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GI PATHOLOGY > Liver Symposium > Flashcards

Liver Symposium Flashcards

1
Q

How are the hepatitis viruses broken down?

A

A + E - enteric, self limiting

B, C, D - parenteral, ?chronic

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2
Q

Which groups are immunised vs HAV?

A 
Travellers
Chronic liver disease Pts
Haemophiliacs
Occupational exposure
Gay men
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3
Q

What antigens are associated with HBV?

A

HBsAg
HBeAg
HBcAg

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4
Q

What antigen, when detected, tells of the presence of HBV?

A

HBsAg

Hepatitis surface antigen

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5
Q

What antigen, when detected, tells of active HBV replication?

A

HBeAg (e antigen)

HBV DNA

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6
Q

Finding HBeAg in the blood means what?

A

HBV is ACTIVE

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7
Q

Finding HBsAg in the blood means what?

A

Virus is PRESENT

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8
Q

IgM anti-HBc in blood is positive for what?

A

Acute infection

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9
Q

IgG anti-HBc is positive for what?

A

Chronic infection

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10
Q

Anti-HBe in blood is indicative of what?

A

Inactive virus

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11
Q

Hepatitis can progress to what?

A

Cirrhosis

End stage liver disease

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12
Q

What proportion of children to HBV positive mothers will have chronic HBV infection?

A

90%

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13
Q

What is the treatment for HBV?

A

Pegylated interferon

Oral Antivirals

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14
Q

What % of patients with HCV report acute jaundice?

A

10%

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15
Q

Why is HCV a more damaging virus?

A

RNA based

Reverse transcriptase

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16
Q

How is HAV diagnosed?

A

IgM fraction (serology)

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17
Q

How does HAV present?

A

Rapid onset illness

Jaundice

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18
Q

What is the treatment for HCV?

A

IFN-free direct-acting antivirals

PEG-IFNlambda

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19
Q

How does HDV survive?

A

In the HBV protein coat

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20
Q

What is the most common cause of acute hepatitis in Grampian?

21
Q

EBV and CMV are associated with what?

A

Mildly deranged LFTs in immunocompromised hosts

22
Q

NAFLD encompasses what diseases?

A

Simple steatosis
Non-alcoholic steatohepatitis
Fibrosis and cirrhosis

23
Q

NAFLD is associated with what?

A 
(Metabolic syndrome)
DM
Obesity
Hypertriglyceridemia
Hypertension
24
Q

What are the non-modifiable risk factors for NAFLD?

A

Age
Ethnicity
Genetic factors

25
Q

How is NAFLD diagnosed?

A 
AST/ALT
USS
MR/CT
ELF panel
MR Spectroscopy
BIOPSY
26
Q

What are the diagnostic high risk factors for NAFLD?

A 
Age > 45
DM+ve
Impaired fasting glucose > 7
BMI > 30
AST:ALT > 1
Low platelets
Low albumin
27
Q

What is the treatment for NAFLD?

A 
Diet/Weight loss
Exercise
Insulin sensitizers
GLP-1 analogues
Vitamin E
Weight loss surgery
28
Q

What are the autoimmune liver diseases?

A 
Autoimmune hepatitis
Primary Biliary cholangitis
Primary sclerosing cholangitis
IgG 4 disease
Autoimmune cholangiopathy
29
Q

How is Autoimmune hepatitis diagnosed?

A

Elevated IgG

Liver biopsy

30
Q

Is autoimmune hepatitis more common in men or women?

31
Q

How is Autoimmune hepatitis treated?

A

Steroids

Long term Azathioprine

32
Q

How is Primary Biliary cholangitis diagnosed?

A

IgM

Anti-mitochondrial antibody positive

33
Q

What are the symptoms of primary biliary cholangitis?

A

Pruritus

Fatigue

34
Q

How is primary biliary cholangitis treated?

A

UDCA

Ursodeoxycholic acid

35
Q

Primary biliary cholangitis is more common in men or women?

36
Q

Primary sclerosing cholangitis is more common in men or women?

37
Q

Primary biliary cholangitis involves which part of the biliary tree?

A

Intrahepatic bile ducts

38
Q

Primary sclerosing cholangitis involves which part of the biliary tree?

A

Intra and extrahepatic bile ducts

39
Q

How does Primary sclerosing cholangitis present?

A

Stricturing disease
Recurrent cholangitis
Jaundice

40
Q

How is Primary sclerosing cholangitis diagnosed?

41
Q

How is Primary sclerosing cholangitis treated?

A

Biliary stents

42
Q

Primary sclerosing cholangitis is associated with what?

A

Inflammatory bowel disease

43
Q

What are the contraindications for liver transplant?

A 
Active substance abuse
Metastases, invasion
Active infection
Psychosocial factors
Comorbidities
44
Q

How is acute liver failure classified?

A

Acetaminophen induced or not

45
Q

Nonacetaminophen induced ALF is listed for transplantation when?

A

INR > 6.5

Encephalopathy present

46
Q

How is liver cirrhosis prioritised?

A

Child’s Pugh scoring A, B, C
MELD score
UKELD score

47
Q

MELD score encompasses what?

A

Bilirubin
Creatinine
INR

48
Q

UKELD score encompasses what?

A

Bilirubin
Sodium
Creatinine
INR

GI PATHOLOGY (20 decks)

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