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