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Alimentary System > Lecture 22 Liver Symposium > Flashcards

Lecture 22 Liver Symposium Flashcards

1
Q

Name the enteric hepatitis viruses

A

A and E

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2
Q

Name the Parental hepatitis virus

A

B, C and D

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3
Q

What are the self-limiting hepatitis viruses

A

A and E

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4
Q

What hepatitis viruses cause chronic diseases

A

B, C and D

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5
Q

Describe the clinical course of Hepatits A

A

IgG increases throughout and IgM initial increase then decline

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6
Q

How is Hep A transmited

A

Faecal-oral
Sexual
Blood

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7
Q

High risk groups for Hep A

A
  • Travellers
  • Patients with chronic liver disease- IDU (especially with HCV or HBV)
  • Haemophiliacs
  • Occupational exposure- lab workers
  • Men who have sex with men (MSM)
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8
Q

Describe the structure of Hep B

A

DNA polymers and HBV DNA surrounded by an inner protein core which is surrounded by an outer lipid envelope containing HB surface antigen

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9
Q

Function of Hepatitis surface antigen (HBsAg)

A

Presence of virus

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10
Q

Function of Hepatitis e antigen (HBeAg)

A

Active replication

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11
Q

Function of Hepatitis core antigen (HBcAg)

A

Active replication (not detected in blood)

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12
Q

Function of HBV DNA

A

Active replication

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13
Q

Treatment for Hepatitis Infections Hep B

A

Pegylated interferon

Oral anti-viral drugs

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14
Q

Name some oral anti-viral drugs Hep B

A 
Lamivudine
Adefovir
Entecavir
Telbivudine
Tenofovir
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15
Q

Describe the structure of Hep C

A

Single stranded RNA
Envelope glycoproteins(E1 and E2)
Envelope
Nuceocapsid

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16
Q

Can the acute phase of Hep C be resolved

A

Yes

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17
Q

Can the chronic phase of Hep C be lived with

A

Yes

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18
Q

When do symptoms appear in Hep C

A

2-3 months

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19
Q

Non specific drugs for Hep C

A
  • PEG-IFN lamda
  • Ribavirin
  • PEG-IFN alpha
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20
Q

Name specific drug treatment doe Hep C

A
  • ABT-33
  • ABT-450/r
  • Ledipasvir
  • AbT-267
  • Fadaprevir
  • Asunaprevir
  • Daclatasvir
  • Simeprevir
  • Sofosbuvir
  • Telaprevir
  • Boceprevir
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21
Q

What virus may be a co-infection of Hep B

22
Q

What is a self-limiting hepatitis virus that is a common cause of hepatitis in Grmapian

23
Q

Name a variant of Hep B

24
Q

What virus is related to Hep C

25
What viruses cause mildly deranged LFTs only in immunocompromised hosts
EBV and CMV
26
What virus except for Hep can cause hepatitis
Herpes simplex
27
What is non-alcoholic fatty over disease
* Umbrella term encompassing three entities * Simple steatosis * Non alcoholic steatohepatitis * Fibrosis and cirrhosis
28
What metabolic syndromes are associated with NFLD
* Diabetes mellitus * Obesity * Hypertriglyceridemia * Hypertension
29
What are other risk factors for NFLD
* Age * Ethnicity (e.g. Hispanics) * Genetic factors (e.g. PNPLA3 gene)
30
Diagnosis of NFLD
• Biochemical tests: AST/ALT ratio • Enhanced liver fibrosis panel (ELF) (hyaluronic acid, TIMP-1, and PIIINP) • Cytokeratin-18- Mutations in this gene have been linked to cryptogenic cirrhosis. • Ultrasound • Fibroscan- a type of ultrasound that can measure the degree of inflammation in your liver. It is a simple, painless test that uses high frequency sound waves • MR/CT • MR Spectroscopy: Actually quantify fat Liver biopsy
31
What is used to score NAFLD
``` Age Diabetes IFG BMI AST:ALT Platelet count Albumin ```
32
Treatment of NAFLD
* Diet and weight reduction * Exercise * Insulin sensitizers e.g. Metformin, Pioglitazone * Glucagon-like peptide-1 (GLP-1) analogues e.g. Liraglutide * Farnesoid X nuclear receptor ligand e.g. Obeticholic acid * Vitamin E * Weight reduction surgeries
33
What are the 3 types of antibodies involved in autoimmune hepatitis
* Type 1: ANA, SMA * Type 2: LKM1 * Type 3: SLA
34
are male/female more at risk of autoimmune hepatitis
Female
35
Whats an indication of autoimmune hepatitis
Elevated IgG
36
How is autoimmune hepatitis diagnosed
Liver biopsy
37
How is autoimmune hepatitis treated
Steroids | Long-term azathioprine
38
What is primary biliary cholangitis
Inflammation of the bile duct
39
Primary biliary cholangitis is predominant in male/female
Female
40
What antibody is present in primary biliary cholangitis
Anti-mitochondrial antibody
41
What are common symptoms of primary biliary cholangitis
Pruritus and fatigue common
42
What is the treatment for primary biliary cholangitis
UDCA
43
Primary sclerosing cholangitis is more common in male/female
Male
44
What antibodies are an indication of Primary sclerosing cholangitis
pANCA positive- perinuclear anti-neutrophil cytoplasmic antibodies
45
What is the purpose of a liver transplant
* Chronic liver disease with poor predicted survival * Chronic liver disease with associated poor quality of life * Hepatocellular carcinoma * Acute liver failure * Genetic diseases e.g. primary oxaluria, tyrosemia
46
Contraindications for liver transplantation
 Active extrahepatic malignancy  Hepatic malignancy with macrovascular or diffuse tumor invasion  Active and uncontrolled infection outside of the hepatobiliary system  Active substance or alcohol abuse  Severe cardiopulmonary or other comorbid conditions  Psychosocial factors that would likely preclude recovery after • transplantation  Technical and/or anatomical barriers  Brain death
47
Acetaminophen-induced ALF is listed for transplantation if
Grade 3 or 4 hepatic encephalopathy INA more than 6.5 Creatinine more than 300 micro mol/l
48
Nonacetaminophen-induced ALF is listed for transplantation if
Age less than 10 or more than 40 INR at least 3.5 Serum bilirubin at lease 300 micomol/l Unfavourable cause (Wilson's disease)
49
What is Orthotopic surgery
liver transplantation, in which the previous liver is removed and the transplant is placed at that location in the body.
50
Name post-operative treatment
* Post operative ICU care * Multidisciplinary care * Prophylactic antibiotics and anti-fungal drugs * Anti-rejection drugs * Steroids * Azathioprine * Tacrolimus/Cyclosporine

Alimentary System (39 decks)

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