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GI and Nutrition > 3.2.3 Pathology of Liver Injury I > Flashcards

3.2.3 Pathology of Liver Injury I Flashcards

1
Q

What is this an iamge of?

A

Ductal proliferation associated with secondary biliary cirrhosis

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2
Q

What is Crigler-Najjar syndrome?

A

Type I has complete lack of enzyme needed for the conjugation of glucuronic acid to bilirubin

Type II - has partial lack of enzyme

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3
Q

What are the three main causes of cirrhosis?

A

Alcohol, viral hepatitis, and fatty liver disease

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4
Q

Mallory hyaline is most often associated with what in liver disease?

A

Alcohol

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5
Q

What is this an image of?

A

Lipofusion - will not stain with Perls Iron stain

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6
Q

What is this an image of?

A

Alpha-1 antitrypsin deficiency

PAS-diastase resistant globules

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7
Q

Portal hypertension can lead to ascites. What is that?

A

Fluid is driven into the space of disse

Tons of fluid in the abdomen

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8
Q

This patient has what type of defect?

A

0.2/1.3 (Conjugated bili:Total) = 0.15 - Unconjugated hyperbilirubinemia

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9
Q

What are the sources of defective conjugation hyperbilirubinemia?

A
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10
Q

Elevated direct (conjugated) bilirubin is a sign of what (2)?

A

Decreased hepatocellular excretion

Impaired bile flow

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11
Q

What is this an image of?

A

Perls Iron staining - hemachromotosis

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12
Q

What is this an image of?

A

Fluorid duct lesion associated with PBC

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13
Q

What is this an image of?

A

Cirrhosis of the liver

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14
Q

How can a defect in RBC lead in increased bilirubin?

A

A defect in which there are too many dead RBCs (hemolytic jaundice)

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15
Q

What are the characteristics of unconjugated bilirubin?

A

Insoluble in water - exists in tight complexes with albumin

Connot be excreted in the urine

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16
Q

What is jaundice?

A

Too much bilirubin in the blood

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17
Q

What is primary biliary cirrhosis?

A

Chronic bile duct destructive disease

Autoimmune disease

Most important: Serum anti-mitochondrial antibody (AMA) is increased

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18
Q

What are the causes of sudden massive hepatic necrosis?

A
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19
Q

Portal hypertension tends to lead to what?

A

Portosystemic shunts

Hemorrhoids

Esophageal varicies

Caput medusa

20
Q

What is this an image of?

A

Bile degeneration - bile accumulation in cells

21
Q

What are some of the things that can accumulate intracellularly in the liver (6)?

A

Bile

Fat

Iron

Copper

Lipofuscin

Protein in RER

22
Q

What zone is most susceptible to ischemia?

A

Zone 3 - closest to central vein

23
Q

What are the tests for cholestasis?

A

Alk phos and GGT

24
Q

What is the cell that causes fibrosis of the liver?

A

Stellate cells

25
Q

What is Dubin-Johnson syndrome?

A

Absence of canalicular protein MDR2 - increased levels of conjugated bilirubin

26
Q

What is this an image of?

A

Confluent necrosis

27
Q

Liver receives blood from where?

A

Portal vein

Hepatic artery

28
Q

What disease is associated with this image?

A

Primary sclerosing cholangitis

29
Q

What is this an image of?

A

Steatosis - fatty accumulations

30
Q

What is this an image of?

A

Interface hepatitis

31
Q

What is the microscopic finding with PSC?

A

Periductal fibrosis

32
Q

What is this an image of?

A

Apoptosis - eosinophilic body in viral hepatitis - aka dead red

33
Q

What will be the characteristics of secondary biliary cirrhosis?

A

Prolonged obstruction of biliary tree - most often gallstones

Microscopically finding ductal proliferation

34
Q

What are the types of apoptosis and necrosis of the liver?

A
35
Q

What is liver cirrhosis?

A

Progressive fibrosis and reorganization of vascular microarchitecture of the liver

Types I and III collagen are deposited in the lobule

36
Q

What are the lab studies that acute hepatitis, cirrhosis, chronic liver disease, and obstructive liver disease will yield?

A
37
Q

What are the diseases of obstructive jaundice?

A
38
Q

Elevated indirect (unconjugated) is a sign of what (3)?

A

Excessive production of bilirubin

Reduced hepatic uptake

Impaired conjugation

39
Q

What are each of the covered parts

A
40
Q

What will you see on PBC histology?

A

Lymphocytic infiltrate in the bile ducts

Granulomas

41
Q

What is this an image of?

A

PBC

42
Q

What will be the cholangiogram findings be in PCS

A

Beaded areas

43
Q

What are the characteristics of primary sclerosing cholangitis (PSC)?

A

Affects younger men 20-40

Associated with ulcerative colitis

p-ANCA in 80% of cases

44
Q

What is this an image of?

A

Iron

45
Q

What is Gilbert syndrome?

A

Mutation in the UGT gene - decreased levels - leads to decreased ability to conjugate bilirubin

46
Q

What are the characteristics of conjugated bili?

A

Water soluble and non-toxic

Can be excreted in the urine

GI and Nutrition (57 decks)

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