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GIHEP > 1. Liver Structure, Function and Dysfunction > Flashcards

1. Liver Structure, Function and Dysfunction Flashcards

1
Q

What things can cause damage to the liver?

A 
Alcohol
Fatty liver disease
Viruses
Drugs
Autoimmune
Inherited metabolic syndromes
Vascular
Chronic biliary disease
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2
Q

How heavy is the average liver?

A

1.5kg

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3
Q

How regenerative are hepatocytes?

A

Stable cells

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4
Q

What is the blood supply to the liver?

A

Hepatic artery and portal vein

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5
Q

What are sinusoids lined with?

A

Fenestrated epithelium and Kupffer cells

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6
Q

What is the space between sinusoids and hepatocytes known as?

A

Space of Disse

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7
Q

What type of cell is found in the Space of Disse?

A

Hepatic Stellate Cells

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8
Q

What is the function of hepatic stellate cells?

A

Can transform into myofibroblasts if the liver is injured, and can both lay down and digest collagen

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9
Q

What is the venous drainage of the liver?

A

Hepatic vein
IVC
Right ventricle

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10
Q

What is a portal tract made up of?

A

Portal vein
Hepatic artery
Bile duct

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11
Q

What cell produces bile?

A

Hepatocytes

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12
Q

Give the drainage of bile

A 
Cannaliculi between hepatocytes
Small ductules
Small ducts in portal tracts
Left and right hepatic duct join to form common hepatic duct
CHD + cystic duct = common bile duct
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13
Q

What are the causes of vascular injury to the liver?

A

Venous congestion
Obstruction to venous outflow
Ischaemic injury

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14
Q

What is Budd Chiari syndrome?

A

Thrombus in venous outflow, associated with polycythaemia

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15
Q

What length of time defines chronic liver damage?

A

> 6 months

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16
Q

What kind of necrosis is seen in small groups of cells?

A

Spotty necrosis

17
Q

What kind of necrosis is seen in large groups of cells?

A

Bridging necrosis

18
Q

What is the grade in relation to liver damage?

A

The extent of inflammation and necrosis

19
Q

What is piecemeal necrosis?

A

Inflammation is both portal and lobular

20
Q

What is the stage in relation to liver damage?

A

How much fibrosis is present

21
Q

What are the 2 reasons a slide of a liver might be blue

A

Trichrome stain: collagen

speckly blue= iron= haemochromatosis

22
Q

What is cirrhosis?

A

Diffuse distortion of liver architecture
Fibrous bands surround regenerative nodules
Vascular relationships are distorted

23
Q

What vascular changes take place in cirrhosis?

A

Obliteration/thrombosis of veins
Shunts form
Sinusoids become capillarised
Increased hepatic venous pressure gradient

24
Q

What does it mean for sinusoids to become capillarised?

A

They lose their fenestrations

25
Q

What initiates portal hypertension?

A

Increased pressure gradient

26
Q

What augments portal hypertension?

A

Splanchnic vasodilation, which increases portal blood flow

27
Q

What is hyperdynamic circulation?

A

Splanchnic vasodilation means the rest of the body is getting less blood, so the body compensates to increase CO

28
Q

What compensation mechanisms are seen in portal hypertension?

A

RAAS and ADH which increase Na and water retention

Reflex renal vasoconstriction

29
Q

What are the effects of reflex renal vasoconstriction?

A

Reduce renal perfusion and GFR

Causes hepatorenal syndrome

30
Q

What causes acites?

A

Sodium and water retention

Low albumin due to dysfunctional liver causes leakage from peritoneal vessels

31
Q

What are shunts?

A

Fluid tries to find a way around the high pressure in the portal system
Both intrahepatic and extrahepatic

32
Q

What are the effects of shunts?

A

Blood bypasses the liver, reducing perfusion and function

porto-systemic anastamoses dilation

33
Q

What is the difference between compensated and decompensated cirrhosis?

A

Compensated is a potentially unstable state without symptoms

34
Q

What are the symptoms of decompensated cirrhosis?

A 
Ascites
Hepatic encephalopathy
Variceal haemorrhage
Hepatorenal syndrome
Jaundice
Infection
Hepatocellular carcinoma

GIHEP (30 decks)

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