116b cirrhosis and liver cancer

Question 1

what can cause liver cirrhosis? what is the appearance of the cirrhosis?

Answer 1

alcohol –> micronodular (no triads/central veins)
Hep B and C –> macronodular (contains vessels)
toxins - hemochromatosis, wilson’s, A1AT deficiency

Question 2

long term outcomes of cirrhosis? reversible?

Answer 2

portal HTN
HCC

irreversible

Question 3

what is the pathogenesis of cirrhosis?

Answer 3

inflammation, cell necrosis –> scars (stellate cells), regeneration –> disortion –> functional problems with blood flow (portal HTN)

Question 4

Budd-Chiari syndrome

Answer 4

hepatic vein/IVC occlusion/thrombosis
from hypercoagulable state (lupus, prergo), HCC
leads to hepatomegaly, abd pain, ascites

Question 5

liver failure from cirrhosis - endocrine problems

Answer 5

feminization due to increased conversion of testosterone to estrone)
spinder angiomas
gynecomastia
testicular atrophy

Question 6

markers of HCC

Answer 6

increased a-fetoprotein (>500)
enlarged liver/mass - repeat US/repeat biopsy
elevation of right diaphragm

Question 7

malig epithelial liver tumors

Answer 7

HCC - liver cell

cholangiocarcinoma - bile duct cell

Question 8

malig non-epithelial liver tumor

Answer 8

angiosarcoma

Question 9

Hepatic adenoma

Answer 9

Benign liver tumor
often related to oral contraceptive or steroid use
circumscribed w/out cirrhosis
can regress spontaneously.