Liver

Question 1

CY82Y in HFE gene

Answer 1

Biopsy when homozygote if serum ferritin > 1000

Question 2

Detection of viral Hepatitis

Answer 2

Hep B - IgM antibody to Hep B core antigen (acute exposure) *sexual activity
- e antigen = natural exposure
- antibody to Hep B surface antigen = vaccination
Hep C - viral load RNA
Hep A - IgM level, IgG indicates prior exposure

Question 3

Symptoms of Epstein-Barr virus

Answer 3

pharyngeal discomfort
Lymphadenopathy
Atypical lymphocytosis

Question 4

Tests for other causes of hepatitis (3)

Answer 4

Wilsons - serum ceroplasmin
Autoimmune - antismooth muscle antibody, increased globulin (serum total protein - serum albumin)
PBC - ama 1:40 titer

Question 5

Fulimant hepatic failure

Answer 5

development of hepatic encephalopathy within 8 wks of onset of acute severe liver injury

Question 6

Symptoms of Gilberts syndrome

Answer 6

URTI, (N) transaminase, (N) unconjugated/direct bili, hyperbilirubinemia