PATHOPHYS Flashcards
what are the only 2 hepatitis viruses that can cause acute hepatitis?
HAV, HEV
which hepatitis causes a more severe illness in pregnant women & elderly?
HEV
HAV, HBV vaccination should be given to all pts with what?
chronic liver disease
which 2 types of hepatitis viruses cause chronic hepatitis?
HBV, HCV
_________ (chronic hepatitis) can be effectively suppressed by current treatment, but cure is rare
HBV
which type of chronic hepatitis can be cured in a large percentage of pts?
HCV
which genotype of HCV is the hardest to cure?
Genotype 1 of HCV
all HBV pts should be screened for what?
HCC
if you have HCV and cirrhosis you should be screened for what?
HCC
what is the MCC of chronic liver dz in the US?
HCV
what is the 2nd MCC of chronic liver dz in the US?
Alcohol
what is the 3rd MCC of chronic liver dz in US?
NAFLD
what are the 2 most important environmental factors determining alcoholic liver disease risk?
ethanol & obesity
what is the genetic defect in hemochromatosis?
defective HFE gene (C282Y) on chromosome 6
unregulated Fe absorption in small intestine
what is the genetic defect in wilson’s disease?
ATPase enzyme (ATP7B gene) on chromosome 13 decreased loading of copper onto ceruloplasmin
what is the genetic defect in alpha1-antitrypsin deficiency?
failure to secrete alpha1-antitrypsin protein (chromosome 14), has abnormally folded molecule that gets stuck in liver cells and can’t get to lung and serum
what is the screening test for hemochromatosis?
transferrin saturation
what is the screening test for wilson’s disease?
ceruloplasmin and free copper levels
what is the screening test for alpha1-antitrypsindeficiency?
alpha1-antitrypsin phenotype
how do you diagnose hemochromatosis?
gene test (C282Y) mutation of HFE gene on chromosome 6
how do you diagnose wilson’s disease?
liver biopsy
how do you diagnose alpha1-antitrypsin deficiency?
liver biopsy
what is the main organ problem in hemochromatosis?
cirrhosis of liver
what is the main organ problem in wilson’s disease?
cirrhosis and fulminant liver failure
what is the main organ problem in alpha1-antitrypsin deficiency?
cirrhosis of the liver
what is the most common cause of cirrhosis?
alcoholic liver disease
what is the most common cause of liver cirrhosis in children?
alpha1-antitrypsin deficiency
name of pathology in liver dz with lack of return of renal function with intravascular volume repletion
hepatorenal syndrome
what are the components of the child pugh score?
albumin biirubin ascites encephalopathy PT/INR
what are the components of MELD?
INR
Bilirubin
creatinine
what is the child pugh score used for?
can be used to determine prognosis after variceal bleeding
what is the MELD score used for?
prognostic & preoperative sign, factor for transplant
