Path 8 Enzyme & Hepatitis

Question 1

3 lab tests for hepatocyte function

Answer 1

• Serum albumin
• PT time
• Serum ammonia

Question 2

3 lab tests for hepatocyte injury

Answer 2

• AST
• ALT
• LDH

Question 3

Test for biliary excretory function

Answer 3

• Serum bilirubin

- Alkaline phosphatase -> GGT

Question 4

Specific for liver damage

Answer 4

ALT

Question 5

Elevated AST with normal ALT

Answer 5

-MI, pericarditis, muscle disease

Question 6

Alcoholic hepatitis lab

Answer 6

AST:ALT > 2

Question 7

Viral hepatitis lab

Answer 7

AST:ALT < 1

Question 8

Toxin lab

Answer 8

Extremely high AST

Question 9

Alkaline phosphatase - other diseases

Answer 9

• Bone disease
• Hyperthyroidism
• CHF

Question 10

GGT

Answer 10

Gamma-glutamyl transferase

-follow AlkPhosph

Question 11

Unconjugated hyperbilirubinemia (4 causes)

Answer 11

• Hemolysis
• Cirrhosis (blood shunting)
• Gilbert’s syndrome
• Crigler-Najjar syndrome

Question 12

Conjugated hyperbilirubinemia (3 causes)

Answer 12

• Dubin-Johnson syndrome
• Hepatitis
• Mechanical obstruction

Question 13

Decreased albumin causes

Answer 13

• End-stage liver disease

- Edema and ascites

Question 14

Prothrombin Time

Answer 14

• Increased in cirrhosis

- Doesn’t correct with vit. K

Question 15

Hepatorenal syndrome

Answer 15

-Severe chronic liver disease -> decreased blood flow to kidney

Question 16

Hepatic encephalopathy

Answer 16

• Asterixis

- Hyperactive reflexes

Question 17

Nutmeg liver

Answer 17

Chronic passive congestion (R heart failure)

Question 18

Budd-Chiari syndrome

Answer 18

• Hepatic vein thrombosis -> fatal

- Tx with portosystemic venous shunt

Question 19

Budd-Chiari syndrome causes (5)

Answer 19

• Polycythemia vera
• Hepatocellularcarcinoma
• Pregnancy
• Oral contraceptives
• Paroxysmal nocturnal hemoglobinuria

Question 20

Sinusoidal Obstruction Syndrome

Answer 20

• 20 to 30 days after bone marrow transplantation

- Toxic injury to sinusoidal endothelium -> thrombi -> hepatic vein fibrosis

Question 21

Hepatitis A

Answer 21

• RNA
• fecal-oral
• Acute only
• No cancer risk

Question 22

Hepatitis B

Answer 22

• dsDNA
• parenteral
• Acute (portal, lobar inflammation)
• 10% chronic (ground glass hepatocytes)

Question 23

Hepatitis C

Answer 23

• ssRNA
• parenteral, vertical
• Chronic -> cirrhosis -> liver transplantation
• Mild steatosis, scattered dead hepatocytes

Question 24

Hepatitis D

Answer 24

• RNA, needs Hep B
• parenteral
• Coinfection mild (5% chronic)
• Superinfection severe (80% chronic)

Question 25

Hepatitis E

Answer 25

• ssRNA
• waterborne
• Self limited unless Pregnant Female

Question 26

Oral-fecal hepatitis

Answer 26

HAV, HEV

Question 27

Most common Fulminant hepatitis

Answer 27

HBV

Question 28

Hepatitis that doesn’t cause carcinoma

Answer 28

HAV

Question 29

Hepatitis immunization

Answer 29

HAV, HBV, HDV

Question 30

Autoimmune hepatitis

Answer 30

• T cell mediated
• Hypergammaglobulinemia (elevated IgG)
• High autoantibody titers

Question 31

Autoimmune hepatitis histo

Answer 31

-Plasma cells (more cytoplasm than lymphocytes)

Question 32

Autoimmune hepatits prognosis

Answer 32

• Fatal w/o Tx

- Normal w/prednisone Tx