3rd Shifting - LQ1 part 2

Question 1

connect the bile canaliculi to bile ductules in the periportal region

Answer 1

Canals of Hering

Question 2

Major 1° Liver diseases

Answer 2

(1) viral hepatitis
(2) alcoholic liver disease
(3) nonalcoholic fatty liver disease (NAFLD)
(4) hepatocellular carcinoma

Question 3

PATTERNS OF HEPATIC INJURY

Answer 3

 Degeneration and intracellular accumulation
 Necrosis and apoptosis
 Inflammation
 Regeneration
 Fibrosis

Question 4

Most severe clinical consequence of liver disease

Answer 4

Hepatic Failure

Question 5

the encephalopathy develops rapidly within 2 weeks of the onset of jaundice

Answer 5

fulminant liver failure

Question 6

if the encephalopathy develops within 3 months of the onset of jaundice

Answer 6

subfulminant liver failure

Question 7

Acute liver illness that is associated with encephalopathy within 6 months after the initial diagnosis

Answer 7

Acute Liver Disease

Question 8

characteristic “musty” or “sweet and sour” body odor due to Shunting of sphlancnic blood from the portal into the systemic circulation

Answer 8

Fetor hepaticus

Question 9

Hepatopulmonary Syndrome Clinical triad

Answer 9

Chronic liver disease
Hypoxemia
Intrapulmonary vascular dilation

Question 10

12th most common cause of death; Account for most liver-related death

Answer 10

CIRRHOSIS

Question 11

CHARACTERISTICS of Liver Cirrhosis

Answer 11

Bridging fibrous septae
Parenchymal nodules
Disruption of architecture of entire liver

Question 12

Transient mild unconjugated hyperbilirubinemia

Answer 12

NEONATAL JAUNDICE (physiologic jaundice of the newborn)

Question 13

Defect in hepatocellular excretion of bilirubin glucuronides across canalicular membrane

Answer 13

Dubin-Johnson syndrome

Question 14

mutation in the ATP8B1 gene on chromosome 18q21 that causes impaired bile secretion

Answer 14

PROGRESSIVE FAMILIAL INTRAHEPATIC CHOLESTASIS (PFIC) 1

Question 15

caused by mutations in the hepatocyte canalicular bile salt export pump (BSEP), encoded by the ABCB11 gene.

Answer 15

PROGRESSIVE FAMILIAL INTRAHEPATIC CHOLESTASIS (PFIC) 2

Question 16

caused by mutations in the ABCB4 gene, characterized by cholestasis with a high serum GGT

Answer 16

PROGRESSIVE FAMILIAL INTRAHEPATIC CHOLESTASIS (PFIC) 3

Question 17

Chronic hepatitis indistinguishable from chorionic viral hepatitis; pathogenesis is attributed to T cell–mediated autoimmunity

Answer 17

AUTOIMMUNE HEPATITIS

Question 18

Antibodies circulating in type 1 Autoimmune Hepatitis

Answer 18

antinuclear (ANA)
anti–smooth muscle (SMA)
anti–actin (AAA),
anti–soluble liver antigen/liver-pancreas antige (anti-SLA/LP)

Question 19

Antibodies circulating in type 2 Autoimmune Hepatitis

Answer 19

anti–liver kidney microsome-1 (ALKM-1) antibodies

anti–liver cytosol-1 (ACL-1)

Question 20

is the leading cause of drug-induced acute liver failure

Answer 20

acetaminophen

Question 21

rare and potentially fatal syndrome of mitochondrial dysfunction in liver, brain, and elsewhere

Answer 21

Reye syndrome

Question 22

Clinical Features of Alcoholic Liver Disease

Answer 22

Hepatic Steatosis (Fatty Liver)
Alcoholic Hepatitis
Alcoholic Cirrhosis

Question 23

cytokeratin intermediate filaments and other proteins; eosinophilic cytoplasmic inclusions in degenerating hepatocytes

Answer 23

Mallory Bodies

Question 24

Mutations in the Jagged 1 on chromosome 20p; Syndrome of paucity of bile ducts; Arteriohepatic Dysplasia

Answer 24

Alagille syndrome

Question 25

larger ducts of the intrahepatic biliary tree are segmentally dilated

Answer 25

Caroli Disease

Question 26

portal tracts are enlarged by irregular, broad bands of collagenous tissue, forming septa that divide the liver into irregular islands

Answer 26

Congenital hepatic fibrosis

Question 27

small clusters of modestly dilated bile ducts embedded in a fibrous, sometimes hyalinized, stroma

Answer 27

Von Meyenburg Complexes

Question 28

Hepatic vein thrombosis

Answer 28

Budd- Chiari syndrome

Question 29

HELLP syndrome

Answer 29

 Hemolytic anemia
 Elevated Liver enzymes
 Low Platelet

Question 30

denotes a liver entirely transformed into roughly spherical nodules, in the absence of fibrosis

Answer 30

Nodular regenerative hyperplasia

Question 31

appears as a well-demarcated but poorly encapsulated nodule, ranging up to many centimeters in diameter

Answer 31

Focal nodular hyperplasia

Question 32

Cavernous hemangiomas

Answer 32

are the most common benign liver tumors.

Question 33

benign neoplasms developing from hepatocytes

Answer 33

Liver cell adenoma

Question 34

most common liver tumor of young childhood

Answer 34

Hepatoblastoma

Question 35

third most frequent cause of cancer deaths

Answer 35

Hepatocellular carcinoma

Question 36

Four major etiologic factors of Hepatocellular carcinoma

Answer 36

• chronic viral infection (HBV, HCV)
• chronic alcoholism
• non-alcoholic steatohepatitis (NASH)
• food contaminants (primarily aflatoxins)

Question 37

second most common hepatic malignant tumor after HCC

Answer 37

Cholangiosarcoma

Question 38

extrahepatic forms of Cholangiosarcoma located at the junction of the right and left hepatic ducts forming the common hepatic duct, and distal bile duct tumors

Answer 38

Klatskin tumors

Question 39

most common anomaly of the gall bladder

Answer 39

folded fundus

Question 40

Five F’s of Cholelithiasis prevalence

Answer 40

fair, fat, fertile, female, forty

Question 41

Occasionally a large stone may erode directly into an adjacent loop of small bowel

Answer 41

Gallstone ileus or Bouveret’s syndrome

Question 42

Characterized by recurrent attacks of severe pancreatitis usually beginning in childhood; Germline (inherited) mutation in the cationic trypsinogen gene (a.k.a. PRSS1)

Answer 42

HEREDITARY PANCREATITIS

Question 43

Defined as inflammation of the pancreas with irreversible destruction of exocrine parenchyma, fibrosis and in the late stages, the destruction of endocrine parenchyma

Answer 43

Chronic Pancreatitis

Question 44

o Autoimmune pancreatitis

o Characterized by a duct-centric mixed inflammatory cells infiltrate

Answer 44

 LYMPHOPLASMACYTIC SCLEROSING PANCREATITIS

Question 45

Migratory thrombophlebitis may occur due to elaboration of platelet-aggregating factors and procoagulants in Pancreatic cancer

Answer 45

Trousseau sign

Question 46

rare neoplasms that occur primarily in children aged 1 to 15 years; distinct microscopic appearance with squamous islands admixed with acinar cells

Answer 46

PANCREATOBLASTOMA