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Y3R5: Medicine I 🩺 > L4: Chronic Viral Hepatitis & Cirrhosis > Flashcards

L4: Chronic Viral Hepatitis & Cirrhosis Flashcards

1
Q

Characters of The Liver

A
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2
Q

Functions of The Liver

A
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3
Q

Def of chronic hepatitis

A
  • Inflammation of the liver.
  • Persistence more than 6 months → chronic
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4
Q

Cause of Chronic Hepatitis

A
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5
Q

Etiology of Viral Hepatitis

A
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6
Q

Compare between Hepatitic viruses in terms of:

  • Trnasmission
  • Classification
  • Antigens
  • Incubation Period
  • Severity/Chronicity
  • Vaccine
A
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7
Q

MOT of HBV

A

HBV is transmitted hematogenously and sexually.

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8
Q

HBV Patients can have either an acute symptomatic disease or an asymptomatic disease.

A

..

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9
Q

antigen-antibody system in HBV

A
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10
Q

HBs Ag

A
  • The marker of infectivity.
  • It can be found in blood and body secretions: salive, urine, semen, vaginal secretion, tears, sweat.and breast milk.
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11
Q

Anti-HBs

A
  • Protective antibody.
  • can persist for many years
  • Appears after HBAg disappearance several weeks (or months).
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12
Q

HBc Ag

A

A marker of replication.

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13
Q

Anti-HBc IgM

A

A marker of acute infection and acute attack of chronic infection.

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14
Q

Anti-HBc IgG

A

A marker of past infection.

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15
Q

Hbe Ag

A

A marker of active replication.

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16
Q

Anti-Hbe

A

A marker of reduced infectivity.

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17
Q

HBV-DNA

A
  • The direct indicator of HBV infection
  • It can integrate into the genome of hepatocytes.
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18
Q

Dx of HBV

A
  • Clinical picture.
  • Laboratory investigations.
  • Radiological investigations.
  • Pathological investigations.
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19
Q

CP of HBV

A
  • Persistent / intermittent fatigue
  • Upper right quadrant pain
  • Jaundice
  • Weakness
  • Anorexia
  • Muscle & joint pain
  • Often asymptomatic
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20
Q

If progressive liver disease, the following symptoms may appear

A
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21
Q

Signs of chronic liver disease include the following:

A
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22
Q

Lab tests for HBV

A
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23
Q

Radiological tests for HBV

A
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24
Q

Complications of HBV

A
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25
Q

Prevention of HBV

A
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26
Q

MOT of HBV

A

Parenteral through blood and body secretions as saliva, urine, semen, vaginal secretion, tears, sweat. And breast milk.

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27
Q

TTT of HBV

A
28
Q

what is the most common cause of liver transplantation?

A

HCV

29
Q

Characters of HCV

A
  • Flaviviral etiology discovered in 1989
  • Formerly “non-A non-B hepatitis”: NANBH
  • Unlike HBV, persistence and chronic progressive disease is usual outcome in adult infection
30
Q

Antigen-antibody system in HCV

A
  • The concentration of HCV in blood is low.
  • Anti-HCV is the indicator of infection and the marker of infectivity
  • HCV-RNA may be detected from blood or liver tissue, It’s the direct evidence of infectivity
31
Q

Signs & Symptoms of HCV

A
32
Q

Physical findings in HCV

A
33
Q

Other common extrahepatic manifestations in HCV

A
34
Q

General baseline studies in patients with suspected hepatitis C include the following

A
  • Complete blood cell count with differential
  • Liver function tests, including alanine aminotransferase level
35
Q

MOT of HCV

A
36
Q

HCV Cannot be transmitted by:

A
37
Q

Complications of HCV

A
38
Q

TTT of HCV

A
39
Q

Direct-acting antiviral agents

A
40
Q

Def of Cirrhosis

A
41
Q

Pathological Classification of Cirrhosis

A
42
Q

Examples of causes of Micronodular Cirrhosis

A

alcohol and hemochromatosis.

43
Q

Examples of causes of Macronodular Cirrhosis

A

chronic hepatitis B,C and alpha-1 antitrypsin deficiency.

44
Q

Etiological types of Cirrhosis

A
  • Mixed
  • Post-Hepatitis
  • Congestive
  • Metabolic
  • Biliary
  • Alcoholic
  • Drugs, Toxins & Chemicals (Methotrexate & Amioradone)
  • Immunologic (Autoimmune)
45
Q

what is the commonest type of cirrhosis in Egypt?

A

Mixed Cirrhosis

46
Q

Mixed Cirrhosis

A
  • It is a combination of hepatic schistosomiasis with chronic viral hepatitis, drug induced or malnutrition.
  • pure hepatic schistosomiasis produces periportal fibrosis without parenchymal affection.
47
Q

Post-Hepatitis Cirrhosis

A
  • It complicates chronic viral e.g. chronic hepatitis B and C. also it can complicate non-viral hepatitis.
48
Q

Congestive Cirrhosis

A
  • It complicates chronic hepatic congestion as in right-sided heart failure, constrictive pericarditis and Budd-Chiari syndrome.
49
Q

Metabolic Cirrhosis

A
  • It occurs in generalized diseases with inborn errors of metabolism as in hemochromatosis and Wilson’s disease.
50
Q

Biliary Cirrhosis

A
  • It is either primary or secondary to prolonged extrahepatic obstruction.
51
Q

Alcoholic Cirrhosis

A
  • It develops after many years of alcohol consumption.
  • The commonest type of cirrhosis in the western countries but is rare in Egypt
52
Q

what causes Complications of liver cirrhosis?

A

Complications of liver cirrhosis are due to two major events, portal hypertension and parenchymal dysfunction.

53
Q

Portal hypertension is due to …..

A

obstruction of the portal blood flow within the cirrhotic liver.

54
Q

Parenchymal dysfunction is due to ……

A

progressive necrosis or degeneration of the hepatic cells.

55
Q

Complications due to portal hypertension

A
56
Q

Complications due to parenchymal dysfunction

A
57
Q

CP of Liver Cirrhosis

A
58
Q

Investigations for Cirrhosis

A
  • Lab
  • Rad
  • Cyto
59
Q

Lab tests for Cirrhosis

A
60
Q

Radiological Tests for Cirrhosis

A
  • Abdominal ultrasonography
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Radionucleotide studies
61
Q

Pathological test for Cirrhosis

A

Liver biopsy: the gold standard for the diagnosis of cirrhosis

62
Q

what is the gold standard for the diagnosis of cirrhosis?

A

Liver Bx

63
Q

TTT of Cirrhosis

A
64
Q

Specific TTT in Cirrhosis

A
  • Phlebotomy for hemochromatosis
  • d-Penicillamine for Wilson’s disease
  • alcohol avoidance for alcohol-induced cirrhosis
  • antiviral agents such as interferon alpha for chronic viral hepatitis C
65
Q

Symptomatic TTT of Cirrhosis

A
  • diuretic therapy and salt restriction for ascites
  • lactulose, neomycin and protein restriction for encephalopathy
66
Q

Liver Transplantation in Cirrhosis

A

it is indicated in end-stage cirrhosis

67
Q

Screening for hepatocellular carcinoma

A

indicated in all cases of liver cirrhosis with serial ultrasonographic examination and serum alpha fetoprotein every six months.

Y3R5: Medicine I 🩺 (47 decks)

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