Term
| ___ is detectable with acute and chronic Hep B infections. It is the earliest indicator of infection and appears before symptoms do. |
|
Definition
| HBsAg (Hep B Surface Antigen) |
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|
Term
| ___ appears 4 weeks after HBsAg disappears. |
|
Definition
| HbsAb aka anti-HBs (Hb surface antibody) |
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|
Term
| What indcates that you are immune to Hepatitis B? |
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Definition
|
|
Term
| What is measured in a hepatitis B titer? |
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Definition
|
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Term
| This will always be present, with a current Hep B infection or from a prior Hep B infection. It will always be positive no matter when the actual infection was. |
|
Definition
| HBcAb aka anti-HBc (Hep B core antibody) |
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Term
|
Definition
- after acute infection resolves
- after vaccination |
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Term
| HBeAG is __ positive in __ or __ infection and indicates __ __ __. |
|
Definition
- transiently positive
- acute or chronic infection
- high viral replication |
|
|
Term
| What value do you follow during course of treatment of Hepatitis B? |
|
Definition
|
|
Term
| HBeAB is positive after __ after the __ ___. |
|
Definition
- after infection
- after HBeAG seroconversion
hope to see this develop during treatment |
|
|
Term
| Hepatitis B: Usually treat for about 6 months after seroconversion, hope for seroconversion but don’t expect it |
|
Definition
|
|
Term
| Gold standard test to determine if Hep B is active, follow the virus titer, and evaluate response to treatment: |
|
Definition
|
|
Term
| If the Hepatitis B envelope antigen is positive, and the Hepatitis B surface antibody (titer) is positive, what now? |
|
Definition
| need to be evaluated and treated |
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|
Term
| Sequence of events in acute Hepatitis B: |
|
Definition
| - surface antigen and envelope antigen present early on before symptoms arise> core antiBODY rises> AST rises> envelope antibody rises> surface antibody rises |
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Term
| With chronic hepatitis B, the ___ stays around, preventing the ___ and __ from forming. |
|
Definition
- HB envelope antigen
- preventing anti-HBe and anti-HBs from forming |
|
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Term
| Pt has positive Hbe antigen, viral titer greater than 20,000, and normal liver enzymes. Now what? |
|
Definition
|
|
Term
| Patient has positive Hbe antigen, titers of 20,000, and elevated liver enzymes. What do you? |
|
Definition
|
|
Term
| Pt has negative HbeAg, titers greater than 20,000, and elevated liver enzymes, what do you do? |
|
Definition
|
|
Term
| Pt has negative HbeAg, titers less than 2,000, and low liver enzymes. what do you do? |
|
Definition
|
|
Term
| Do you treat Hep B in a patient with cirrhosis? |
|
Definition
yes, if its compensated cirrhosis
no, if its uncompensated cirrhosis |
|
|
Term
| Do you treat Hep B in a patient with cirrhosis? |
|
Definition
yes, if its compensated cirrhosis
no, if its uncompensated cirrhosis |
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Term
|
Definition
|
|
Term
| lab findings with hemochromatosis: |
|
Definition
- elevated transaminases
- elevated transferrin saturation
- elevated ferritin
- genetic screen postive for mutation
- liver biopsy
associated with PCT |
|
|
Term
| Lab findings with Wilson's disease: |
|
Definition
- elevated transaminases
- decreased serum ceruloplasmin
- increased excretion of copper in the urine
PATHOPNEUMONIC: KAYSER-FLEISCHER RINGS |
|
|
Term
| What is pathopneumnic for Wilson's disease: |
|
Definition
|
|
Term
| what test do you do if you suspect Wilson's disease? |
|
Definition
|
|
Term
| Kayser Fleischer rings are seen best with a __ __ exam. These are a sign of early or late Wilson's disease? |
|
Definition
- slit-lamp exam
- late Wilson's disease |
|
|
Term
|
Definition
| Penicillamine- chelating agent |
|
|
Term
| Tmt of autoimmune hepatitis: |
|
Definition
Prednisolone + Azathioprine
minimum of 2 years |
|
|
Term
| Metabolic Diseases of the liver: |
|
Definition
- Alpha-1 Antitrypsin deficiency- affects lung and liver, more likely to have lung symptoms
- Cystic fibrosis: greater than 50% have liver involvement, 10% symptomatic |
|
|
Term
| Young pt with COPD and elevated liver enzymes may make you suspect: |
|
Definition
| alpha 1 antitrypsin deficiency |
|
|
Term
| Budd Chiari Syndrome is __ __ __ |
|
Definition
| - Hepatic vein obstruction |
|
|
Term
| Causes of Budd Chiari Syndrome (Hepatic Vein Obstruction): |
|
Definition
- Right sided heart failure
- Constrictive pericarditis
- Neoplasm
- Birth control pills
- Thrombosis |
|
|
Term
| Preferred screening test for Budd Chiari Syndrome: |
|
Definition
| Duplex Doppler Ultrasound |
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|
Term
| Unconjugated Hyperbilirubinemia is a __ issue and presents with __ but without ___. Three causes of this include: |
|
Definition
- prehepatic issue
- jaundice
- without biluria
- Gilbert's Syndrome
- Hemolytic process
- Crigler Najjar |
|
|
Term
| with conjugated hyperbilirubemia pts present with __ __ instead of jaundice. Causes of this include: |
|
Definition
- dark urine
- hereditary cholestatic syndrome
- biliary obstruction |
|
|
Term
|
Definition
- Non-cardioselective Beta
- esophageal variceal ligation (EVL)
- transjugular intersystemic portal shunt (TIPS) |
|
|
Term
|
Definition
- diuretic- spiranolactone is doc b/c potassium sparing
- paracentesis |
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