Clin Med 2 > Hepatitis > Flashcards

Hepatitis Flashcards

(49 cards)

Study These Flashcards
1
Q

What is acute hepatitis

A

inflammation of the liver

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2
Q

What is the cause of acute hepatitis

A 
infectious
- Hep B and C
non-infectious
- alcohol
- drugs
-autoimmune
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3
Q

Clinical acute hepatitis

A
  • fatigue/maliase
  • anorexia
  • N/V
  • fever
  • enlarged tender liver
  • jaundice
  • normal/low WBC
  • elevated aminotransferase (>1000U/L)
  • hyperbilirubinemia
  • increase PT/INR (>1.5)
  • encephalopathy
  • viral has viral sickness included
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4
Q

Transmission of hep a

A

fecal-oral route due to crowding and poor sanitation

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5
Q

Is there a vaccine for hep A

A

yes

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6
Q

Dx hep A

A

anti-HAV appears early (IgM= active, IgG= previous exposure)

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7
Q

Tx hep A

A

symptomatic

recovery in 3 mo and no chronic liver dz

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8
Q

Transmission Hep B

A

infected blood products, sexual contact, delivery by HBV+ mother

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9
Q

Do adults or infants develop acute hepatitis infection from HBV

A

infants

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10
Q

Is there a vaccine for Hep B

A

yes

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11
Q

If mother is HBV+ and delivers baby, what do we give baby? What could we give mother in 3rd trimester?

A
  • vaginal delivery give baby HBIG and HBV vaccine within 12 hrs of birth
  • give mother antiviral therapy in 3rd trimester is high viral load
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12
Q

HbSAg

A
  • first evidence of infection

- persistent for more than 6 months–> chronic infection

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13
Q

HBV DNA

A

active viral replication; viral core

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14
Q

Anti-HBc

A

IgM indicating acute hepatitis infection and IgG indicated chronic or recovered infection

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15
Q

Anti-HBs

A

after successful vaccination or recovery from HBV infection

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16
Q

Transmission of Hep C

A 
IVDA
body piercing
tattooing
hemodialysis
pre-1992 blood transfusion
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17
Q

Do people usually develop chronic HCV

A

yes

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18
Q

Dx HCV

A

anti-HCV ELISA

HCV RNA PCR serology for confirmation (do if ELISA positive)

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19
Q

Tx HCV

A

8-12 weeks Ledipasvir/sofosbuvir (Harvoni)

Recover in 3-6mo

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20
Q

Hep D is only associated with what and only present when?

Study These Flashcards
A

Associated with HBV and HBsAg has to be present

21
Q

Transmission Hep D

Study These Flashcards
A

blood- percutaneous exposure

22
Q

Dx Hep D

23
Q

Transmission Hep E

Study These Flashcards
A

fecal oral- waterborne

consuming undercooked pig meat or if pet a pig

24
Q

Who gets autoimmune hepatitis

Study These Flashcards
A

young to middle aged women

25
When is autoimmune hepatitis common
following viral illness or drug exposure
26
Labs autoimmune hepatitis
aminotransferace>1000 positive ANA and/or smooth muscle Ab most common IgG increase
27
Dx autoimmune hepatitis
liver biopsy
28
Tx autoimmune hepatitis
corticosteriods | azathioprine
29
How much alcohol consumed to produce cirrhosis
over 50g alcohol/day for 10 yrs
30
What preceded alcoholic hepatitis
recent period of heavy drinking
31
Sign of alcoholic hepatitis
fatty liver
32
Lab alcoholic hepatitis
macrocytic anemia thrombocytopenia AST/ALT ratio 2:1 and mildly elevated PT/INR elevated
33
Imaging alcoholic hepatitis
CT/MRI: mod-severe steatosis
34
Tx alcoholic hepatitis
``` Emergent - steroids: methylpredisone if MELD over 18 - pentoxiphylline if steriods C/I General - stop alcohol - correct folate, thiamine, and zinc def - abstinence - liver transplant if abstinent for 6mo ```
35
Drugs that cause direct hepatotoxicity and are dose related
``` APAP ALcohol niacin tetracycline valproic acid vitamin a ```
36
Drugs that cause direct hepatotoxicity and are not dose related and an allergy at times
``` amiodarone aspirin diclofenac fluoroquinolones phenytoin methyldopa ```
37
Non-inflammatory drug induced cholestasis
azathioprine estrogen anabolic steriod diclofenac
38
Inflammatory drug induced cholestasis
``` augmentin azithromycin erythromycin macrobid- nitrofurytoin cephalosporin azathriprine ```
39
How much of world infected with HBV
1/3
40
What is the dominant cause of cirrhosis and HCC
chronic HBV
41
What is a predictor of cirrhosis and HCC
High HBV DNA
42
chronic HBV labs
HbSAg and anti-HBc IgG
43
Imaging chronic HBV
US/CT/MRI- coarse nodular echogenic appearance
44
TX HBV
entecavir and tenofovir
45
Clinical active chronic HBV
elevated transaminase more than 3-6mo HBV DNA elevated cirrhosis (ugly liver F2-F4) acute liver failure
46
Most cases chronic HCV
Africa, C. America, E. Asia
47
Who has an increased risk of developing cirrhosis with chronic HCV
chronic alcohol ingestion male hcv>40yo co-infection with HIV/HBV
48
Prevent Chronic HCV
needle exchange for IVDA tx substance abuse blood donor screening universal precautions
49
Tx Chronic HCV
12 wks w/o cirrhosis and 24wks w/ cirrhosis | Ledipasvir/sofosbuvir (harvoni)
Clin Med 2
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