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Liver & GIT

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Chronic persistent hepatitis can be differentiated from chronic active hepatitis by (LQ)

A Liver enzyme
B Ultra sound

C Liver biopsy
D Serum ammonia

Ans. C Liver biopsy

Important Points:

Definition – Liver disorders in which hepatic inflammation and necrosis continue for at least 6 months.

1. Classification by cause – These are:

i. Chronic viral hepatitis – hepatitis B,C and D

ii. Autoimmune hepatitis: a. Type I (anti actin/lupoid) Q

b. Type II (Anti LKM) Q

c. Type III (Anti soluble liver antigen) Q

iii. Drugs – (alpha methyldopa, isoniazid) Q

iv. Alcoholic liver disease

v. Non alcoholicsteato hepatitis

vi. Metabolic – Wilson’s disease, hemochromatosis

vii. Cryptogenic

a. Chronic persistent hepatitis Qis classified by grade as minimal or mild chronic hepatitis and by stage as absent or mild fibrosis.

b. Chronic lobular hepatitis Qis classified as mild to moderate grade and by stage as absent or minimal fibrosis.

c. Chronic active hepatitis Q is classified as mild to severe grade and mild to severe fibrosis by staging.

d. Piecemeal necrosis Qis the minimal histological requirement to establish the diagnosis of chronic active hepatitis.


Chronic Viral Hepatitis

1. Piecemeal Necrosis 2. Portal fibrosis 3. Bridging Necrosis

4. Interface hepatitis 5. Ground Glass Appearance


Hepatitis C – Macro Vesicular Steatosis

Hepatitis D – Micro Vesicular Steatosis

Hepatitis E – Marked Cholestatis

Extra Edge: Chronic Viral Hepatitis

Clinical and laboratory features suggest progression of acute hepatitis to chronic hepatitis: (Ref. H 17th Pg-1945)

1. Lack of complete resolution of clinical symptoms of anorexia, weight loss, and fatigue and the persistence of hepatomegaly;

2. The presence of bridging/interface or multilobular hepatic necrosis on liver biopsy during protracted, severe acute viral hepatitis;

3. Failure of the serum aminotransferase, bilirubin, and globulin levels to return to normal within 6–12 months after the acute illness;

4. The persistence of HBeAg for >3 months or HBsAg for >6 months after acute hepatitis.

Liver & GIT Flashcard List

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