Liver Symposium Flashcards

1
Q

Hep A & E?

A

enteric viruses

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2
Q

Hep B, C & D?

A

parenteral viruses

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3
Q

Hep A & E?

A

self-limiting acute infections

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4
Q

Hep B, C and D?

A

chronic disease

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5
Q

Hep A?

A
Occurs sporadically or in epidemic form 
Transmission: faecal, sexual, blood 
5-14yrs commonest group
Asymptomatic disease cases very common
Acute disease diagnosed by IgM antibodies
Patients with chronic liver disease
Haemophiliacs 
Occupation exposure: lab workers
Men who have sex with men (MSM)
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6
Q

Hep B?

A

Hepatitis surface antigen (HBsAG) = presence of virus
Hepatitis e antigen (HBeAg) = active replication
Hepatitis core antigen (HBcAg) = active replication not detected in blood
HBV DNA = active replication
Drugs: Lamivudine, Adefovir

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7
Q

Hep C?

A

Rarely causes acute liver failure
Most asymptomatic until cirrhotic
May have normal LFTs
Drugs: Ledipasvir, ABT-333

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8
Q

Hep D?

A

Small RNA virus, does not code for its own protein coat, enveloped HBsAg
Co-infection or super-infection with HBV
Transmission as for HBV
Very resistant to treatment

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9
Q

Hep E?

A

Previously thought to be limited to tropical countries – increasing in UK
COMMONEST cause of acute hepatitis in Grampian
Self-limiting, no long term sequelae
No specific treatment and no effective vaccine currently

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10
Q

What can non-alcoholic fatty liver disease be?

A

simple steatosis
non-alcoholic steatohepatitis
fibrosis and cirrhosis

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11
Q

what is NAFLD associated with?

A

metabolic syndrome

DM, obesity, hypertension

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12
Q

Diagnosis of NAFLD?

A
biochemical AST/ALT ratio?
enhanced liver fibrosis panel
US
fibroscan
MR/CT
Liver biopsy
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13
Q

Treatment of NAFLD?

A
diet and weight reduction
excercise
insulin sensitisers (metaformin)
GLP-1 analogues
vitamin E
weight reduction surgeries
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14
Q

Autoimune hepatits?

A
Female predominant 
Elevated IgG
Three antibody types: 1: ANA, SMA. 2: LKM1. 3: SLA
Liver biopsy diagnostic
Responds well to steroids
Long term azathioprine
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15
Q

Primary biliary cholangitis?

A
Female predominant
IgM elevated
Anti-mitochondrial antibody positive 
Intrahepatic bile duct involved
Pruritis and fatigue common
UDCA treatment of choice
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16
Q

Primary sclerosis cholangitis?

A
Male predominant 
pANCA positive 
Intra and extrahepatic bile ducts involved
Stricturing disease
MRCP test of choice
Recurrent cholangitis, jaundice
Liver tx, Biliary stents