Liver symposium: viral, alcoholic, transplant Flashcards

1
Q

what types of hepatitis are enteric ?

A

A

E

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2
Q

what types of hepatitis are parenteral ?

A

B
C
D

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3
Q

what types of hepatitis are self limiting ?

A

A

E

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4
Q

what types of hepatitis can cause chronic disease ?

A

B
C
D

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5
Q

how is hep A transmitted ?

A

faecal-oral
sexual
blood

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6
Q

how does hep A present ?

A

usually asymptomatic

acute disease diagnosed by IgM bodies

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7
Q

who is offered immunisation for hep A ?

A
travellers 
patients with CLD
haemophiliacs
occupational risk - lab workers
MSM
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8
Q

what is a complication of hep B infection ?

A

can lead to cirrhosis

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9
Q

what is the treatment for hep B ?

A

interferons and antivirals

lamivudine, adefovire, entocuvir, telbivudine, tenofovir

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10
Q

what does the IgM anti-HBc antibody show in hep B ?

A

acute infection

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11
Q

what does the IgG anti-HBc antibody show in hep B ?

A

chronic infection

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12
Q

what does the anti-HBe antibody show in hep B?

A

inactive virus

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13
Q

how does hep C present ?

A

mostly asymptomatic until cirrhosis

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14
Q

how is hep C treated ?

A

interferons and antivirals

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15
Q

when is hep D usually seen in infection ?

A

co-infection with hep B

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16
Q

what does hep E commonly cause ?

A

acute hepatitis

17
Q

what conditions does non-alcoholic fatty liver disease encompass ?

A

simple steatosis
non alcoholic steatohepatitis
fibrosis and cirrhosis

18
Q

what is NAFLD associated with ?

A

diabetes
obesity
hypertriglyceridemia
hypertension

19
Q

how is NAFLD diagnosed ?

A
biochemical test: AST/ALT ratio
enhanced liver fibrosis panel (ELF)
cytokeratin-18
USS
fibroscan
MRI/CT
MR spectroscopy
liver biopsy
20
Q

what constitutes a high risk score for NAFLD ?

A
age > 45
diabetic
BMI > 30
AST:ALT >1
platelet count low <150
albumin low <34
21
Q

what is the treatment for NAFLD ?

A
diet and weight reduction
exercise
insulin sensitisers
GLP-1 analogues
fanesoid X nuclear receptor ligand
vitamin E
weight reduction surgery
22
Q

what are examples of autoimmune liver disease ?

A

autoimmune hepatitis
primary biliary cholangitis
primary sclerosing cholangitis

23
Q

what is a blood feature of autoimmune hepatitis ?

A

elevated IgG

24
Q

how is autoimmune hepatitis diagnosed ?

A

liver biopsy

25
what is the treatment for autoimmune hepatitis ?
responds to steroids | long term azathioprine
26
what is a blood feature of primary biliary cholangitis ?
elevated IgM | anti-mitochondrial antibody positive
27
how does primary biliary cholangitis present ?
pruritus | fatigue
28
what is the treatment for primary biliary cholangitis ?
UDCA - ursudiol
29
what is primary sclerosing cholangitis ?
inflammation and stricture/fibrosis of biliary ducts | unknown aeitology but associated with men with UC
30
how is PSC diagnosed ?
MRCP
31
what are clinical features of PSC ?
recurrent cholangitis | jaundice
32
what is the treatment fro PSC ?
liver transplant | biliary stent
33
who is eligible for liver transplant ?
``` CLD with poor prognosis CLD with poor quality life hepatocellular carcinoma acute liver failure genetic disease ```
34
what are contraindications for a liver transplant ?
``` extra hepatic malignancy microvascular/diffuse tumour invasion active/uncontrolled extra hepatic infection active substance/alcohol abuse comorbidity psychosocial factors technical/anatomical factors brain death ```
35
what are three different scores for liver transplantation ?
Child's Pugh score MELD score UKELD
36
what is needed for post-op care of a liver transplant
ICU MDT antibiotics and antifungals anti-rejection drugs - steroids azathioprine, cyclosporin