More stuff

Question 1

What is elev in acute HAV

Answer 1

ALT/AST

HAV-Ab (specifically IgM antibody)

Question 2

what do you look at for past HAV infxn and imm?

Answer 2

HAV-Ab (Total, so IgG, IgM, IgA)

Question 3

WHat do you check for HBV

Answer 3

HBsAg, HBcAg, HbeAg [“SpECies”]

Question 4

HBv Acute

Answer 4

HBsAg,

IgM Anti- HBc

Question 5

hbv chronic active

Answer 5

HBsAg
IgG anti-HBc
HBeAg

Question 6

hbv chronic carrier

Answer 6

HBsAg,
IgG anti-HBc,
IgG anti-Hbe

Question 7

hbv resolved

Answer 7

IgG anti-HBc,
IgG anti-HBs,
IgG anti-Hbe

Question 8

hbv vaccine

Answer 8

IgG anti-HBs

Question 9

HCV-Ab (IgG)

Answer 9

– 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

Question 10

HCV RIBA (recombinant immunoassay)

Answer 10

– Low risk population

– Confirmatory test for patient with positive HCV- Ab

Question 11

HCV RNA (Quantitative & Qualitative)

Answer 11

– PCR
– Confirmatory
– Quantitative measurements for establishing response to therapy

Question 12

HDV superinfection vs coinfection

Answer 12

superinfectino where you have hbv then get hdv is more severe, fulm hep dis

Question 13

Acute Hepatitis Panel

Answer 13

• Hepatitis A Antibody, IgM
• Hepatitis B Core Antibody, IgM • Hepatitis B Surface Antigen
• Hepatitis C Antibody

Question 14

Hepatitis Serology, Chronic Carrier

Answer 14

• Hepatitis Be Antibody
• Hepatitis B Surface Antigen • Hepatitis Be Antigen
• Hepatitis C Antibody

Question 15

Mild elevations of AST AND ALT with severe liver dysfunction could indicate

Answer 15

Mitochondrial dysfunction ✦ Acute fatty liver of pregnancy ✦ Alcoholic hepatitis
✦ Reye’s syndrome

Question 16

AST: ALT >2

Answer 16

alc hep (alc induces mito dmg and mito rel AST)

Question 17

AST: ALT < 1 and <0.5

Answer 17

✦  < 0.5 ✦  NASH
✦ ALT > AST (helps differentiate alcoholic from Non-alcoholic steatohepatitis)
✦  < 1
✦  Chronic viral hepatitis
✦  Extrahepatic biliary obstruction

Question 18

PBC vs PSC intra vs extrahep?

Answer 18

PBC is intra, PSC is extrahepatic

Question 19

when does GGT incr

Answer 19

drugs and alc enhancing p450, eg rif,

CAN be elev in acute pancreatitis

Question 20

5-NT

Answer 20

establishes source of incr ALP (confirms its from the liver)

Question 21

in addn to liver dmg, PT time can also be prolonged in

Answer 21

vitamin K def,

Question 22

uunconj bili can be elev in

Answer 22

gilberts

rif

Question 23

conj bili eelev in

Answer 23

dubin johnson

biliary obstruction

Question 24

Classifying jaundice, based on whether conj, unconj, or mixed hyperbilirubinmeia

Answer 24

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

Question 25

jaundice and urine bili levels

Answer 25

only CONJ bili is in urine.
So if there is NO bili in urine, this means there is no conj bili, so bili isn’t getting conj, therefor its a blood issue

Question 26

What if no urobilinogen in urine?

Answer 26

means bile duct obstruction! bc conj billi normally gets conv to uro

Question 27

which ig will increase in chronic liver dis

Answer 27

IgG

Question 28

which ig will increase in alc cirr

Answer 28

igG and IgA

Question 29

what will incr in autoimm hep?

Answer 29

ANA

Question 30

what does incr CEA (from stomach, pancr, bowel) mean

Answer 30

what will be incr in metastatic liver cancer?

Question 31

what does incr in alpha fetoprot mean?

Answer 31

HCC!