Term
| what are the three functions of the liver |
|
Definition
| process carbs, proteins, lipids |
|
|
Term
| what is another name for hep A |
|
Definition
|
|
Term
|
Definition
| fecal-oral: day care, water, produce, food |
|
|
Term
| how does someon <3yo present with hep A |
|
Definition
|
|
Term
| what are the signs of hep A (7) |
|
Definition
| fever, jaundice, nausea, vomiting, diarrhea, upper right quadrant pain, fulminant hep A (rare) |
|
|
Term
| how is hep A diagnosed (5) |
|
Definition
elevated ALT, AST, bilirubin
anti-hepA IgM (few days - 6mo)
anti-hepA IgG (life long) |
|
|
Term
| how is hep A tereated (3) |
|
Definition
IV fluids for dehydration
corticosteroids for severe jaundice
managem fulminant hepatic failure |
|
|
Term
| what is the vaccination schedule for hep A |
|
Definition
1st dose 1yo
2nd dose 18mo |
|
|
Term
| what is the impact of hep B in the world and the us |
|
Definition
350 millionin world
1/50 in us |
|
|
Term
| what countries have highest amount of hep B, what is the main mode of transmission |
|
Definition
asia, china, pacific islands, africa, alaska
maternal infant, percutaneous |
|
|
Term
| what countries have medium abount of hep B, what is the main mode of transmission |
|
Definition
mediterranean, east eurpoe, asia, japan, middle east, south america
percutaneous, sex |
|
|
Term
| what countries have low amount of hep B, what is the main mode of transmission |
|
Definition
| US, canada, west europe, australia, new zeland |
|
|
Term
| what are 6 ways hepatitis B is transferred, what is the most in the us, what is the most world wide |
|
Definition
transfusions
transplants
health care
percutaneous: high in US
sexual: high in US
perinatal: high in world |
|
|
Term
|
Definition
unexplained serum sickness
polyarteritis nodosa
glomemlonephritis non post-strep
papular acrodermatitis
aplastic anemia |
|
|
Term
| what are 4 complicatins fo hep B |
|
Definition
chronic active hepatitis
cirrhosis/portal HTN
hep C
hepatocellular carcinoma |
|
|
Term
| chronic hep B: liver enzymes, surface antigen, other antigens, DNA copies, liver biopsy |
|
Definition
surface antigen: present for >6 mo
elevated AST/ALT
HB DNA > 10^5
biopsy: inflammation and necrosis >4 |
|
|
Term
| inactive hep B carrier: liver enzymes, surface antigen, DNA copies, liver biopsy |
|
Definition
surface antigen: more than 6 mo
anti-HBeAg
HB DNA <10^5
biopsy: necrosis and inflammation <4 |
|
|
Term
| resolved hep B: antibodies, DNA copies, liver enzymes |
|
Definition
anti-HBc
anti-HBs
HBsAg
no DNA copies
normal liver enzymes |
|
|
Term
| what are the two ways to prevent hep B |
|
Definition
vaccination
immunoglobulins and vaccination prevention of maternal transmission |
|
|
Term
| what is the procedure for maternal hep B transmission prevention |
|
Definition
if you dont know if mom has it treat the baby (check after and if mom is negative stop treatment)
Ig and vaccine in 12 hours, 2 mo, and 6 mo |
|
|
Term
|
Definition
|
|
Term
|
Definition
phosphorlyated in body
competes with growing DNA terminating reverse transcriptase |
|
|
Term
| what type of virus is hep C |
|
Definition
|
|
Term
| how many people have hep C |
|
Definition
|
|
Term
| what is the main complication of hep c, what are the chances of contracing |
|
Definition
| 40-60% get chronic liver disease (MOST COMMON CAUSE OF CHRONIC LIVER DISEASE) |
|
|
Term
| how is hep C transmitter (6) |
|
Definition
blood transfusion: decreased when manditory check began
IV drug use - high
sex - high
congenital
toothbrush
razors |
|
|
Term
| what are the two ways to diagnose hep C, which is better, why |
|
Definition
antibody assay for anti-HC IgG (ELISA/RIBA): could show false positives
nucleic acid testing for HC RNA: better, quantitative, will show positive before LFT increases |
|
|
Term
| what is the testing procedure for pregnant women and baby with hep C testing |
|
Definition
test mom before delivery. if positive, test baby at 2-3 mo.
