3.2.3 Pathology of Liver Injury I Flashcards
What is this an iamge of?

Ductal proliferation associated with secondary biliary cirrhosis
What is Crigler-Najjar syndrome?
Type I has complete lack of enzyme needed for the conjugation of glucuronic acid to bilirubin
Type II - has partial lack of enzyme
What are the three main causes of cirrhosis?
Alcohol, viral hepatitis, and fatty liver disease
Mallory hyaline is most often associated with what in liver disease?
Alcohol
What is this an image of?

Lipofusion - will not stain with Perls Iron stain
What is this an image of?

Alpha-1 antitrypsin deficiency
PAS-diastase resistant globules
Portal hypertension can lead to ascites. What is that?
Fluid is driven into the space of disse
Tons of fluid in the abdomen
This patient has what type of defect?

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

What are the sources of defective conjugation hyperbilirubinemia?

Elevated direct (conjugated) bilirubin is a sign of what (2)?
Decreased hepatocellular excretion
Impaired bile flow
What is this an image of?

Perls Iron staining - hemachromotosis
What is this an image of?

Fluorid duct lesion associated with PBC
What is this an image of?

Cirrhosis of the liver
How can a defect in RBC lead in increased bilirubin?
A defect in which there are too many dead RBCs (hemolytic jaundice)
What are the characteristics of unconjugated bilirubin?
Insoluble in water - exists in tight complexes with albumin
Connot be excreted in the urine
What is jaundice?
Too much bilirubin in the blood
What is primary biliary cirrhosis?
Chronic bile duct destructive disease
Autoimmune disease
Most important: Serum anti-mitochondrial antibody (AMA) is increased
What are the causes of sudden massive hepatic necrosis?

Portal hypertension tends to lead to what?
Portosystemic shunts
Hemorrhoids
Esophageal varicies
Caput medusa
What is this an image of?

Bile degeneration - bile accumulation in cells
What are some of the things that can accumulate intracellularly in the liver (6)?
Bile
Fat
Iron
Copper
Lipofuscin
Protein in RER
What zone is most susceptible to ischemia?
Zone 3 - closest to central vein
What are the tests for cholestasis?
Alk phos and GGT
What is the cell that causes fibrosis of the liver?
Stellate cells
What is Dubin-Johnson syndrome?
Absence of canalicular protein MDR2 - increased levels of conjugated bilirubin
What is this an image of?

Confluent necrosis
Liver receives blood from where?
Portal vein
Hepatic artery
What disease is associated with this image?

Primary sclerosing cholangitis
What is this an image of?

Steatosis - fatty accumulations
What is this an image of?

Interface hepatitis
What is the microscopic finding with PSC?

Periductal fibrosis
What is this an image of?

Apoptosis - eosinophilic body in viral hepatitis - aka dead red
What will be the characteristics of secondary biliary cirrhosis?
Prolonged obstruction of biliary tree - most often gallstones
Microscopically finding ductal proliferation
What are the types of apoptosis and necrosis of the liver?

What is liver cirrhosis?
Progressive fibrosis and reorganization of vascular microarchitecture of the liver
Types I and III collagen are deposited in the lobule
What are the lab studies that acute hepatitis, cirrhosis, chronic liver disease, and obstructive liver disease will yield?

What are the diseases of obstructive jaundice?

Elevated indirect (unconjugated) is a sign of what (3)?
Excessive production of bilirubin
Reduced hepatic uptake
Impaired conjugation
What are each of the covered parts


What will you see on PBC histology?
Lymphocytic infiltrate in the bile ducts
Granulomas
What is this an image of?

PBC
What will be the cholangiogram findings be in PCS
Beaded areas
What are the characteristics of primary sclerosing cholangitis (PSC)?
Affects younger men 20-40
Associated with ulcerative colitis
p-ANCA in 80% of cases
What is this an image of?

Iron
What is Gilbert syndrome?
Mutation in the UGT gene - decreased levels - leads to decreased ability to conjugate bilirubin
What are the characteristics of conjugated bili?
Water soluble and non-toxic
Can be excreted in the urine