TYK52 - Revision history

WikiSysop at 22:51, 23 January 2022

2022-01-23T22:51:53Z

← Older revision		Revision as of 22:51, 23 January 2022
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	Which of the following halogenated agents is NOT associated with fulminant autoimmune hepatitis?		Which of the following halogenated agents is NOT associated with fulminant autoimmune hepatitis?

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	E. Isoflurane		E. Isoflurane
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	==Answer==		==Answer==
	The answer is B. The first large study on halothane-associated liver injury reported an incidence of 1:35,000 for fatal hepatic necrosis after halothane anesthesia. Patients are thought to be at higher risk after repeated exposures. This is in contrast to a MILD form of hepatocelluar injury than can occur in 20% of patients after halothane anesthesia. The mild form involves a transient elevation in liver enzymes (ALT) and slight alterations in cellular integrity by electron microscopy. The metabolism of halogenated agents causes tissue acetylation. Antibodies against these neo-antigens is thought to be the mechanism of the severe type of hepatic injury. The onset for the severe type occurs at 4-7 days and is usually present with jaundice and fever. Enflurane, isoflurane, halothane, and desflurane have been reported to trigger this fulminant type. As sevoflurane is metabolized by a distinctly different pathway than the agents with a methyl-ethyl structure, the autoimmune response is not known to occur. The MILD injury can still occur.		The answer is B. The first large study on halothane-associated liver injury reported an incidence of 1:35,000 for fatal hepatic necrosis after halothane anesthesia. Patients are thought to be at higher risk after repeated exposures. This is in contrast to a MILD form of hepatocelluar injury than can occur in 20% of patients after halothane anesthesia. The mild form involves a transient elevation in liver enzymes (ALT) and slight alterations in cellular integrity by electron microscopy. The metabolism of halogenated agents causes tissue acetylation. Antibodies against these neo-antigens is thought to be the mechanism of the severe type of hepatic injury. The onset for the severe type occurs at 4-7 days and is usually present with jaundice and fever. Enflurane, isoflurane, halothane, and desflurane have been reported to trigger this fulminant type. As sevoflurane is metabolized by a distinctly different pathway than the agents with a methyl-ethyl structure, the autoimmune response is not known to occur. The MILD injury can still occur.

	==Notes==		==Notes==
	<references />		<references />


	==Keywords==		==Keywords==
	:


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WikiSysop: 1 revision imported

2021-03-20T16:48:30Z

1 revision imported

← Older revision	Revision as of 16:48, 20 March 2021
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https://pedsanesthesia.net/wikiOLD032021>JustinHamrick at 11:19, 9 March 2015

2015-03-09T11:19:14Z

New page

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Which of the following halogenated agents is NOT associated with fulminant autoimmune hepatitis?

A. Halothane

B. Sevoflurane

C. Desflurane

D. Enflurane

E. Isoflurane

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==Answer==
The answer is B. The first large study on halothane-associated liver injury reported an incidence of 1:35,000 for fatal hepatic necrosis after halothane anesthesia. Patients are thought to be at higher risk after repeated exposures. This is in contrast to a MILD form of hepatocelluar injury than can occur in 20% of patients after halothane anesthesia. The mild form involves a transient elevation in liver enzymes (ALT) and slight alterations in cellular integrity by electron microscopy. The metabolism of halogenated agents causes tissue acetylation. Antibodies against these neo-antigens is thought to be the mechanism of the severe type of hepatic injury. The onset for the severe type occurs at 4-7 days and is usually present with jaundice and fever. Enflurane, isoflurane, halothane, and desflurane have been reported to trigger this fulminant type. As sevoflurane is metabolized by a distinctly different pathway than the agents with a methyl-ethyl structure, the autoimmune response is not known to occur. The MILD injury can still occur.

==Notes==
<references />

==Keywords==
:

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