liver symposium Flashcards
which hepatitis infections are enteric - transmitted by contact or digestion
A and E
Which hepatitis viruses are parenteral viruses - transmitted through skin penetration
B,C and D
Which hepatitis viruses are self limiting
A and E
Which hepatitis lead to chronic disease
B,C and D
Which hepatitis lead to cirrhosis
B and C
What does IgM show in Hep A
If the patient currently has the disease
What does IgG show in patient with hepatitis A
if the patient has had it in the past
What age group commonly gets Hep A
5-14 years old
Who is given the HAV - Hep A vaccine
- Travellers
- Patients with chronic liver disease
- haemophiliacs - cant clot blood
- occupational exposure
- Gay men
What does positive HBsAG mean
Active infection
What does HBeAg positive mean
Chronic active
What does HBeAg negative mean
Chronic inactive
What does Anti-HBs positive mean
Cleared the infection before or is vaccinated
What does IgM anti-HBc mean
Acute infection
What does IgG anti HBC mean
Chronic infection
What is the most common oral therapy used for hepatitis B
Tenofovir - side effect of renal toxicity
Describe hep C virus
Most asymptomatic until cirrhosis with normal LFT’s
Describe Hep D virus
Co-infection or super infection with HBV - hep B virus
Very resistant to treatment
What is the commonest cause of acute hepatitis in grampian
Hep E
Describe the NAFLD score
Age >45 high risk
Diabetes - high risk
BMI>30 high risk
AST:ALT>1 - high risk
Platelets <150 high risk
Albumin <34 high risk
What is the treatment for NAFLD - non-alcoholic fatty liver disease
Diet and weight reduction
Excercis
Metformin
GLP1 analogues - liraglutide
Vitamin E
How is autoimmune hepatitis diagnosed
Liver biopsy
High IgG
What is the treatment for autoimmune hepatitis
Long term azathioprine - immunosupressant
Describe features of primary biliary cholangitis
Female mainly
IgM elevates
Anti-mitochondrial antibody positive (AMA)
Intrahepatic bile duct involved
What is the main treatment for primary biliary cholangitis
UDCA - ulcodeoxycolic acid is the main treatment - good bile acid which helps the bile flow
Describe features of primary sclerosing cholangitis
Male mainly
pANCA positive
Intra and extra-hepatic ducts involved
MRCP used to investigate
it is a stricturing disease
Who gets given 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
What are contraindications for transplant
Active extrahepatic malignancy
Active infection
Active substance or alcohol abuse
Brain death
What is the current liver transplant done
Orthotopic liver transplant - transplant liver is moved exactly to where the original liver was from
