High-Yield Concepts in Non-Viral Hepatitis (Gastrointestinal Diseases)

Question 1

Cause of most drug Hepatotoxicity

Answer 1

Phase I toxic metabolite (cytochrome P450)

Question 2

Examples of Direct Hepatotoxins

Answer 2

Carbon tetrachlorode, acetaminophen, tetracycline, Amanita phalloides (deathcap mushroom)

Question 3

Examples of Idiosyncratic Hepatotoxins

Answer 3

Halothane, isoniazid, chlorpromazine

Question 4

Drugs wherein hepatotoxicity is more frequent in patients with underlying CLD

Answer 4

Aspirin, methotrexate, isoniazid, antiretrovirals

Question 5

Acetaminophen dose producing clinical evidence of liver injury

Answer 5

10-15 grams

Question 6

Acetaminophen dose usually associated with fatal fulminant disease

Answer 6

≥ 25 grams

Question 7

Last resort for Acetaminophen Hepatotoxicity

Answer 7

Liver transplantation (if with progressive hepatic failure despite NAC therapy)

Question 8

Most important adverse effect of Eryththromycin

Answer 8

Cholestatic reaction (infrequent)

Question 9

Hepatotoxic component of Trimethoprim-Sulfamethoxazole (TMP-SMX)

Answer 9

Sulfamethoxazole

Question 10

Autoimmune Hepatitis (AIH)

Answer 10

Chronic disorder characterized by continuing hepatocellular necrosis and inflammation, usually with fibrosis, which can progress to cirrhosis and liver failure

Question 11

Type I AIH

Answer 11

Classic syndrome in young women

ANA antibodies (and p-ANCA)

Question 12

Type II AIH

Answer 12

Often seen in children, common in Mediterranean

Anti-LKM antibodies

Question 13

Anti-LKM1

Answer 13

Type II AIH and hepatitis C

Question 14

Anti-LKM2

Answer 14

Drug-induced hepatitis

Question 15

Anti-LKM3

Answer 15

Chronic hepatitis D

Question 16

Mainstay of treatment for AIH

Answer 16

Glucocorticoid therapy