liver symposium

Question 1

which hepatitis infections are enteric - transmitted by contact or digestion

Answer 1

A and E

Question 2

Which hepatitis viruses are parenteral viruses - transmitted through skin penetration

Answer 2

B,C and D

Question 3

Which hepatitis viruses are self limiting

Answer 3

A and E

Question 4

Which hepatitis lead to chronic disease

Answer 4

B,C and D

Question 5

Which hepatitis lead to cirrhosis

Answer 5

B and C

Question 6

What does IgM show in Hep A

Answer 6

If the patient currently has the disease

Question 7

What does IgG show in patient with hepatitis A

Answer 7

if the patient has had it in the past

Question 8

What age group commonly gets Hep A

Answer 8

5-14 years old

Question 9

Who is given the HAV - Hep A vaccine

Answer 9

• Travellers
• Patients with chronic liver disease
• haemophiliacs - cant clot blood
• occupational exposure
• Gay men

Question 10

What does positive HBsAG mean

Answer 10

Active infection

Question 11

What does HBeAg positive mean

Answer 11

Chronic active

Question 12

What does HBeAg negative mean

Answer 12

Chronic inactive

Question 13

What does Anti-HBs positive mean

Answer 13

Cleared the infection before or is vaccinated

Question 14

What does IgM anti-HBc mean

Answer 14

Acute infection

Question 15

What does IgG anti HBC mean

Answer 15

Chronic infection

Question 16

What is the most common oral therapy used for hepatitis B

Answer 16

Tenofovir - side effect of renal toxicity

Question 17

Describe hep C virus

Answer 17

Most asymptomatic until cirrhosis with normal LFT’s

Question 18

Describe Hep D virus

Answer 18

Co-infection or super infection with HBV - hep B virus

Very resistant to treatment

Question 19

What is the commonest cause of acute hepatitis in grampian

Answer 19

Hep E

Question 20

Describe the NAFLD score

Answer 20

Age >45 high risk
Diabetes - high risk
BMI>30 high risk
AST:ALT>1 - high risk
Platelets <150 high risk
Albumin <34 high risk

Question 21

What is the treatment for NAFLD - non-alcoholic fatty liver disease

Answer 21

Diet and weight reduction
Excercis
Metformin
GLP1 analogues - liraglutide
Vitamin E

Question 22

How is autoimmune hepatitis diagnosed

Answer 22

Liver biopsy
High IgG

Question 23

What is the treatment for autoimmune hepatitis

Answer 23

Long term azathioprine - immunosupressant

Question 24

Describe features of primary biliary cholangitis

Answer 24

Female mainly
IgM elevates
Anti-mitochondrial antibody positive (AMA)
Intrahepatic bile duct involved

Question 25

What is the main treatment for primary biliary cholangitis

Answer 25

UDCA - ulcodeoxycolic acid is the main treatment - good bile acid which helps the bile flow

Question 26

Describe features of primary sclerosing cholangitis

Answer 26

Male mainly
pANCA positive
Intra and extra-hepatic ducts involved
MRCP used to investigate
it is a stricturing disease

Question 27

Who gets given a transplant

Answer 27

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

Question 28

What are contraindications for transplant

Answer 28

Active extrahepatic malignancy
Active infection
Active substance or alcohol abuse
Brain death

Question 29

What is the current liver transplant done

Answer 29

Orthotopic liver transplant - transplant liver is moved exactly to where the original liver was from