELD stands for Model for End-Stage Liver Disease.

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PSC cancer associations

Cholangiocarcinoma, colorectal cancer, gallbladder cancer

MKSAP 20

PSC stands for Primary Sclerosing Cholangitis.

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Hepatitis C–related vasculitis

Mixed cryoglobulinemia

MKSAP 20

This condition is associated with the presence of cryoglobulins in the blood.

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MASLD treatment

Weight loss, diet modification, and moderate exercise

MKSAP 20

These lifestyle changes are essential for managing MASLD.

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Diagnosis suggested by first-trimester pregnancy, prolonged vomiting, elevated AST/ALT

Hyperemesis gravidarum

MKSAP 20

This condition involves severe nausea and vomiting during pregnancy.

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USPSTF hepatitis C screening indication

All patients age 18-79 years

MKSAP 20

USPSTF stands for United States Preventive Services Task Force.

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Diagnosis suggested by fever, jaundice, tender hepatomegaly, alcohol use disorder, abdominal distention from ascites

Alcoholic hepatitis

MKSAP 20

This condition results from excessive alcohol consumption leading to liver inflammation.

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Most common antibiotic causing cholestatic liver damage

Amoxicillin-clavulanate

MKSAP 20

This antibiotic combination is known for its potential liver toxicity.

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Test for acute cholecystitis if high clinical likelihood but negative ultrasound

HIDA scan

MKSAP 20

HIDA stands for hepatobiliary iminodiacetic acid scan.

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Diagnosis suggested by second- or third-trimester pregnancy, pruritus, mild AST/ALT elevations

Intrahepatic cholestasis of pregnancy

MKSAP 20

This condition causes itching and is related to liver function during pregnancy.

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Cirrhosis-related bone disease and screening test

Osteoporosis, DXA

MKSAP 20

DXA stands for dual-energy X-ray absorptiometry, a test for bone density.

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Diagnosis suggested by fever, RUQ abdominal pain, jaundice

Cholangitis

MKSAP 20

This condition involves infection of the bile duct.

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Treatment for autoimmune hepatitis

Prednisone, usually with azathioprine

MKSAP 20

This treatment regimen helps to manage autoimmune inflammation in the liver.

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Diagnosis suggested by hepatomegaly, caudate lobe hypertrophy, ascites, RUQ pain

Budd-Chiari syndrome | MKSAP 20 ## Footnote This syndrome is caused by hepatic vein obstruction.

Most common cause of ALF

Acetaminophen overdose | MKSAP 20

Hepatitis B treatment indications

ALF, immune-active or reactivation phase, immunosuppression, cirrhosis, pregnant patients with viral load >200,000 U/mL in third trimester | MKSAP 20

Differential diagnosis for Gilbert syndrome

Hemolysis, drug-induced hyperbilirubinemia | MKSAP 20

Treatment for SBP

Third-generation cephalosporin plus albumin | MKSAP 20

Diagnostic testing for chronic hepatitis C

HCV antibody followed by HCV RNA | MKSAP 20

PBC treatment

Ursodeoxycholic acid | MKSAP 20

HCC screening test in patients with cirrhosis

Ultrasonography and AFP measurement every 6 months | MKSAP 20

Hepatitis B first-line treatments

Entecavir or tenofovir | MKSAP 20

Causes of high elastography scores

ALT >100 U/L, hepatic congestion or severe steatosis, infiltrative disorders, bile duct obstruction | MKSAP 20

Diagnosis suggested by normal ALT/AST, positive HBsAg, positive HBeAg, high HBV DNA

Hepatitis B infection immune-tolerant phase | MKSAP 20

Recommended tests for suspected liver fibrosis and cirrhosis

AST-to-platelet ratio index, Fibrosis-4 score, and elastography | MKSAP 20

Focal nodular hyperplasia treatment

None | MKSAP 20

Cholecystectomy indications for asymptomatic gallstones

Gallstones >3 cm, porcelain gallbladder, gallbladder polyp >1 cm | MKSAP 20

Liver transplantation indications

Acute liver failure, MELD 3.0 score ≥15, decompensated cirrhosis, or hepatocellular carcinoma | MKSAP 20

Diagnostic criterion for acute hepatitis A

HAV IgM antibodies | MKSAP 20

Bowel disease associated with PSC

IBD | MKSAP 20

Diagnosis suggested by ALF, neuropsychiatric symptoms, Coombs-negative hemolytic anemia in patient <40 years

Wilson disease | MKSAP 20

Diagnosis suggested by RUQ pain without gallstones on ultrasound in critically ill patient

Acalculous cholecystitis | MKSAP 20

Medical treatment for ascites

Sodium restriction, spironolactone, furosemide | MKSAP 20

Common autoimmune hepatitis antibodies

ANA and smooth-muscle antibody | MKSAP 20

Hepatic tumor associated with oral contraceptive agent in women

Hepatic adenoma | MKSAP 20

Treatment for HELLP syndrome and fatty liver of pregnancy

Delivery | MKSAP 20

PSC ERCP indications

Dominant stricture, bile duct mass | MKSAP 20

Hepatitis B–associated vasculitides

Polyarteritis nodosa, cryoglobulinemia | MKSAP 20

Intrahepatic cholestasis of pregnancy treatment

Ursodeoxycholic acid | MKSAP 20

Hepatitis B vertical transmission prevention drugs

Lamivudine, tenofovir | MKSAP 20

Common hepatic encephalopathy precipitants

Infection, GI bleeding, medications, volume depletion | MKSAP 20

Hepatic encephalopathy drug treatments

Lactulose (initial), rifaximin (second) | MKSAP 20

Diagnosis suggested by acute hepatitis and hemolytic anemia in a young adult

Wilson disease | MKSAP 20

Obstructive cholangitis treatment

Antibiotics and ERCP | MKSAP 20

PSC gold standard treatment

Liver transplantation | MKSAP 20

Test for all patients with cirrhosis not receiving nonselective β-blocker

Upper endoscopy to assess for varices | MKSAP 20

SBP prophylaxis after an episode of SBP

Long-term antibiotics | MKSAP 20

Hepatitis C treatment indication

All patients with infection (unless short life expectancy) | MKSAP 20

Hepatopulmonary syndrome test

Echocardiography with administration of agitated saline | MKSAP 20