Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastroenterology > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

CFx of viral hepatitis?

A
  • Flu like prodrome (N/V/anorexia/arthralgia)

- Some progress to icteric phase lasting days to weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the features of the icteric phase of viral hepatitis?

A
  • Pale stools and dark urine 1-5d prior to icteric phase
  • Hepatomegaly and RUQ pain
  • Splenomegaly and cervical lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ix in acute viral hepatitis?

A
  • AST and ALT (x10-20 N)
  • ALP and bilirubin mildly elevated
  • Viral serology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rx acute viral hepatitis?

A
  • Supportive

- Admit if: encephalopathy, coagulopathy, severe vomiting, hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DDx for hepatitis?

A
  • Viral infection
  • EtOH
  • Drugs
  • Immune mediated
  • Toxins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mx HBV?

A
  • Counselling re progression
  • HCC screening with q6m U/S
  • Consider pharmacological Rx
  • HAV vax
  • Blood and sexual precautions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment options in HBV?

A
  • Interferon
  • Tenofovir
  • Entacavir
  • Lamivudine
  • Adeofivr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the treatment goal in HBV Rx?

A

Reduce serum HBV-DNA to undetectable level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the phases of chronic HBV infection?

A
  1. Immune tolerance
  2. Immune clearance
  3. Immune control
  4. Immune escpae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the immune tolerance phase of HBV infection?

A
  • Extremely high HBV-DNA
  • HBeAG +ve but normal LFTs
  • Little immune control and minimal immune mediated liver dage
  • Characteristic of perinatal infection / incubation period in adult
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the immune clearance phase of HBV infection?

A
  • Falling but elevated HBV-DNA
  • HBeAG +ve
  • Immune attack on HBV and immune-mediated liver damage
  • Progressive disease w/o Rx and increasing liver fibrosis
  • Likely to benefit from Rx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the immune control phase of HBV infection?

A
  • Lower HBV DNA
  • HBeAG -ve, Anti HBeAb +ve
  • ALT/AST normal
  • Immune control w/o immune mediated liver damage
  • risk of reactivation esp w/ immunosuppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the immune escape phase of HBV infection?

A
  • Elevated HBV-DNA
  • HBeAG -ve due to core promoter gene mutation
  • Anti-HBeAb +ve
  • ALT/AST high
  • Characterised by progressive disease w/o treatment and increasing liver fibrosis
  • Likely to benefit from treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contrast risk of HCC in HBV and HCV.

A

Risk of HCC in HBV increases w/ increasing age; ?surrogate for increasing liver fibrosis.
Risk of HCC in HCV increases only after cirrhosis develops.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Hep D?

A

Defective RNA virus requiring HBsAg for entry into hepatocyte; therefore only infects pts with HBV
-More aggressive disease than HBV alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mx HDV?

A

Low dose IFN and liver transplant for end stage disease

17
Q

RFx for HCV?

A
  • IVDU
  • blood transfusion pre 1992
  • Tattoos
  • Intranasal cocaine use
18
Q

When do clinical manifestations of HCV occur?

A

6-8/52 after exposure

19
Q

Dx of HCV?

A
  • Elevated ALT/AST
  • +ve anti HCV
  • Detectable HCV-RNA in serum
20
Q

Mx HCV?

A
  • Blood borne precautions
  • Vax HAV, HBV
  • Avoid EtOH
21
Q

What is the Rx and aim in HCV Mx?

A

Pegylated IFNa + ribavarin aims to clear HCV infection; only 50-80% success.
Success determined by fall in HCV-RNA

22
Q

AEx of HCV Rx?

A
  • Depression/fatigue
  • Haemolysis
  • Bone marrow suppression
  • Fever
  • Precipitate Ai disease
23
Q

Prognosis HCV?

A
  • 80% acute HCV becomes chronic; 20% of these evolve to cirrhosis
  • Risk of HCC inc if cirrhotic
24
Q

What is the meaning of the following test results?

  • HBsAg =NEG
  • Anti-HBc =NEG
  • Anti-HBs =NEG
A

Susceptible, consider vaccination

25
Q

What is the meaning of the following test results?

  • HBsAg =NEG
  • Anti-HBc =POS
  • Anti-HBs =POS
A

Resolved HBV infection

26
Q

What is the meaning of the following test results?

  • HBsAg =NEG
  • Anti-HBc =NEG
  • Anti-HBs =POS
A

Vaccinated

27
Q

What is the meaning of the following test results?

  • HBsAg =POS
  • Anti-HBc =POS
  • IgM anti HBc (high titre)
  • Anti-HBs =NEG
A

Acute HBV infection

28
Q

What is the meaning of the following test results?

  • HBsAg =NEG
  • Anti-HBc =POS
  • IgM anti HBc = NEG
  • Anti-HBs =NEG
A

Chronic HBV infection

29
Q

What is the meaning of the following test results?

  • HBsAg =NEG
  • Anti-HBc =POS
  • Anti-HBs =NEG
A

Isolated core antibody positive

  • distant resolved HBV infection (high risk Hx)
  • false positive (low risk Hx)
  • resolving acute HBV (between HBsAg loss and detectable antiHBs)
  • passive transfer of maternal anti HBc

Gastroenterology (54 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions