Gastroenterology & Hepatology — Flashcards

Flashcard 451: What is the referral for Hepatitis C? _____

Answer: Referred for specialist care

Flashcard 452: What is the definitive management of autoimmune hepatitis for patients with decompensated cirrhosis or acute liver failure?

Answer: Liver transplantation is indicated for decompensated cirrhosis or fulminant hepatic failure. First-line medical therapy remains corticosteroids and/or azathioprine.

Extra: Autoimmune hepatitis (AIH) usually responds well to steroids (Prednisolone) and Azathioprine. However, for those who progress to end-stage liver disease or present with acute liver failure, liver transplantation is the definitive treatment. Approximately 10-20% of AIH patients will eventually require a transplant.

Flashcard 453: What is the mainstay investigation to diagnose hepatitis C? _____ → HCV RNA (if anti-HCV antibody test is +ve)

Answer: Anti-HCV antibodies

Flashcard 454: There are 2 main types of hepatitis C; _____ & Chronic

Answer: Acute

Flashcard 455: Autoimmune hepatitis is associated with other autoimmune diseases, most commonly _____

Answer: autoimmune thyroid disease

Flashcard 456: Patients with autoimmune hepatitis should be vaccinated against _____ & B

Answer: hepatitis A

Flashcard 457: How do you diagnose autoimmune hepatitis? _____ -ve test for viral hepatitis High titers of autoantibodies + clinical findings

Answer: LFTs → raised ALT & AST

Flashcard 458: _____ hepatitis C < 6 months Chronic hepatitis C > 6 months after initial infection

Answer: Acute

Flashcard 459: Autoimmune hepatitis can present with _____ in ~40% of patients and ~30% have cirrhosis at the time of presentation

Answer: jaundice

Flashcard 460: What is the mainstay management of autoimmune hepatitis? _____

Answer: Corticosteroids (e.g., prednisolone) +/- Azathioprine

Extra: The goal of treatment is to induce and maintain remission. Prednisolone is used for induction, while Azathioprine is often added as a steroid-sparing agent for maintenance.