More stuff Flashcards
What is elev in acute HAV
ALT/AST
HAV-Ab (specifically IgM antibody)
what do you look at for past HAV infxn and imm?
HAV-Ab (Total, so IgG, IgM, IgA)
WHat do you check for HBV
HBsAg, HBcAg, HbeAg [“SpECies”]
HBv Acute
HBsAg,
IgM Anti- HBc
hbv chronic active
HBsAg
IgG anti-HBc
HBeAg
hbv chronic carrier
HBsAg,
IgG anti-HBc,
IgG anti-Hbe
hbv resolved
IgG anti-HBc,
IgG anti-HBs,
IgG anti-Hbe
hbv vaccine
IgG anti-HBs
HCV-Ab (IgG)
– In high risk population
– Antibodies to 1/4 viral proteins
– Current, convalescent, or old HCV infection
– behaves more like IgM or “total” Ab than usual IgG Ab
– May take upto 6 months to be positive after acute exposur
HCV RIBA (recombinant immunoassay)
– Low risk population
– Confirmatory test for patient with positive HCV- Ab
HCV RNA (Quantitative & Qualitative)
– PCR
– Confirmatory
– Quantitative measurements for establishing response to therapy
HDV superinfection vs coinfection
superinfectino where you have hbv then get hdv is more severe, fulm hep dis
Acute Hepatitis Panel
- Hepatitis A Antibody, IgM
- Hepatitis B Core Antibody, IgM • Hepatitis B Surface Antigen
- Hepatitis C Antibody
Hepatitis Serology, Chronic Carrier
- Hepatitis Be Antibody
- Hepatitis B Surface Antigen • Hepatitis Be Antigen
- Hepatitis C Antibody
Mild elevations of AST AND ALT with severe liver dysfunction could indicate
Mitochondrial dysfunction ✦ Acute fatty liver of pregnancy ✦ Alcoholic hepatitis
✦ Reye’s syndrome
AST: ALT >2
alc hep (alc induces mito dmg and mito rel AST)
AST: ALT < 1 and <0.5
✦ < 0.5 ✦ NASH ✦ ALT > AST (helps differentiate alcoholic from Non-alcoholic steatohepatitis) ✦ < 1 ✦ Chronic viral hepatitis ✦ Extrahepatic biliary obstruction
PBC vs PSC intra vs extrahep?
PBC is intra, PSC is extrahepatic
when does GGT incr
drugs and alc enhancing p450, eg rif,
CAN be elev in acute pancreatitis
5-NT
establishes source of incr ALP (confirms its from the liver)
in addn to liver dmg, PT time can also be prolonged in
vitamin K def,
uunconj bili can be elev in
gilberts
rif
conj bili eelev in
dubin johnson
biliary obstruction
Classifying jaundice, based on whether conj, unconj, or mixed hyperbilirubinmeia
if conj (d.bili) is less than 20% of total (t.bili), this indicates its unconj jaundice–hemolysis etc
if conj is 20-50% of total, viral/alc hep
if conj is >50% total, it is conj jaundice, due to obstructino of bile
