Liver symposium Flashcards

1
Q

What 5 main viruses cause viral hepatitis?

A

A,B,C,D,E

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2
Q

What 2 hepatitis viruses are enteric? Suggest how they may spread and their duration

A

A+E

faecal-oral, self limiting

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3
Q

What 3 hepatitis viruses are parenteral? Suggest how they may spread and their duration

A

B,C,D

blood, chronic

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4
Q

What is hepatitis A infection most commonly due to?

A

Waste management and disposal

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5
Q

What age is common for hep A infection and what can patients often present with?

A

young –> 5-14

jaundice

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6
Q

Who would be immunised for hepatitis A?

A

travellers - Africa, Asia

patients with chronic liver disease

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7
Q

How would you diagnose hepatitis A?

A

IgM antibodies

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8
Q

In hepatitis B what is the difference between the core antigen and E antigen?

A

E antigen - blood

core - liver

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9
Q

What does the hep B surface antigen tell us?

A

presence of virus - not active or inactive however

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10
Q

What do anti-hb antibodies tell us?

A

protection

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11
Q

What do IgM anti-HBc tell us?

A

acute infection

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12
Q

What do IgG anti-HBc tell us?

A

chronic infection

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13
Q

What do anti-HBe tell us?

A

inactive

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14
Q

What can be the 2 outcomes of chronic hep B?

A

no further damage

cirrhosis leading to cancer/end stage liver disease

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15
Q

Name 2 treatments for hepatitis B

A

adefovir - antiviral drugs

PEG interferon

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16
Q

Is hepatitis C an RNA or DNA virus?

A

RNA

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17
Q

What percentage of infected cases are chronic in hep C?

18
Q

What must be present for hepatitis D?

19
Q

Where does hepatitis E come from?

A

infected pork meat, animals, tropical

20
Q

What are the 3 entities of NAFLD?

A

steatosis
non alcoholic steatohepatitis
firbrosis + cirrhosis

21
Q

What is NAFLD associated with?

A

diabetes, obesity, hypertension, hypertriglyceridemia

22
Q

What are risk factors for NAFLD?

A

age, ethnicity, genetics

23
Q

List some diagnostic tests for NAFLD

A

biopsy, AST/ALT ratio, ELF, MR, fibroscan, ultrasound, cytokeratin 18

24
Q

What is the NAFLD score and what is it used for?

A

based on parameters such as BMI, age, blood test and help to decide treatment

25
Treatment for NAFLD?
diet, exercise, weight loss | insulin sensitizers
26
What are the main 3 autoimmune liver diseases?
autoimmune hepatitis PBC PSC
27
What is cholangitis?
infection of the bile duct which tends to occur if gallstones are present
28
Compare autoimmune hepatitis and PBC with the elevation of IgG and IgM
ah - IgG | PBC - IgM
29
What 2 autoimmune liver diseases are female predominant?
autoimmune hepatitis and PBC
30
How is autoimmune hepatitis diagnosed and treated?
biopsy | steroids, azathioprine
31
What antibody is diagnostic for PBC?
anti-mitochondrial
32
What is used to treat PBC?
UDCA
33
What antibody is positive in PSC?
pANCA
34
Compare PBC and PSC with the bile ducts involved
PSC invove intra and extra | PBC intra
35
What may be needed for PSC? Why?
liver transplant | structuring and narrowing
36
What are some indications for liver transplant?
CLD, cancer, active failure
37
What is a contraindication for liver transplant?
malignancy spread, alcohol and drug use
38
What scores are used to decide who gets a transplant first?
MELD, UKELD
39
What treatment is give post transplant?
ICU, steroids, cyclosporine, antibiotics
40
What does orthotopic mean?
In the same place - liver is put in same place as the old one