Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Alimentary System > Liver Symposium > Flashcards

Liver Symposium Flashcards

1
Q

what are the five types of viruses that cause viral hepatitis

A

hepatitis A, B, C, D, E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what type of viruses are hepatitis A and E

A

enteric viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what type of viruses are hepatitis B, C, D

A

parenteral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which viruses cause self limiting acute infections

A

Hepatitis A and E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which viruses cause chronic disease

A

Hepatitis B,C and D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how many people die each year from causes of viral hepatitis

A

1 million people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how does Hepatitis A occur

A

sporadically or in epidemic form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

in what three ways is hepatitis A transmitted

A

Faecal - oral
sexual
blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the age group most commonly affected by hepatitis A

A

5 - 14 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is the prevalence of hepatitis A increasing or decreasing

A

decreasing worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

are cases mostly symptomatic or asymptomatic for hepatitis A

A

asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how are acute diseases of hepatitis A diagnosed

A

IgM antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

who is recommended to be vaccinated for Hepatitis 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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the structure of Hepatitis B

A

Egg shaped
DNA polymerase within the core (inner protein core)
Outer lipid envelope containing HB surface antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what antigen is produced by HBV structure

A

IgE similar to core antigen, released into blood and modulates immune system to help virus survive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the different HBV antigens

A

Hepatitis surface antigen (HBsAg)

Hepatitis e antigen (HBeAg)

Hepatitis core antigen (HBcAg)

HBV DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does the presence of Hepatitis surface antigen (HBsAg) mean

A

Presence of the virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does the presence of Hepatitis e antigen (HBeAg) mean

A

Active replication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does the presence of Hepatitis core antigen (HBcAg) (not detected in blood) mean

A

active replication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the different HBV antibodies

A

Anti-HBs Protection

IgM anti-HBc Acute infection
IgG anti HBc Chronic infection/exposure

Anti-HBe Inactive virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does the presence of anti-HBs antibodies mean

A

protection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what does the presence of Igm anti-HBcs mean

A

acute infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does the presence of IgG anti HBcs mean

A

Chronic infection/exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does the presence of anti-HBes mean

