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STEP 2 GI > uw revision Autoimmune hepatitis, viral (A, B) > Flashcards

uw revision Autoimmune hepatitis, viral (A, B) Flashcards

1
Q

Autoimmune hepatitis. CP?

A

Asymptomatic
Symptomatic (anorexia, nausea, abdominal pain, jaundice)

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2
Q

Autoimmune hepatitis. Lab. liver?

A

Hepatocellular pattern (incr. AST and ALT, +/- mildly elevated ALP and total bilirubin)

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3
Q

Autoimmune hepatitis. Labs immunoglobulins?
formula?

A

Hypergammaglobulinemia with elevated gamma gap

gap: total protein - albumin –> >4g/dl.

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4
Q

Autoimmune hepatitis. Antibodies?

A

Elevated anti-smooth muscle autoantibodies - more specific

also in case was antinuclear antibody - most common antibody

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5
Q

Autoimmune hepatitis. histology?

A

Portal and periportal lymphoplasmacytic infiltration

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6
Q

Autoimmune hepatitis. Age?

A

Chronic liver disease that occur in middle-aged women with comorbid autoimmune disease (eg autoimmune thyroiditis)

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7
Q

Autoimmune hepatitis. Tx?

A

Immunosupression with GK (PREDNISONE) +/- azathioprine

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8
Q

KEPENU TX in autoimmune?

A

in acute liver failure or decompensated cirrhosis.

Can be considered in autoimmune, but first step - immunosupression.

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9
Q

Hepatitis A table. Transmission/risk? 3

A

Fecal-oral transmission
Poor sanitation/hygiene, travel to endemic areas
Contaminated food and water

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10
Q

Hepatitis A table. CP?

A

Fever, nausea, RUQ pain, jaundice, hepatomegaly

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11
Q

Hepatitis A table. Diagnostic testing?

A

Elevated tranaminases (>1000)
Anti-hepatitis A serology

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12
Q

Hepatitis A table. Mx?

A

Supportive/expectant
Spontaneous recovery in most patients

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13
Q

Hepatitis A. Spread food?

A

Unsanitary foods, eg shellfish and water supplies.

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14
Q

Hepatitis A. venues?

A

Poor sanitation - homeless shelters and day care centers (children often do not have jaundice and may go undiagnosed)

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15
Q

Hepatitis A. Who is at risk?

A

unvaccinated persons, international travels, MENS HAVING SEX WITH MEN

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16
Q

Hepatitis A. Dx serology?

A

Anti-HAV IgM serology

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17
Q

Hepatitis A. how long takes to resolve?

A

2-3 months.

18
Q

HBV table. HBsAg? 3

A

Acute HBV (early)
Chronic active HBV
Inactive HBV carrier state

19
Q

HBV table. HBeAg - proteins that circulates in blood when virus replicates

A

Early phase

Might be +/- in chronic active HBV infection

20
Q

negative HBeAg - shows low infectivity and viral load.

HBeAg and anti-HBeAg are positive only in a subset of patients and correlate with active viral replication [early infection, chronic infection with viral replication)

anti-HBeAg - typically evident in recovery phase of acute infection.

A

.

21
Q

HBV table. IgM anti-HBc. 2

A

Acute HBV early phase and WINDOW PERIOD

22
Q

HBV table. IgG anti-HBc. 3

A

Acute HBV recovery
chronic active HBV infection
immune due to natural HBV infection

23
Q

HBV table. Anti-HBs 3

A

Acute HBV recovery
Vaccinated for HBV
Immune due to natural HBV infection

24
Q

HBV table. Anti-HBe 3

A

Acute HBV recovery
+/- chronic active HBV infection
Inactive HBV carrier state

25
Q

HBV table. HBV DNA?5

A

Acute HBV:
Early phase: +++
Window: +
Recovery: likely +

Chronic active HBV infection: ++
Inactive HBV carrier state: normal/mildly +

26
Q

HBV table.
Acute HBV - early phase. 4

A

HBsAg, HBeAg, IgM anti-HBc
HBV DNA +++

27
Q

HBV table.
Acute HBV - window phase. 2

A

IgM anti-HBc
HBV DNA +

28
Q

HBV table.
Acute HBV - recovery phase. 4

A

IgG anti-HBc, Anti-HBs, Anti-HBe
HBV DNA likely +

29
Q

HBV table.
Chronic active HBV infection. 5

A

HBsAg
+/- HBeAg
IgG anti-HBc
+/- Anti-HBe
HBV DNA ++

30
Q

HBV table. Inactive HBV carrier state?3

A

HBsAg
Anti-HBe
HBV DNA normal/mildly +

31
Q

HBV table. vaccinated? 1

A

Anti-HBs

32
Q

HBV table. Immune due to natural HBV infection. 2

A

IgG anti-HBc
Anti-HBs

33
Q

Anti-HBc - only in response to viral infection, not present in vaccination.

A

.

34
Q

only diagnostic for early infection during window?

A

IgM anti-HBc

35
Q

what correlate with active replication? 2

A

HBeAg and anti-HBeAg

36
Q

negative HBsAg?

A

cleared infection

37
Q

from answer: chronic infection (active or inactive), positive and negative?

A

positive HBsAg and negative anti-HBs

38
Q

HBeAg - SHOWS INFECTIVITY, but poor test for acute HBV infection.

A

.

39
Q

despite HBV DNA can be present prior others, but this test is generally not performed to diagnose acute infection.

A

.

40
Q

yra dvi schemos - acute and chronic - ju nepatariau niekur

A

STEP 2 GI (32 decks)

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