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GI AM > Liver symposium > Flashcards

Liver symposium Flashcards

1
Q

What is viral hepatitis caused by?

A

A, B= enteric viruses

C, D, E= parenteral viruses

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2
Q

What hepatitis viruses cause acute infections?

A

A, E

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3
Q

What hepatitis viruses cause chronic disease?

A

B, C, D

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4
Q

Where is Hep A prominent?

A

Developing countries and Greenland

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5
Q

How is Hep A transmitted?

A

Faecal oral
Sexual
Blood

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6
Q

What is the most common presentation of Hep A?

A

Asymptomatic

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7
Q

How is acute Hep A diagnosed?

A

By IgM antibody presence

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8
Q

Who is given immunisation against Hep A?

A 
Travellers
Patients with chronic liver disease
Haemophiliacs
Occupational exposure i.e. lab
Men who have sex with men (MSM)
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9
Q

What is the typical timespan of Hep A?

A

Presentation 2 weeks after infection
Viremia gone by 6 weeks post infection
Clinical illness lasting 8 weeks post infection

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10
Q

What is the structure of the Hep B virus?

A

Inner protein core with antigen enclosing DNA

Outer lipid envelope containing surface antigen

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11
Q

What antigens are expressed from HBV?

A

HBeAg
HBcAg
HBsAg

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12
Q

What is the HBeAg and what does it do?

A

Antigen that is a sign of active replication

Iterferes with host immune system and prevents them from attacking the virus

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13
Q

What is HBsAg used to detect?

A

Presence of hep B virus, rather than activity

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14
Q

What is HBcAg used to detect and where is it found?

A

Active replication of HV

Only found in liver

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15
Q

What antibodies launch a response against HBV?

A

IgM
IgG
Anti HBe
Anti HBs

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16
Q

What is IgM presence used to detect in HBV?

A

If the virus has been acquired in the last 6 months

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17
Q

What does IgG indicate in HBV?

A

Chronic infection

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18
Q

What is the usual progression of HBV?

A

No progression from chronic virus

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19
Q

What can HBV progress onto?

A

Cirrhosis
Hepatocellular carcinoma
End stage liver disease

20
Q

How does Hep C progress?

A

15% resolution
70% live with chronic
15% progress to cirrhosis, hepatocellular carcinoma and possible death

21
Q

How is HCV treated?

A

Direct acting antiviral oral drugs

22
Q

How is HCV diagnosed?

A

Test for the anti HCV antibody

23
Q

WHt is Hep D?

A

Small RNA virus that can co infect with HBV

24
Q

Why is HDV a confection with HBV?

A

HDV cannot support itself, it needs the HBV surface antigen

25
Q

How is hep B spread?

A

Blood, semen or other bodily fluids

26
Q

How is Hep D spread?

A

Blood, semen or other bodily fluids

27
Q

How does HDV infect with HBV?

A

Enveloped by the HB antigen

28
Q

What is hep E?

A

Self limiting virus

Most common cause of acute hepatitis in Grampian

29
Q

What is non alcoholic fatty liver disease>

A

Umbrella term encompassing simple steatosis, non alcohol steatohepatitis
Fibrosis and cirrhosis

30
Q

With is non alcoholic fatty liver disease associated with?

A

Diabetes mellitus
Obesity
Hypertriglyceridaemia
Hypertension

31
Q

What are th risk factors for non alcoholic fatty liver disease?

A

Age
Ethnicity
Genetic factors

32
Q

What is the natural progression of non alcoholic fatty liver disease?

A

Steatosis–>non alcohol steatohepatitis –> cirrhosis

33
Q

How is non alcoholic fatty liver disease diagnosed?

A

LFT
Ultrasound
Fibroscan
Biopsy

34
Q

How is non alcoholic fatty liver disease treated?

A

Improve insulin sensitivity i.e., weight loss, exercise
Treat risk factors i.e., diabetes, hypertension
Avoid excessive alcohol

35
Q

What are the types of autoimmune liver disease?

A

Autoimmune hepatitis
Primary biliary cholangitis
Primary sclerosis cholangitis

36
Q

What does autoimmune hepatitis cause?

A

Elevated IgG

37
Q

How is autoimmune hepatitis diagnosed and treated?

A

Liver biopsy

Long term azathioprine steroid

38
Q

What does primary biliary cholangitis cause?

A

Elevated IgM
positive antimicrobial antibody
Pruritus and fatigue

39
Q

What anatomical structure is involved in primary biliary choangitis?

A

Intrahepatic bile duct

40
Q

What does primary scleroid cholangitis cause?

A

pANCA positive
Stricturing
Recurrent cholangitis, jaundice

41
Q

What anatomical structures are involved in primary sclerosis cholangitis?

A

Intra and extra hepatic bile ducts

42
Q

When is a liver transplant considered for patients?

A

Chronic liver disease with poor predicted survival or quality of life
Hepatocellular carcinoma
Acute liver failure
Genetic diseases

43
Q

What are the contraindications for liver transplant?

A

Active extra hepatic malignancy
Active substance or alcohol abuse
Other comorbitities
Brain death

44
Q

What gets priority on the liver transplant list?

A

Acute liver failure

45
Q

What is the prioritisation method for liver transplant?

A

UKELD scores

46
Q

What kind of transplant is a liver transplant?

A

Orthotopic

47
Q

What treatment is given post liver transplant?

A

ICU
Antibiotics and antifungals
Antirejections

GI AM (34 decks)

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