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Year 2- GIT > Liver Symposium > Flashcards

Liver Symposium Flashcards

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1
Q

Which 5 main viruses can cause viral hepatitis?

A

Hepatitis A, B, C, D and E

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2
Q

Which types of hepatitis’ are enteric viruses?

A

A and E

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3
Q

Which types of hepatitis’ are parenteral viruses?

A

B, C, D

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4
Q

Which types of hepatitis’ are self limiting acute viruses?

A

A and E

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5
Q

Which types of hepatitis’ cause chronic infections?

A

B,C, D

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6
Q

How is Hep.A initially confirmed?

A

IgM antibodies

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7
Q

How can hepatitis A be transmitted?

A

Faecal-oral route
Sexually
Blood

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8
Q

Which age range is most common to get Hep.A?

A

5-14

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9
Q

What does HepB contain in the inner core which helps it to replicate?

A

DNA polymerase

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10
Q

What does the HepB surface antigen allow the virus to do?

A

Avoid the immune system

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11
Q

What happens to the E antigen produced by HepB virus?

A

Released into blood and modulates the immune system to help the virus survive

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12
Q

If testing and there is Hepatitis B surface antigen, what does this suggest?

A

Presence of virus

(remember this could be dead or alive!)

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13
Q

If testing and there is Hepatitis B E antigen, what does this suggest?

A

Active replication of the virus

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14
Q

If testing and there is Hepatitis B core antigen, what does this suggest?

A

Active replication of the virus but not detected in blood

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15
Q

If testing and there is Hepatitis B DNA antigen, what does this suggest?

A

Active replication of the virus

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16
Q

What is the function of the anti-surface antibody produced by the body?

A

Protection

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17
Q

Which antibody is produced by the body in response to an acute HepB infection?

A

IgM antibody

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18
Q

Which antibody is produced by the body in response to a chronic HepB infection?

A

IgG antibody

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19
Q

What can chronic hepatitis B cause to happen?

A

Cirrhosis of liver -> end stage liver disease

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20
Q

Are the vast majority of people infected w HepC symptomatic or asymptomatic?

A

Asymptomatic

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21
Q

What can HepC cause to happen?

A

Cirrhosis of liver

->sometimes HepC doesn’t even get diagnosed until this point as so hard to diagnose as mostly asymptomatic

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22
Q

Is HepC DNA or RNA virus?

A

RNA

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23
Q

How is HepC diagnosed?

A

First look for HepC antibodies
Then look for HepC or RNA in blood

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24
Q

Is HepD RNA or DNA based?

A

RNA

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25
Q

What does HepD depend on?

A

HepB

Parasite of a virus in some ways!

26
Q

What does HepD rely on HepB for?

A

Production of protein coat

27
Q

A patient can also have HepD if they have what?

A

HepB

28
Q

Is HepD easy to treat?

A

No, very resistant to treatment

29
Q

How are HepB and HepD transmitted?

A

When bodily fluids for an infected person come into contact with a non-infected person

30
Q

Describe the treatment for HepE.

A

No specific treatment
No effective vaccine currently available

31
Q

What is meant by drug induced liver disease?

A

When various drugs are taken for various reasons which can cause different patterns and mechanisms of injury to the liver

32
Q

Name one drug in particular that can cause a lot of liver damage.

A

Paracetamol

33
Q

Which three diseases fall under the umbrella term of non-alcoholic fatty liver disease?

A

Simple steatosis
Non-alcoholic steatohepatitis
Fibrosis and cirrhosis

34
Q

Non-alcoholic fatty liver disease is associated with many components of metabolic syndrome like what?

A

Obesity
Diabetes
Hypertriglyceridemia
Hypertension

35
Q

What are some of the risk factors for non-alcoholic fatty liver disease?

A

Age
Ethnicity
Genetics

36
Q

What test is used to confirm the diagnosis of NAFLD?

A

Blood tests- AST/ALT ratio

37
Q

Which radiography investigations can confirm NAFLD?

A

Ultrasound
Fibroscan
MR
CT

38
Q

Which investigation is the gold-standard of diagnosis?

A

Liver biopsy because it tells the extent of fibrosis or steatosis

39
Q

Which scoring system can be used to determine if someone has fibrosis or not?

A

Fib-4 score

40
Q

If a score is less than 1.45 for the Fib4 score, what does this suggest?

A

No advanced fibrosis

41
Q

If a score is more than 3.45 for the Fib4 score, what does this suggest?

A

Suggests there is scarring or cirrhosis

42
Q

What are some of the treatment options for NAFLD?

A

Diet and weight reduction
Exercise
Weight reduction surgeries
Vitamin E
Insulin sensitizers
Glucagon like peptide-1

43
Q

Name three more common autoimmune liver diseases.

A

Autoimmune hepatitis
Primary biliary cholangitis
Primary sclerosing cholangitis

44
Q

Is autoimmune hepatitis predominantly seen in men or women?

A

Women

45
Q

Which antibody is elevated in those with autoimmune hepatitis?

A

IgG

46
Q

What is the diagnostic test for autoimmune hepatits?

A

Liver biopsy

47
Q

Does autoimmune hepatitis respond well to treatment?

A

Yes
->steroids and in the long term, azathioprine

48
Q

Is primary biliary cholangitis predominantly seen in men or women?

A

Women

49
Q

Which antibody is elevated in those with primary biliary cholangitis?

A

IgM

50
Q

What is usually affected by primary biliary cholnagitis?

A

Bile ducts

51
Q

Which two symptoms are common in those with primary biliary cholangitis?

A

Fatigue
Pruritus (itching)

52
Q

Is primary sclerosing cholangitis predominantly seen in men or women?

A

Men

53
Q

Which antibody group is positive in primary sclerosing cholangitis?

A

pANCA

54
Q

What is usually affected by primary sclerosing` cholangitis?

A

Itra and extrahepatic bile ducts

55
Q

Which test is used to diagnose primary sclerosing cholangitis?

A

MRI or MRCP

56
Q

What do patients with primary sclerosing cholangitis usually present with?

A

Jaundice or recurrent cholangitis

57
Q

What is the only treatment for primary sclerosing cholangitis?

A

Liver transplant

58
Q

Who would get a liver transplant?

A

Those who-
-have chronic liver disease w poor survival prediction
-have chronic liver disease w poor life quality
-have hepatocellular carcinoma
-acute liver failure
-have certain genetic diseases

59
Q

What are some contraindications for a liver transplant?

A

Active substance or alcohol abuse
Active extrahepatic malignancy
Uncontrolled infection in other part of body
Psychosocial factors which may impact how they recover

60
Q

Which score is used today to prioritise who gets a liver transplant?

A

UKELD score

61
Q
A

Year 2- GIT (37 decks)

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