Liver Symposium Flashcards
What types of viruses are enteric viruses?
Hep A and E
What type of viruses are parenteral viruses?
Hep B, C and D
What the types of viruses that cause self limiting acute infections?
Hep A and E
What are the types of viruses that cause chronic disease?
Hep B, C and D
What are the types of transmission for hepatitis A?
Faecal - oral
Sexual
Blood
How is acute disease from hep A diagnosed?
IgM antibodies
What groups of people are more at risk of Hep A virus?
Travellers Patients with chronic liver disease Haemophiliacs Occupational exposure - lab workers Men who have sex with men
What HBV antigens suggest presence of hep B virus?
Hepatitis surface antigen (HBsAG)
What HBV antigens suggest active replication of hep B virus? + which one is not detected in blood
Hepatitis e antigen (HBeAg)
Hepatitis core antigen (HBcAg) - not detected in blood
HBV DNA
Which antibody shows protection against hep B virus?
Anti-HBs
What antibody shows acute infection of hep B?
IgM anti-HBc
What antibody shows chronic infection/exposure of hep B?
IgG anti-HBc
What antibody shows inactive hep B virus?
Anti-HBe
What are the treatment options for HBV?
Pegylated interferon
Oral antiviral drugs
What is HDV?
Small RNA virus enveloped by HBsAg
How does HDV occur?
As co-infection or super-infection with HBV. Transmission the same as HBV
What 3 entities are covered under non-alcohol fatty liver disease?
Simple steatosis
Non-alcoholic steatohepatitis
Fibrosis and cirrhosis
What are the risk factors of NAFLD?
Diabetes mellitus Obesity Hypertrigylceridemia Hypertension Age Ethnicity (e.g. hispanics) Genetic (e.g. PNPLA3 gene)
What tests are used to diagnose NAFLD?
AST/ALT ratio Enhanced liver fibrosis panel Cytokeratin-18 USS Fibroscan MR/CT MR spectroscopy Liver biopsy
What is the treatment options for NAFLD?
Diet and weight reduction Exercise Insulin sensitisers Glucagon-like peptide-1 analogues Farnesoid X nuclear receptor ligand Vitamin E Surgery (weight reduction)
What are the 3 types of antibodies in autoimmune hepatitis?
Type 1: ANA, SMA
Type 2: LKM1
Type 3: SLA
What is the treatment for autoimmune hepatitis?
Responds well to steroids
Long term azathioprine
Which immunoglobulin is elevated in autoimmune hepatitis?
IgG
Which immunoglobulin is elevated in primary biliary cholangitis?
IgM
What are common symptoms of primary biliary cholangitis?
Pruritus
Fatigue
What is the treatment for primary biliary cholangitis?
UDCA
What are the results of pANCA test in primary sclerosing cholangitis?
Positive pANCA
Which ducts are involved in primary sclerosing cholangitis?
Intra + extrahepatic bile ducts
What test is done for primary sclerosing cholangitis?
MRCP
What are the treatments for primary sclerosing cholangitis?
Liver therapy
Biliary stents
What cases is transplant considered?
Chronic liver disease w/ poor prognosis or poor quality of life
Hepatocellular carcinoma
Acute liver failure
Genetic disease
When is liver transplant not considered?
Active extrahepatic malignancy
Hepatic malignancy with macrovascular or diffuse tumour invasion
Active + uncontrolled infection outside hepatobliary system
Substance/alcohol abuse
Cardiopulmonary/other comorbid conditions
Psychosocial factors
Brain death
What is the post-op treatment for transplant?
ICU care
Multidisciplinary care
Prophylactic antibiotics and antifungal drugs
Anti-rejection drugs (steroids, azathioprine, tacrolimus/cyclosporine)
