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Alimentary system > Liver symposium: viral, alcoholic, transplant > Flashcards

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
Q

what is the treatment for autoimmune hepatitis ?

A

responds to steroids

long term azathioprine

26
Q

what is a blood feature of primary biliary cholangitis ?

A

elevated IgM

anti-mitochondrial antibody positive

27
Q

how does primary biliary cholangitis present ?

A

pruritus

fatigue

28
Q

what is the treatment for primary biliary cholangitis ?

A

UDCA - ursudiol

29
Q

what is primary sclerosing cholangitis ?

A

inflammation and stricture/fibrosis of biliary ducts

unknown aeitology but associated with men with UC

30
Q

how is PSC diagnosed ?

A

MRCP

31
Q

what are clinical features of PSC ?

A

recurrent cholangitis

jaundice

32
Q

what is the treatment fro PSC ?

A

liver transplant

biliary stent

33
Q

who is eligible for liver transplant ?

A 
CLD with poor prognosis
CLD with poor quality life
hepatocellular carcinoma
acute liver failure
genetic disease
34
Q

what are contraindications for a liver transplant ?

A 
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
Q

what are three different scores for liver transplantation ?

A

Child’s Pugh score
MELD score
UKELD

36
Q

what is needed for post-op care of a liver transplant

A

ICU
MDT
antibiotics and antifungals
anti-rejection drugs - steroids azathioprine, cyclosporin

Alimentary system (9 decks)

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