Podcast
Questions and Answers
What is the typical incubation period of Hepatitis A?
What is the typical incubation period of Hepatitis A?
Which of the following is a risk factor for Hepatitis A?
Which of the following is a risk factor for Hepatitis A?
What is the primary route of transmission for Hepatitis A?
What is the primary route of transmission for Hepatitis A?
What is the significance of elevated levels of Alpha Fetoprotein?
What is the significance of elevated levels of Alpha Fetoprotein?
Signup and view all the answers
What is the role of C Reactive Protein in the context of Hepatocellular Carcinoma?
What is the role of C Reactive Protein in the context of Hepatocellular Carcinoma?
Signup and view all the answers
What is the enzyme that is released into circulation following cell injury or death?
What is the enzyme that is released into circulation following cell injury or death?
Signup and view all the answers
In which phase of Hepatitis does the level of AST rise to 20-30 times higher than normal?
In which phase of Hepatitis does the level of AST rise to 20-30 times higher than normal?
Signup and view all the answers
What is the significance of elevated levels of AST in liver disease?
What is the significance of elevated levels of AST in liver disease?
Signup and view all the answers
What is the significance of Alpha Fetoprotein in cancer treatment?
What is the significance of Alpha Fetoprotein in cancer treatment?
Signup and view all the answers
What is the characteristic pattern of AST and ALT levels in acute and chronic hepatitis?
What is the characteristic pattern of AST and ALT levels in acute and chronic hepatitis?
Signup and view all the answers
What is the approximate duration of the acute stage of hepatitis B infection?
What is the approximate duration of the acute stage of hepatitis B infection?
Signup and view all the answers
What is the risk of becoming a chronic carrier for infants infected with hepatitis B during the last trimester of pregnancy?
What is the risk of becoming a chronic carrier for infants infected with hepatitis B during the last trimester of pregnancy?
Signup and view all the answers
What is the primary route of transmission for hepatitis B?
What is the primary route of transmission for hepatitis B?
Signup and view all the answers
What is the duration of the icteric phase in Hepatitis?
What is the duration of the icteric phase in Hepatitis?
Signup and view all the answers
What is the most common cause of chronic active hepatitis?
What is the most common cause of chronic active hepatitis?
Signup and view all the answers
What is the function of the HBeAg antigen?
What is the function of the HBeAg antigen?
Signup and view all the answers
What is the characteristic of the IgM anti-HBc antibody?
What is the characteristic of the IgM anti-HBc antibody?
Signup and view all the answers
What is the principal cause of chronic liver disease, cirrhosis, and liver transplants?
What is the principal cause of chronic liver disease, cirrhosis, and liver transplants?
Signup and view all the answers
What is the window period in hepatitis B infection?
What is the window period in hepatitis B infection?
Signup and view all the answers
What is the result of increased capillary pressure and obstruction of venous flow through the liver in cirrhosis?
What is the result of increased capillary pressure and obstruction of venous flow through the liver in cirrhosis?
Signup and view all the answers
What is the effect of liver damage on albumin synthesis?
What is the effect of liver damage on albumin synthesis?
Signup and view all the answers
What is the significance of the presence of HBV DNA in the serum?
What is the significance of the presence of HBV DNA in the serum?
Signup and view all the answers
What is the effect of toxic effects of alcohol on the liver?
What is the effect of toxic effects of alcohol on the liver?
Signup and view all the answers
What is the risk of liver cancer for individuals with chronic HBV infection?
What is the risk of liver cancer for individuals with chronic HBV infection?
Signup and view all the answers
What is the characteristic of the IgG anti-HBc antibody?
What is the characteristic of the IgG anti-HBc antibody?
Signup and view all the answers
What is the type of cirrhosis caused by autoimmune destruction of bile ducts?
What is the type of cirrhosis caused by autoimmune destruction of bile ducts?
Signup and view all the answers
What is the life expectancy of patients with primary biliary cirrhosis?
What is the life expectancy of patients with primary biliary cirrhosis?
Signup and view all the answers
What is the purpose of the hepatitis B vaccine?
What is the purpose of the hepatitis B vaccine?
Signup and view all the answers
What is the cause of secondary biliary cirrhosis?
What is the cause of secondary biliary cirrhosis?
Signup and view all the answers
What is the common feature of all types of cirrhosis?
What is the common feature of all types of cirrhosis?
Signup and view all the answers
What is the primary reason for the development of esophageal varices in patients with cirrhosis?
What is the primary reason for the development of esophageal varices in patients with cirrhosis?
Signup and view all the answers
What is the most common cause of portal hypertension?
What is the most common cause of portal hypertension?
Signup and view all the answers
What is the goal of treatment for esophageal varices?
What is the goal of treatment for esophageal varices?
Signup and view all the answers
What is the name of the procedure where a tubular device is placed between the portal and hepatic vein to create a diversion for blood flow?
What is the name of the procedure where a tubular device is placed between the portal and hepatic vein to create a diversion for blood flow?
Signup and view all the answers
What is the percentage of people with HCV that develop post necrotic cirrhosis?
What is the percentage of people with HCV that develop post necrotic cirrhosis?
Signup and view all the answers
What is the name of the device used to tie off bleeding varices?
What is the name of the device used to tie off bleeding varices?
Signup and view all the answers
What is the term for the pressure difference between the hepatic vein and right atrium?
What is the term for the pressure difference between the hepatic vein and right atrium?
Signup and view all the answers
What is the name of the procedure where the spleen vein is connected to the left kidney vein to control bleeding?
What is the name of the procedure where the spleen vein is connected to the left kidney vein to control bleeding?
Signup and view all the answers
What is the term for the bursting of esophageal veins?