A

Inactive virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the first question to consider for an HBV infection
is HBsAg present positive - chronic / active infection negative - no active infection (vaccination)
26
if the patients HBsAg came back positive what is the next question to consider
is there clinical evidence of active infection yes - Igm or anti-HBc? no - chronic infection (evaluate for chronic infection)
27
if there is IgM or anti-HBc present what does this mean
acute infection negative - chronic infection
28
what is the most important clinical consequence of chronic HBV infection
liver fibrosis or cirrhosis Approximately 15% to 40% of chronic hepatitis B patients will progress to cirrhosis, HCC, or liver failure. Approximately 5% to 10% of liver transplantations are related to hepatitis B.
29
are patients with chronic hepatitis B who do not have progression of fibrosis to cirrhosis at risk for end-stage liver disease
no but still are at risk of developing HCC.
30
what is used to supress HBV replication in chronic cases
oral antiviral agents effectively and safely suppress HBV replication during long-term use, and recent data have demonstrated that long-term viral suppression stabilizes or improves liver histology.
31
what are the two treatment options for HBV
Pegylated interferon Oral antiviral drugs
32
what are five oral therapies available for HBV
Lamivudine Adefovir Entecavir Telbivudine Tenofovir
33
when was hepatitis C discovered
1989
34
how many people in scotland are affected by HCV
1%
35
are patients affected by HCV mainly asymptomatic
yes - most asymptomatic until cirrhotic - may have normal LFTs 10% patients report acute jaundice Rarely causes acute liver failure
36
what type of virus is HCV
RNA virus
37
what are the percentages of people affected by different stages of HCV
15% - exposed and resolved 85% - chronic [80% stable] 20% - cirrhosis [75% slowly progressive] 25% - HCC transplant / death
38
how are patients with HCV diagnosed
screening tests, look for presence of hep c/rna in blood
39
how is HCV treated
combination of drugs 90% clearance rate
40
what are some drugs used for HCV
simprevir faldaprevir ledipasvir sofobuvir
41
what is hepatitis D
Small RNA virus, -does not code for its own protein coat -enveloped by HBsAg
42
what causes a co-infection or super infection with hepatitis D
HBV
43
how resistant is HDV to treatment
very
44
what is the prevalence of hepatitis E in UK
Increasingly recognized in UK Commonest cause of acute hepatitis in Grampian
45
is there any treatment or vaccine available for hepatitis E
no
46
what are some other viruses that may cause viral hepatitis
Hepatitis F ?variant of B Hepatitis G Related to HCV, Hepatitis GB ? Cause liver disease EBV Generally cause mildly CMV deranged LFTs only in immunocompromised hosts Herpes simplex Rare severe acute hepatitis
47
what is non alcoholic fatty liver disease
Umbrella term encompassing three entities Simple steatosis Non alcoholic steatohepatitis Fibrosis and cirrhosis
48
what is non alcoholic fatty liver disease associated with
Diabetes mellitus Obesity Hypertriglyceridemia Hypertension
49
what are risk factors for NAFLD
Age Ethnicity (e.g. Hispanics) Genetic factors (e.g. PNPLA3 gene)
50
what are the stages towards developing cirrhosis with NAFLD
steatosis NASH cirrhosis
51
what are the different diagnostic methods for NAFDL
Biochemical tests: AST/ALT ratio Enhanced liver fibrosis panel (ELF) (hyaluronic acid, TIMP-1, and PIIINP) Cytokeratin-18 Ultrasound Fibroscan MR/CT MR Spectroscopy: Actually quantify fat Liver biopsy - gold standard
52
what is the gold standard procedure for NAFDL
liver biopsy
53
what is the NAFLD score
Criteria Low Risk high risk Age <45 >45 Diabetes or Absent Present *IFG ≥ 7 mmol/L BMI <30 >30 AST: ALT <1(AST1(AST>ALT) Platelet count Normal >150 Low <150 Albumin Normal >34 Low <34 * Impaired fasting glucose patients are classed as high risk for 3 or more categories
54
what does Fib-4 score measure
<1.45 - no advanced fibrosis > 3.25 - cirrhosis
55
what are treatments available for NAFDL
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
56
what are some autoimmune liver diseases
Autoimmune hepatitis Primary biliary cholangitis (PBC) Primary sclerosing cholangitis (PSC) Overlap syndromes Autoimmune cholangiopathy IgG 4 disease
57
who does autoimmune hepatitis affect
females
58
what is a marker for autoimmune hepatitis
Elevated IgG Three types of antibodies Type 1: ANA, SMA Type 2: LKM1 Type 3: SLA
59
what diagnoses autoimmune hepatitis
Liver biopsy diagnostic
60
how is autoimmune hepatitis treated
Responds well to steroids Long term azathioprine
61
who does primary biliary cholangitis affect
females
62
what is used as a marker for primary biliary cholangitis
IgM elevated Anti-mitochondrial antibody positive Intrahepatic bile duct involved
63
what symptoms are common for Primary biliary cholangitis
Pruritus and fatigue common
64
what is choice of treatment for primary biliary cholangitis
UDCA treatment of choice
65
who does primary sclerosing cholangitis affect
males
66
what markers are used for primary sclerosing cholangitis
pANCA positive Intra and extrahepatic bile ducts involved Stricturing disease
67
what is the diagnostic test for primary scleorising cholangitis
MRCP test of choice
68
what are common symptoms for primary sclerosing cholarngitis
Recurrent cholangitis, jaundice
69
what are the treatment options for primary cholangitits
Liver Tx, Biliary stents
70
who receives a 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
71
what are contraindications for a transplant
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
72
how are patients prioritised with cirrhosis
Child’s Pugh scoring A, B and C MELD score ( Bilirubin, Creatinine and INR) UKELD( Bilirubin, Sodium, Creatinine and INR)
73
what type of surgery is a liver transplant
orthotopic
74
what makes up post operative treatment for a liver transplant
Post operative ICU care Multidisciplinary care Prophylactic antibiotics and anti-fungal drugs Anti-rejection drugs Steroids Azathioprine Tacrolimus/Cyclosporine

Alimentary System (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions