10/8: Hepatobiliary Pathology

Question 1

what are the portal triads composed of?

Answer 1

hepatic artery
portal vein
bile duct

Question 2

describe liver blood flow

Answer 2

hepatic artery and portal vein to the portal triad vessels than sinusoids then the central vein then sublobular vein then hepatic vein

Question 3

what are the functions of the hepatocytes?

Answer 3

protein synthesis
oxidation of drugs
lipid metabolism
carb metabolism
produces bile

Question 4

what are the types of reversible changes?

Answer 4

accumulation of fat (stenosis)
accumulation of bile

Question 5

how does the liver regenerate?

Answer 5

hepatocyte divide near site of injury
if severe, stem cells divide

Question 6

this is often a result of chronic liver disease

Answer 6

scar formation

Question 7

how can you get acute liver failure?

Answer 7

acetaminophen, hepatitis, drugs

Question 8

what are the clinical features of acute liver failure?

Answer 8

nasea/vomiting –> jaundice –> icterus –> hepatic encelepathy –> coagulation –> hepatorenal syndrome

Question 9

this is yellow coloration

Answer 9

jaundice

Question 10

this is discoloration of the eyes

Answer 10

icterus

Question 11

hepatic encelepathy is beleived ot be caused by

Answer 11

elevated ammonia levels

Question 12

this is bleeding and bruising

Answer 12

coagulopathy

Question 13

what is present in chronic liver failure?

Answer 13

cirrhosis
portal hypertension
ascites

Question 14

does cirrhosis mean you have chronic liver disease?

Answer 14

no

Question 15

this is increased fluid in the perioteneal space

Answer 15

ascites

Question 16

describe Hep A

Answer 16

benign, self limiting
ingestion of contaminated food (enteric)
not chronic
IgM diagnosis

Question 17

describe Hep B

Answer 17

most common
parenteral transmission
vaccine is 95% effective
elevated risk for hepatocellular carcinoma

Question 18

describe Heb C

Answer 18

pareneteral transmission
acute but can become chronic
antiviral combination therapy
HCV

Question 19

describe HepD

Answer 19

coinfection with hep B
parenteral
superinfection

Question 20

describe Hep E

Answer 20

enterically
zoonotic (animal reservoir)
IgM

Question 21

what Hepatitis is self-limiting?

Answer 21

Hep A and E

Question 22

what other ways can you get liver disease?

Answer 22

bacteria (S. Aeureus, salmonella typhi)
parasites (entoameba histolycia)

Question 23

autoimmune hepatitis presents with what features?

Answer 23

autoantibodies
response to immunosuppresion (remission in 90%)
can be genetic

Question 24

what are the patterns of injury for drugs and toxins?

Answer 24

fibrosis
fatty change
cholestasis
necrosis

Question 25

what kind of drug reactions are there?

Answer 25

predictable (intrinsic) unpredictable (idiosyncratic)

Question 26

this is symptoms and abnormailites that develop in teh setting of an already fatty-liver

Answer 26

steatohepatitis

Question 27

this is becoming more common and associated with type 2 diabetes, obesity, hyperlipidema

Answer 27

NAFLD

Question 28

what are the types of metabolic liver disease?

Answer 28

hemochromatosis wilson disease alpha-1 antitrypsin

Question 29

this is excessive iron absoption that may be acquired but usually hereditary from the HFE gene

Answer 29

hemochromatosis

Question 30

hemochromatosis causes tissue deposition of

Answer 30

hemosiderin

Question 31

this is a disease (ATP7B) that leads to impaired copper excretion

Answer 31

wilson disease

Question 32

kayser-fleischer rings in the eyes are associated with

Answer 32

Wilson disease

Question 33

this is loss of function of alpha-1 which inhibits proteases

Answer 33

alpha-1 anti-trypsin

Question 34

what are the benign and malignant tumors?

Answer 34

benign = focal nodular hyperplasia, cavernous hemangioma, hepatocellular adenoma malignant - hepatocellular carcinoma

Question 35

this tumor may be single or multiple and is common in younger women

Answer 35

focal nodular hyperplasia

Question 36

this tumor is most common in reproductive age women

Answer 36

hepatocellular adenoma

Question 37

this is the most common benig liver tumor

Answer 37

cavernous hemangioma

Question 38

what is the carcinogen for hepatocellula carcinoma

Answer 38

exposure to HBV, HCV, NAFLD and alflatoxin

Question 39

this functiosn to concentrate, store, and excrete bile

Answer 39

gallbladder

Question 40

where does the gallbladder recieve bile?

Answer 40

common hepatic duct

Question 41

how does teh gallbladder excrete bile?

Answer 41

common bile duct cystsic duct

Question 42

what are the layers of the gallbladder wall?

Answer 42

mucosa msucularis externa connective tissue/adventitia serosa

Question 43

what is cholelithiasis?

Answer 43

gallstones

Question 44

what are teh types of gallstones?

Answer 44

cholesterol stones pigment stones

Question 45

what are teh cholesterol stone risks?

Answer 45

dyslipidemia female insuline resistance gallbladder statsis

Question 46

what are the pigment stone risks?

Answer 46

GI infection biliary infection chornic hemolysis

Question 47

a disease characterized by defective copper metabolism is

Answer 47

wilsons disease

Question 48

this contributes to a majority of chronic liver disease

Answer 48

alcohol

Question 49

cirrohsis is characterized by all of teh following except

Answer 49

reversible

Question 50

the most powerful carcinogen for hepatocytes is

Answer 50

aflatoxin