Autoimmune hepatitis is most characteristically associated with elevated levels of which one of the following immunoglobulins?
Correct Answer E:
Autoimmune hepatitis: Autoimmune hepatitis is condition of unknown aetiology which is most commonly seen in young females. Recognized associations include other autoimmune disorders, hypergammaglobulinaemia and HLA B8, DR3.
Three types of autoimmune hepatitis have been characterized according to the types of circulating antibodies present:
Features:
Management:
The action of which one of the following brush border enzymes results in the formation of glucose and galactose?
Correct Answer D:
Brush border enzymes:
Gastrointestinal physiology: enzymes: Amylase is present in saliva and pancreatic secretions. It breaks starch down into sugar.
The following brush border enzymes are involved in the breakdown of carbohydrates:
A 31-year-old woman who initially presented with abdominal pain and constipation is diagnosed with irritable bowel syndrome.
Which one of the following bits of dietary advice is it least suitable to give?
Correct Answer C: Insoluble sources of fibre such as bran and wholemeal should be avoided in IBS.
Irritable bowel syndrome: management: The management of irritable bowel syndrome (IBS) is often difficult and varies considerably between patients. NICE issued guidelines in 2008.
First-line pharmacological treatment - according to predominant symptom:
Second-line pharmacological treatment:
Other management options:
General dietary advice:
What percentage of patients who contract the hepatitis C virus will become chronically infected?
Correct Answer B: Hepatitis C - 80-85% become chronically infected.
Hepatitis C: Hepatitis C is likely to become a significant public health problem in the UK in the next decade. It is thought around 200,000 people are chronically infected with the virus. At risk groups include intravenous drug users and patients who received a blood transfusion prior to 1991 (e.g. haemophiliacs).
Transmission:
Management of chronic infection:
Complications of treatment:
Which one of the following is not associated with non-alcoholic steatohepatitis?
Correct Answer E: Obese T2DM with abnormal LFTs - ? non-alcoholic fatty liver disease.
Non-alcoholic fatty liver disease: Non-alcoholic fatty liver disease (NAFLD) is now the most common cause of liver disease in the developed world. It is largely caused by obesity and describes a spectrum of disease ranging from:
NAFLD is thought to represent the hepatic manifestation of the metabolic syndrome and hence insulin resistance is thought to be the key mechanism leading to steatosis.
Non-alcoholic steatohepatitis (NASH) is a term used to describe liver changes similar to those seen in alcoholic hepatitis in the absence of a history of alcohol abuse. It is relatively common and though to affect around 3-4% of the general population. The progression of disease in patients with NASH may be responsible for a proportion of patients previously labelled as cryptogenic cirrhosis.
Associated factors:
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