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GI II Exam 1 > Liver Path IV > Flashcards

Liver Path IV Flashcards

1
Q

Hep D

A

needs Hep B

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2
Q

yellow fever

A

like ebola

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3
Q

chronic liver disease

A

Hep C

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4
Q

Hep C route of transmission

A

one third have unknown risk factors

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5
Q

path viral hepatitis

A

not caused by virus but immune response to infected hepatocyte

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6
Q

extrinsic pathway

A

death receptor

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7
Q

intrinsic pathway

A

mitochondria

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8
Q

cytotoxic T cell apoptosis

A

type IV hypersensitivity

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9
Q

mito pathway

A

intrinsic

  • CTL recognize foreign viral expression of MHC-1
  • perforin creates channels for granzymes
  • caspase activation - hepatocyte apoptosis
  • IFN-delta from CTL activates macros to phagocytose

caspase - cytochrome c

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10
Q

acute hepatitis clinical

A

jaundice, flu-like, RUQ pain, acholic stool, choluria, pruritis, eruptive xanthomas, encephalopathy

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11
Q

best panel to dx acute hepatitis

A

anti-HAV
HBs-Ag
IgM anti-HBc
anti-HCV

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12
Q

hepatitis A

A

fecal oral
1 month incubation

shellfish, daycare, food

does not cause chronic or carrier state

childhood - asymptomatic - long term immunity
adult - acute hepatitis pattern

vaccine very effective

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13
Q

HAV vaccine

A

active - all children >1yr, travelers, drug use, liver disease
Hep A Ig - lasts 3 months
prevaccination testing - age >40, geography, drug use

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14
Q

hep A path

A

ingestion - replication in liver
-shed in bile - to intestines - to feces

brief viremia

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15
Q

IgM HAV

A

diagnostic

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16
Q

anti-HAV antibody

A

vaccination

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17
Q

hep B

A

lots have chronic infection

mode of transmission and pattern of disease different between high, intermediate, and prevalence populations

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18
Q

dane particle

A

hepatitis B

-dsDNA circular and incomplete

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19
Q

low prevalence hep B

A

sexual contact, IV drug use
1-6 month incubation

70% asymptomatic
95% recover - 5% to chronic hepatitis

may lead to hepatocellular carcinoma

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20
Q

hep B with recovery

A

HBsAg - appear then disappear

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21
Q

window period

A

in Hep B
-IgM anti-HBc

from drop in HBsAg until IgG anti-HBs

22
Q

acute hep B symptoms

A

with onset of anti-HBc

first IgM then IgG - IgM goes away within 6 months - IgG for life

23
Q

chronic hepatitis B definition

A

HBsAg for more than 6 months

24
Q

HBeAg

A

denotes high infectivity with high HBV DNA with elevated ALT

denotes low infective with low HBV and low ALT

25
Q

risk of Hep B

A

active hepatitis
cirrhosis
hepatocellular carcinoma

26
Q

younger age at time of hep B infection

A

higher probability of chronicity

27
Q

incubation period

A

Hep B

exposure until HBsAg appears

28
Q

anti-HBs

A

denotes recovery and lifelong immunity

29
Q

chronic Hep B infection

A

persistance of HBVsAg

30
Q

vertical transmission

A

of Hep B
-HBV mother gives to baby

develop immune tolerant chronic Hep B infection

normal ALT, positive for ABeAg, HBV DNA >100,000

poor response to tx

immune active phase - 20-40yo

immune active phase - high HBV DNA
inactive chronic carrier - low HBV DNA

31
Q

ground glass

A

seen Hepatitis B

HBsAg in ER

32
Q

chronic active Hep B

A

apoptosis of hepatocytes

33
Q

number 1 cause of cirrhosis

34
Q

hep C

A

ssRNA - unstable genome - difficulty vaccine production

genotype 1 most common - more resistant - require triple therapy

leading infectious cause of chronic liver disease

IV drug use, idiopathic, sex

75% asymptomatic

35
Q

all baby boomers

A

should be tested for Hep C

36
Q

hep C genome

A

unstable - cannot make vaccine

37
Q

most common hep C

A

stable chronic hepatitis

20% to cirrhosis
may lead to hepatocellular carcinoma

38
Q

metabolic syndrome

A

with HCV genotype 3

39
Q

marker for hep C

A

HCV-RNA - to confirm diagnosis

goes away with recovery

chronic - persists

40
Q

chronic hep C

A

see bridging fibrosis

41
Q

ss-RNA virus that is replication defective

A

Hep D

dependent on HBV for multiplication

  • coinfection
  • superinfection
  • latent infection - liver tranpsplant
42
Q

superinfection of Hep D

A

chronic HBsAg carrier - severe acute hepatitis or exacerbation of chronic

43
Q

Hep E

A

hep A of india

ss-RNA - with multiple animal reservoirs

in underdeveloped world - major cause of epidemics

acute with chronic carrier state

44
Q

dangerous in pregnant women

A

Hep E infection - fatality

45
Q

grading of chronic liver disease

A

look at inflammation - number of lymphos and location

and look at fibrosis - level of bridging

46
Q

acute asymptomatic hepatitis

A

Hep A, B, C, E

47
Q

acute symptomatic hepatitis

A

Hep A, B, C, D/B, E

48
Q

chronic hepatitis

A

Hep B,C

includes carrier state

49
Q

fulminant hepatitis

A

Hep B or Hep D/B

50
Q

helminth infection of liver

A

liver fluke - clonorchis sinensis??

GI II Exam 1 (29 decks)

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