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?

A

85

18
Q

What must be present for hepatitis D?

A

hep B

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
Q

Treatment for NAFLD?

A

diet, exercise, weight loss

insulin sensitizers

26
Q

What are the main 3 autoimmune liver diseases?

A

autoimmune hepatitis
PBC
PSC

27
Q

What is cholangitis?

A

infection of the bile duct which tends to occur if gallstones are present

28
Q

Compare autoimmune hepatitis and PBC with the elevation of IgG and IgM

A

ah - IgG

PBC - IgM

29
Q

What 2 autoimmune liver diseases are female predominant?

A

autoimmune hepatitis and PBC

30
Q

How is autoimmune hepatitis diagnosed and treated?

A

biopsy

steroids, azathioprine

31
Q

What antibody is diagnostic for PBC?

A

anti-mitochondrial

32
Q

What is used to treat PBC?

A

UDCA

33
Q

What antibody is positive in PSC?

A

pANCA

34
Q

Compare PBC and PSC with the bile ducts involved

A

PSC invove intra and extra

PBC intra

35
Q

What may be needed for PSC? Why?

A

liver transplant

structuring and narrowing

36
Q

What are some indications for liver transplant?

A

CLD, cancer, active failure

37
Q

What is a contraindication for liver transplant?

A

malignancy spread, alcohol and drug use

38
Q

What scores are used to decide who gets a transplant first?

A

MELD, UKELD

39
Q

What treatment is give post transplant?

A

ICU, steroids, cyclosporine, antibiotics

40
Q

What does orthotopic mean?

A

In the same place - liver is put in same place as the old one