Hepatitis

Question 1

Recovery is rare

Chronic infection is the rule

Answer 1

Hepatitis C

Question 2

MArked cholestasis

Answer 2

Hepa E

Question 3

Microvesicular steatosis

Answer 3

Hepa D

Question 4

Extra hepatic manifestation:

Serum sickness like syndrome

Answer 4

Hepa B

Question 5

Acidophilus degeneration of hepayocytes

Answer 5

Councilman / apoptosis bodies

Question 6

Lab features that suggest progression to chronicity

Answer 6

• lack of complete resolution of anorexia etc
• bridging/interface or multilobular hepatic necrosis
• ALT and glob in levels don’t return to normal
• HbeAg > 3 mos or HbsAg more than 6 months after acute hepatitis

Question 7

Causes vanishing bile duct syndrome

Answer 7

CoAmox

Question 8

Most pronounced side effect of ribavirin therapy

Answer 8

Hemolysis

Question 9

Favorable genotypes of Hepa C

Answer 9

Genotype 2 and 3

Question 10

Treatment for chronic Hepa C

Answer 10

PEG IFN and ribavirin

Question 11

Best prognostic indicator in Hepa C

Answer 11

Liver histology

Question 12

Treatment of Hepatitis C

Answer 12

24 weeks for 2 and 3

48 weeks for genotype 1

Question 13

HBV DNA levels to treat Hepa B

Answer 13

20,000 IU/mL

Question 14

Persistence of This antibody beyond the 3 months of acute infection predictive of the development of chronic infection

Answer 14

HBeAg

Question 15

Extrahepatic manifestations of Hepatitis B

Answer 15

Serum sickness like syndrome
Glomerulonephritus with. Ephrotic syndrome
Generalized vasculitis
Essential mixed cryohlobulinemia

Question 16

Hepa C extrahepatic manifestation

Answer 16

Immune complex glomerulonephrigis

Question 17

This disorder characterized by athritis, cutaneous vasculitis and glomerulonephrigis
And extrahepatic manifestation of hepatitis

Answer 17

Essential mixed cryoglobulinemia (EMC)

Question 18

Formed by acidophilic degeneration of hepatocytes

Answer 18

Councilman or apostolic bodies

Question 19

Seen in chronic hepatitis B but not in acute hepatitis. And this can be ID histochemically by orcein or aldehyde fuschin

Answer 19

HBsAg in Large hepatocytes with ground glass appearance

Question 20

Severe histologic lesion in acute hepatitis

Answer 20

Bridging hepatic necrosis/
Subacute or confluent necrosis or interface hepatitis

(Bridging between lobules with collapse of reticulin framework)

Question 21

Accounts got more than 50% fulminant cases of viral hepatitis

Answer 21

Hepa B

Question 22

Why do we treat acute hepatitis C?

Answer 22

Recovery is rare, progression to chronic hepatitis is the ruletreat with long acting PEG IFN and ribavirin

Question 23

Hepa A vaccination schedule

Answer 23

2 doses 0,6-12

Question 24

Hepa B vaccination

Answer 24

3 IM deltoid 0,1,6

Question 25

Drug induced hepatic injury: Acetaminophen Carbon tetrachloride

Answer 25

Direct toxic effect ``` CCl4= necrosis, fatty infiltration Acetaminophen= centrilobular necrosis ```

Question 26

Drug induced hepatic injury: Coamoxiclav Isonizid Ciprofloxacin

Answer 26

Idiosyncratic

Question 27

When do we treat Chronic Hepa B patients?

Answer 27

HBV DNA >2 x 10^4 IU/ml whose ALT is 2x above the upper limit of normal (if ALT normal treatment is not recommended) Compensated cirrhosis treat regardless of HBeAg and ALT (if HBV DNA >2 x 10^3 IU/ml ) Decompensated cirrhosis treat and evaluate for liver transplant

Question 28

First line therapy for Hepatitis B

Answer 28

PEG IFN - finite duration and highest rate of HBeAg responses Entecavir Tenofovir

Question 29

Hepa B drugs creatinine monitoring

Answer 29

Adenovirus | Tenofovir

Question 30

Extrahepatic complications of Hepa C unrelated to immune complex injury

Answer 30

Shogrens Lichen plants Porphyria cutaneous tarda Type 2 DM

Question 31

Antibodies in chronic hepa C

Answer 31

Anti- LKM1

Question 32

Hepatitis drug that should not be used in cirrhosis, transplantation and immunosuppressive

Answer 32

PEG IFN

Question 33

There is no documental antiviral resistance with this drug and it has finite treatment (48 weeks) However it is not effective in high level HBV DNA. >10^9 IU/ml

Answer 33

PEG IFN

Question 34

How does hepatitis D affect Hepa B infection?

Answer 34

Increases severity of acute hepatitis | Does not increase likelihood of progression to chronic Hepa.

Question 35

Distinguishing serologic feature of chronic hepatitis D

Answer 35

Anti-LKM3 positive Anti LKM1- autoimmune hepatitis

Question 36

Chronic Hepa develops in cases of acute hepatitis C in ?% of cases

Answer 36

50-70%

Question 37

Rate in 20 yrs regardless of clinical severity progression to cirrhosis of px with chronic hepatitis C

Answer 37

20-25%