Liver Disease Cases Flashcards

1
Q

AST/ALT 500-3000 indicates

A

acute hepatitis

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2
Q

AST/ALT <500-3000 indicates

A

chronic hepatitis

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3
Q

AST/ALT >5-10000 indicates

A

acetominophen toxicity, shock liver

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4
Q

AST>ALT ratio of 2-3:1 or greater indicates

A

alcohol hepatitis

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5
Q

AST>ALT ratio 1-2:1 indicates

A

cirrhosis

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6
Q

ALT>AST indicates

A

fatty liver disease

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7
Q

AST and ALT elevation indicates

A

liver disease, celiac, hypothyroidism, muscle damage

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8
Q

Sources of Alk Phos

A

bone, placenta, liver, kidney

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9
Q

T/F biliary obstruction has higher elevation in alk phos than intrahepatic cholestasis

A

F

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10
Q

Examples of intrahepatic cholestasis

A

drug induced, pbc, hepatic granulomas/sarcoid

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11
Q

Examples of extrahepatic cholestasis

A

bile duct obstruction due to stones, cancer, psc

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12
Q

Sources of indirect bilirubin

A

hemolysis or resorption of hematomas

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13
Q

Are cholestasis and hyperbilirubinemia synonymous?

A

no –> cholestasis of pregnancy has no bilirubin elevation necessarily

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14
Q

Is there higher bilirubin in intrahepatic disease/hepatocellular disease or in extrahepatic cholestasis?

A

intrahepatic cholestasis or hepatocellular disease

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15
Q

Which hepatitis virus is dna?

A

hbv

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16
Q

Which hepatitis viruses are enterically transmitted?

17
Q

Diagnostic marker for acute HepA

18
Q

Immunity marker for HepA

A

total antibody + and IgM - (suggests it’s all IgG)

19
Q

Prevention of HepA

A

Ig prophylaxis or vaccine

20
Q

E protein

A

precore mutation in HBV that prevents secretion of E protein –> some people are e+/-

21
Q

T/F The younger you are the more likely you have a subclinical HBV infection

A

T –> allows it to persist in the population

22
Q

What is immune tolerance in HBV?

A

you have lots of viral particles but no impact on the liver –> normal histology, markers –> early transmission/perinatal (but Eantigen+)

23
Q

Risk of cirrhosis in HepC

A

20% in 20 years

24
Q

Leading risk factor for liver cancer in US

A

HepC cirrhosis

25
Difference between liver cancer in HepB and HepC
in HepC it is seen only with cirrhosis
26
Disadvantages to HepC ELISA
delay between infection and detection (window period), immunosuppressed patients may not make detectable response, false positive
27
Does a -HepC antibody test rule out infection?
No --> only viral RNA test is definitive
28
R > 5 and ALT >2x uln indicates
hepatocellular DILI (R = ALT/uln/ALKP/uln)
29
RULN indicates
cholestatic DILI
30
2<5 indicates
mixed cholestatic and hepatocellular DILI
31
Hys law
if ALT >3X and Tbili>2X, likelihood of death is about 10%
32
Xanthomas suggest hepatocellular/cholestatic disease
cholestatic
33
PSC vs PBC demographic
PSC = young men, PSC = older women