baby will have some antibodies but if they dont have viral copies by then they dont have hepC |
|
|
Term
| what is the immune response to hep c |
|
Definition
acquired: T cells release cytokines causing inflammation leading to necrosis. CD8 supresses replication and triggers apoptosis
innate: NK cells kill target cells
humoral: antibody neutralizes extra-hepatic viruses |
|
|
Term
|
Definition
standard percautions
cannot make vaccine it replicates too fast and has genetic diversity |
|
|
Term
| how is hep C treated ((5) |
|
Definition
interferon
pegylated interferon, ribavarin, combo
viral relapsers |
|
|
Term
| what is the cause of type 1 auto-immune hepatitis (5) |
|
Definition
anti-nuclear antobody
smooth muscle antibody
anti-actin antibody
anti-neutrophil cytoplasmic antibody
anti-soluble liver pancrease antobody |
|
|
Term
| what is the cause of type 2 auto-immune hepatitis (2) |
|
Definition
anti-liver-kidney microsomal antibody
anti-liver cytosol antigen |
|
|
Term
| what are the signs of auto-immune hepatitis (3) |
|
Definition
often asymptomatic
often present with other autoimmune diseases
non-specific symptom hepatitis |
|
|
Term
| what are the other autoimmune diseases hepatitis occurs with (4) |
|
Definition
|
|
Term
| what are 5 diagnostic test for auto-immune hepatitis |
|
Definition
NAN
SMA
anti-LKM
AST/ALT ratio
liver histology |
|
|
Term
| how is autoimmune hepatitis pervented |
|
Definition
| check liver enzymes and biopsy frequently in those with autoimmune conditions |
|
|
Term
| how is autoimmune hepatitis treated |
|
Definition
|
|
Term
| what are the three categories of causes for drug induced hepatitis and some drugs in each category |
|
Definition
dose dependant: acetaminophen, cyclophosphamicle
idiosyncratic: isoiazid, ketoconazole, amoxl-clavulonate
metabolite toxicity: statins, valproic acid |
|
|
Term
| what are 6 signs of drug induced hepatitis |
|
Definition
high index of suspicion
no infection
rash adenopathy
eosinophilia
cholestatic
hepatocellular signs
improves on drug DC |
|
|
Term
| what are 5 metabolic liver disease that cause hepatitis |
|
Definition
wilsons
hemochromatosis
a1-anti-trypsin deficiency
non-alcoholic fatty liver disease
non-alcoholic steatohepatitis |
|
|
Term
| how can wilsons disease be identified |
|
Definition
|
|
Term
| how can hemochromatosis be idenfitifed |
|
Definition
| serum ferritin (underdiagnosed) |
|
|
Term
| how can a1-anti-trypsin deficiency be identified |
|
Definition
|
|
Term
| what are 5 signs of non-alcoholic fatty liver disease |
|
Definition
| obesity, metabolic syndrome, type II diabetes, hyperlipidemia, hyperinsulinemia |
|
|
Term
| how does hyperinsulinemia contribute to non-alcoholic fatty liver disease |
|
Definition
| increases pro-inflammatory cytokines causing fatty change and necrosis |
|
|
Term
| how is non-alcoholic fatty liver disease diagnosed when asymptomatic (2) |
|
Definition
|
|
Term
| how is non-alcoholic fatty liver disease diagnosed when symptomatic (4) |
|
Definition
fatigue
upper right quadrant pain
metabolic syndrome
diabetes |
|
|
Term
| non-alcoholic fatty liver disease treatment (5) |
|
Definition
weight loss
exercise
increased insulin sensitivity: pio/rosiglitazone)
antioxidants (vitamin E)
anti-hyperlipidemia (statins) |
|
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