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Alimentary System > Liver Symposium > Flashcards

Liver Symposium Flashcards

1
Q

What is the transmission for hepatitis A?

A

Faecal-oral

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2
Q

Where is prevalence for hepatitis A high?

A

In areas with poor sanitation

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3
Q

Regarding to HAV what does elevated IgM suggest?

A

Acute infection

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4
Q

Regarding HAV what does elevated IgG suggest?

A

Chronic infection

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5
Q

Give examples of groups that should be immunised against hepatitis

A 
Travellers 
Patients with chronic liver disease
Haemophiliacs 
Occupational exposure 
Men who have sex with men
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6
Q

What does the presence of HBsAg indicate?

A

Presence of the virus

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7
Q

Does the presence of HBsAg suggest active or non-active replication?

A

Can be either

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8
Q

What does the presence of HBV e antigen suggest?

A

Active replication

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9
Q

What does the presence of HBV DNA suggest?

A

Active replication

Because you find the physical DNA of the virus

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10
Q

What does Anti-HBs in the blood suggest?

A

Protection against HBV

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11
Q

What does the presence of IgM anti-HBc suggest?

A

Acute infection

Acquired within the last 6 months

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12
Q

What does the presence of IgG anti-HBc suggest?

A

Chronic infection/exposure to HBV

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13
Q

What does Anti-HBe suggest?

A

That the virus is inactive

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14
Q

What is key for the treatment of HBV?

A

Prevention

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15
Q

What prevention methods are there for HBV?

A

Immunisation
Safe sex
Using gloves (lab workers)
Avoidance of sharing IV drug abuse

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16
Q

What are the 3 stages of HBV infection?

A

Replicative stage in which levels of HBV are high and liver damage is being cause
Inflammatroy phase where aminotransferases are elevated, liver biopsy shows chronic infection but replication declines
Patients amy enter inactive phase where viral replication has stopped and there is no ongoing liver inflammation

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17
Q

Do all cases of HBV progress to liver cirrhosis?

A

No

in most cases hepatitis B does not progress

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18
Q

Is progression to chronic hepatitis more prominent in the HCV or HBV?

A

HCV

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19
Q

What % of HCV progresses to chronic infection?

A

85%

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20
Q

What are the symptoms of HCV?

A

Mostly asymptomatic until cirrhotic

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21
Q

What % of chronic HCV progresses to liver cirrhosis?

A

20%

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22
Q

What is the route of infection of HCV?

A

Blood-blood

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23
Q

What is HDV a parasite of?

A

Hep B

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24
Q

Why is Hep D considered to be a satellite virus?

A

Because it needs the host to be infected with Hep B also

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25
Q

Is Hep D + Hep B easy to treat?

A

No it is very resistant to treatment

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26
Q

How is hepatitis B spread?

A

Blood-blood

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27
Q

What is the transmission route for hepatitis E?

A

Faecal-oral

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28
Q

Is there a vaccination for HEV?

A

No

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29
Q

What is co-infection?

A

When HBV and HDV infect at the same time

30
Q

What is super-infection?

A

When HDV infects sometime after HBV has infected

31
Q

Rx HBV

A

Pegylated interferon

Oral antiviral drugs:
Lamivudine
Adefovir
Entecavir

32
Q

Is there a vaccine for HBV?

A

Yes

33
Q

Is there a vaccine available for HCV?

A

No

34
Q

What is the treatment for hep C?

A

Pegylated interferon

Ribavirin

35
Q

What is the treatment for Hep B?

A

Oral antiviral drugs
e.g lamivudine
Pegylated interferon

36
Q

What are the 5 main viruses that cause viral hepatitis?

A

A,B,C,D and E

37
Q

Which viruses are enteric viruses?

A

A and E

38
Q

What is meant by enteric viruses?

A

Food, water, faecal and oral transmission

39
Q

What is meant by a parental virus?

A

Transmission method is by the blood

40
Q

Which viruses are acute viruses?

A

A and E

41
Q

Which hepatitis viruses can become chronic?

A

B,C and D

42
Q

How does HAV present?

A

Fever
high liver enzymes
Diagnosis made by detecting certain antibodies in the blood

43
Q

What is the diagnostic test for HCV?

A

Test for HCV antibody

44
Q

Is there any vaccine available for HEV?

A

No

45
Q

Who is NAFLD common in?

A 
Those with:
DM
Obesity 
Hypertriglyceridemia 
Hypertension
46
Q

What are the other risk factors for NAFLD?

A

Age
ethnicity
Genetic factors

47
Q

What are the 3 types of autoimmune liver diseases?

A

Autoimmune hepatitis
Primary biliary cholangitis
Primary sclerosing cholangitis

48
Q

Is autoimmune hepatitis more common in M or F?

A

F

49
Q

Which antibody is elevated in autoimmune hepatitis?

A

IgG

50
Q

How is autoimmune hepatitis diagnosed?

A

Liver biopsy

and antibody testing

51
Q

How is autoimmune hepatitis treated?

A

With steroids

52
Q

Which gender is predominantly affected with primary biliary cholangitis?

A

F

53
Q

Which antibody is elevated in primary biliary cholangitis?

A

IgM

54
Q

What would be seen on liver biopsy in primary biliary cholangitis?

A

Inflammation around the bile ducts

55
Q

Which bile ducts are affected in primary biliary cholangitis?

A

Intrahepatic bile duct

56
Q

What symptoms are common in primary biliary cholangitis?

A

Pruritus and fatigue

57
Q

How does primary biliary cholangitis affect the liver?

A

The bodies immune system attacks the intrahepatic biliary tree

58
Q

How does primary sclerosing cholangitits `ffect the liver?

A

The bodies immune system attacks the intra and extra hepatic bile cuts

59
Q

What can primary sclerosing C. cause?

A

Jaundice

60
Q

What are the reasons for liver transplantation?

A

Chronic liver disease
Hepatocellular carcinoma
Acute liver failure
Genetic diseases

61
Q

What are contraindications for liver transplant?

A 
Active extra hepatic malignancy 
Active substance or alcohol abuse 
Brain death 
Technical/anatomical barriers 
Active and uncontrolled infection outside the hepatobiliary system Severe cardiopulmonary or other comorbid conditions
62
Q

What scores are used to prioritise those with cirrhosis that are suitable for transplantation?

A

MELD score

UKELD score

63
Q

What are some components of post-operative treatment of liver transplantation?

A

Post operative ICU care
Multidisciplinary care
Prophylactic antibiotics and anti-fungal drugs
Anti rejection drugs

64
Q

Give an example of an anti- rejection drug?

A

Steroids
Azathioprine
Tacrolimus

65
Q

What is the gold standard for HCV diagnosis?

A

HCV RNA PCR

66
Q

What is autoimmune hepatitis?

A

Chronic autoimmune disease of the liver

67
Q

Hows does autoimmune hepatitis come about?

A

When abnormal T cells and antibodies direct attack against hepatocyte surface antigens

68
Q

What classifies type 1 AIH?

A

ANA and SMA antibodies

69
Q

What classifies type 2 AIH?

A

LKM1 antibodies

70
Q

What classifies type 3 AIH?

A

SLA antibodies

71
Q

Investigations for AIH?

A 
Antibodies:
ANA
SMA 
LKM1
SLA 
IgG

LFTs

Liver biopsy

72
Q

RX AIH?

A

Prednisolone (steroid)
Azathioprine (immunosuppressant)
Liver Tx

Alimentary System (29 decks)

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