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Flashcards in Hepatitis & Cirrhosis Deck (122)
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1

Liver Function Tests

Aminotransferases (ALT/AST)
Alkaline phosphatase (AP)
Gamma glutamyl transpeptidase (GGT)
Albumin
Prothrombin time (PT)
BIlirubin

2

Types of Autoimmune Hepatitis

Type 1 (Classic)
Type 2 (ALK-1)

3

Who does type 1 autoimmune hepatitis affect?

Women of all ages

4

Who does type 2 autoimmune hepatitis affect?

Girls & young women

5

Clinical Manifestations of Autoimmune Hepatitis

Mostly asymptomatic
Advanced cirrhosis
Fulminant hepatitis

6

Labs for Autoimmune Hepatitis

Serological markers present
Aminotransferases more elevated than bilirubin & AP

7

Extrahepatic Manifestations of Autoimmune Hepatitis

Hemolytic anemia
Thyroiditis
Celiac sprue
ITP
Type I DM
UC

8

Treatment of Autoimmune Hepatitis

Corticosteroids
Azathioprine (2nd line)

9

Acute Complications of Steroid Therapy

HGN
Hyperglycemia
Insomnia
Psychosis
Gastric Irritaiton

10

Chronic Complications of Steroid Therapy

Osteoporosis
PUD
Glaucoma
Cataracts
Immunosuppresion

11

Define Hemochromatotosis

Gene defect resulting in increased iron absorption in the intestinal tract from the diet

12

What does hemochromatosis eventually lead to?

Cirrhosis
Cardiomyopathy
DB
Hypogonadism

13

When do symptoms of hemochromatosis usually occur?

Around age 40
Iron stores reach 15-40 g
Females delayed due to menstruation & breast feeding

14

Clinical Manifestations of Hemochromatosis are Influenced by What

Age
Sex
Alcohol use
Dietary iron
Menstruation & breast feeding

15

What factors accelerate the process of hemochromatosis?

Alcohol abuse
Hepatitis C

16

Classic Presentation of Hemochromatosis

Cutaneous hyperpigmentation
DM
Cirrhosis

17

Reversible Cardiovascular Manifestations of Hemochromatosis

Cardiomyopathy
Vibrio vulnificus
Conduction disturbances
Listeria monocytogenes

18

Reversible Liver Manifestations of Hemochromatosis

Pastcuerlla psudotubercullosis
Abdominal pain
Elevated LFTs
Hepatomegaly

19

Reversible Skin Manifestations fo Hemochromatosis

Bronzing
Grayness

20

Irreversible Liver Manifestations of Hemochromatosis

Cirrhosis
Hepatocellular CA

21

Irreversible Anterior Pituitary Gland Manifestations of Hemochromatosis

Gonadotropin insufficiency

22

Irreversible Pancreas Manifestations of Hemochromatosis

DM

23

Irreversible Thyroid Manifestations of Hemochromatosis

Hypothyroidism

24

Irreversible Genitalia Manifestations of Hemochromatosis

Primary hypogonadism

25

Irreversible Joint Manifestations of Hemochromatosis

Psuedogout

26

Diagnosis of Hemochromatosis

Clinical +
Elevated transferrin
Pathologic
Liver biopsy (gold-standard)

27

Treatment of Hemochromatosis

Avoid red meat/ iron supplements
Avoid ETOH
Avoid raw seafood
Hepatitis A&B vaccinations
Phlebotomy: take off blood

28

Define Phlebotomy

Removal of 500 mL of blood

29

Goal of Phlebotomy

Hgb = 10-12 gm/dL
Ferritin

30

Maintenance Phlebotomy

Every 2-4 months