What is the term for the bursting of esophageal veins?
Signup and view all the answers
What is the name of the procedure where the bleeding varices are removed?
What is the name of the procedure where the bleeding varices are removed?
Signup and view all the answers
Study Notes
ASPARTATE AMINOTRANSFERASE (AST)
- Enzyme present in tissues with high metabolic activity
- Released into circulation following cell injury or death
- AST levels rise within 12 hours and remain elevated for 5 days following severe cell damage
- Levels can be 10-100 times higher than normal in liver disease
- Elevated levels seen in acute and chronic hepatitis (ALT > AST) and active cirrhosis (AST > ALT)
- AST levels increase during the prodromal phase of hepatitis and are 20-30 times higher than normal in the icteric phase
ALPHA FETOPROTEIN
- Elevated levels associated with liver cancer
- Produced by the liver and used to monitor cancer treatment effectiveness
- Hepatocellular carcinoma biomarker reflecting tumor behavior and clinical prognosis
C REACTIVE PROTEIN
- Biomarker used in the context of hepatocellular carcinoma
- Marker of systemic inflammation
HEPATITIS A
- Formerly known as infectious hepatitis
- Transmitted through the fecal-oral route
- Risk factors include crowded, unsanitary conditions, and food and water contamination
- Caused by a small RNA-containing virus
- Virus replicated in the liver, excreted in bile, and shed in stool
- Incubation period is 2-4 weeks
- Individuals with the disease can be contagious for up to 2 weeks before the onset of symptoms
- Infection is more common than the actual disease
- By mid-adult life, about half of people in developed countries have evidence of infection (anti-HAV antibodies) but few recall being ill
- Disease does not cause a carrier state or chronic hepatitis
HEPATITIS B
- Transmitted through contact with infected blood, bodily fluids, or contaminated needles
- Maternal transmission can occur if the mother is infected during the third trimester
- Vaccine prevents transmission and development
- High risk of death from cirrhosis and liver cancer
- Transmission through blood, saliva, seminal, menstrual, and vaginal fluid
- Acute hepatitis B can cause acute liver failure and death
- Chronic hepatitis B can lead to cirrhosis and liver cancer
- Caused by a stranded DNA virus known as the Dane particle
- Transmitted through contact with infected blood, bodily fluid, or contaminated needles
- Maternal transmission can occur if the mother is infected during the last trimester
HEPATITIS PANEL HBV
- 3 antigens: 2 core (HBcAg and HBeAg), 1 surface antigen (HbsAg)
- 3 antibodies: anti-HBs, anti-HBc, anti-HBe
- IgM: antibodies in the acute state
- IgG: antibodies in the chronic state
- HBeAg appears soon after HbsAg, signifying viral replication
- HbsAg is a viral antigen that appears before the onset of symptoms, peaks during the acute disease, and then declines to undetectable levels in 3-6 months
- Anti-HBe is detectable shortly after the disappearance of HBeAg, signaling the onset of resolution of acute illness
- IgM anti-HBc is detectable shortly before the onset of symptoms, concurrent with an increase in serum transaminases
- Over time, IgM antibody is replaced by IgG anti-HBc
- IgG anti-HBs signals recovery from HBV infection, non-infectivity, and protection from future infection
- HBV DNA is a reliable marker of active HBV replication
4 PHASES OF HEPATITIS
- Incubation: period of initial exposure to the onset of symptoms
- Prodromal: begins 2 weeks after exposure and ends with the appearance of jaundice
- Icteric: begins 1-2 weeks after the prodromal phase and lasts for approximately 2-6 weeks
- Recovery phase (convalescent): begins with the resolution of jaundice, approximately 8 weeks after exposure
CHRONIC ACTIVE HEPATITIS
- Persists for more than 6 months and can lead to liver damage over time
- Constitutes a carrier state (patient harbors the virus, usually HBV, HCV, or HDV, without significant symptoms of liver disease)
- 70-80% of chronic cases are due to HCV
- Persistence of clinical manifestations and liver inflammation
- LFTs remain abnormal for longer than 6 months
- ALT depends on the level of disease activity, but is usually the first sign of infection
- HbsAg persists, and HBV DNA persists
CIRRHOSIS
- Irreversible inflammatory disease that disrupts liver function and structure
- Leading cause of death in the US, representing the end stage of chronic liver disease
- Normal liver architecture and function are disrupted with the development of diffuse fibrosis and nodular regeneration
- Obstruction can cause portal hypertension
- Blood shunting can lead to hypoxia, which can cause necrosis, atrophy, and failure
TYPES OF CIRRHOSIS
- Alcoholic cirrhosis (Laennec's cirrhosis)
- Primary biliary cirrhosis (cholangitis)
- Secondary biliary cirrhosis
- Post-necrotic cirrhosis (macronodular cirrhosis)
ESOPHAGEAL VARICES
- Varices are large, swollen veins
- Blood in the G.I. tract and spleen drain into the liver via the portal system
- In cirrhosis, the blood cannot flow easily into the liver
- Esophageal veins become overwhelmed with increased blood flow, leading to swelling and risk of bursting
- Portal hypertension: pressure rises in the portal system due to liver disease
- Pressure >6 is considered elevated, and pressure >10 is dangerous
- Varices seen most commonly in the esophagus, but also in the stomach, rectum, and small bowel
- Bleeding varices are life-threatening
- Causes of esophageal varices: portal hypertension, most commonly caused by cirrhosis due to excessive alcohol consumption or hepatitis
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
ASPARTATE AMINOTRANSFERASE (AST) is an enzyme present in tissues with high metabolic activity. Learn about its release, levels, and significance in liver disease and hepatitis.
