11 Liver and Biliary System Pathology Flashcards
What are the functions of the liver?
What is encephalopathy? What pathology relating to the liver may cause this?
Encephalopathy: brain disease, damage, or malfunction
Eg caused by deranged metabolism of ammonia
What is acute liver failure and what may cause it?
- Acute liver failure: rapid onset, no previous history of liver disease
- Causes:
- Medication overdose (eg paracetamol)
- Acute viral infection (hep A/B)
- Acute, excessive alchohol intake
Liver cirrhosis is irreversible and results in impairment of liver function. What happens in liver cirrhosis? (3)
Damage to the liver due to alcohol is thought to be due to the excessive build up of acetaldehyde. Outline how exposure to alcohol affects the liver. (3)
What are the signs and symptoms which may be caused by alcoholic liver disease?
Ascites: the accumulation of protein-containing (ascitic) fluid within the abdomen
Here are 5 categories of causes of liver cirrhosis:
- Drugs
- Infection
- Deposition
- Autoimmune
- Other
Give a specific examples within each category
What does NAFLD stand for? How is it caused?
NAFLD= Non-alcoholic fatty liver disease
Causes:
Accumulation of lipids in hepatocytes- link to insulin resistance
(If inflammation present: Non-Alcoholic Steatohepatitis)
What are the risk factors for NAFLD?
Outline the pathophysiology of hereditary haemochromatosis and Wilson’s disease.
What do the acronyms that relate to autoimmune causes of liver cirrhosis stand for?
PBC= Portal biliary cirrhosis
PSC= Primary sclerosing colangitis
AMA= Anti-microbial antibody
ASMA= Anti smooth muscle antibody
ANA= Anti nuclear antibody
- PBC- affects more women*
- PSC- affects more men*
Fill in the missing vein labels:
Liver cirrhosis can result in portal hypertension. Describe portal hypertension and the consequences of it.
Portal hypertension= build up of blood in portal venous system
Consequences:
- Compress veins entering liver
- Causes ascites
- Build up of pressure in splenic circulation- splenomegaly
-
Blood shunt from portal system to systemic venous circulation
- …causes varices: distension of veins in mucosa
What are the 3 sites where varices can be caused by portal hypertension?
- Oesophageal
- Anorectal
- Umbilical
If the oesophageal varices caused by portal hypertension rupture, what do they cause?
Haematemesis
Between which veins does blood shunt in anorectal varices due to portal hypertension?
Explain how umbilical varices due to portal hypertension can cause caput medusa.
What are gall stones made of?
What are the risk factors for developing galls stones?
Outline biliary colic.
Outline acute cholecystitis.
Outline acute cholangitis (including its management).
Fill in the table with the appropriate ticks.
Explain how acute pancreatitis can be caused by gallstones.
Can block pancreatic duct
Evokes infammatory response
Acinar cell injury and necrosis
Autodigestion of pancreas
How does acute pancreatitis present?
How is acute pancreatitis investigated and managed?
How is hepatorenal syndrome caused?
