7: Pathology of the liver

Question 1

Blood travels through ___ from the hepatic/portal veins to the central veins in liver cells.

Answer 1

zones

Question 2

The liver has massive ___ potential.

Answer 2

regenerative

Question 3

Why can patients offer halves of their liver for transplant?

Answer 3

Massive regenerative potential

Question 4

By which process does the liver usually heal?

Answer 4

Restitution

Question 5

Which healing process does the liver undergo if it’s regenerative potential is overcome, e.g by drugs or alcohol?

Answer 5

Scarring and fibrosis (cirrhosis)

Question 6

What follows the initial insult to hepatocytes e.g viral, drug, toxin?

Answer 6

Inflammation

Question 7

What follows inflammation in liver disease?

Answer 7

Resolution

OR

Chronic inflammation > Fibrosis > Cirrhosis

Question 8

What is end-stage liver fibrosis called?

Answer 8

Cirrhosis

Question 9

What is seen in hepatocytes during acute liver failure?

Answer 9

Massive necrosis

Question 10

What are the three types of jaundice?

Answer 10

Pre-hepatic

Hepatic

Post-hepatic

Question 11

Bilirubin is ___ if it has passed through the liver and ___ if it hasn’t

Answer 11

conjugated , unconjugated

Question 12

What molecule overwhelms the liver in high concentrations and causes pre-hepatic jaundice?

Answer 12

Haemoglobin

Question 13

What causes painless post-hepatic jaundice?

Answer 13

Pancreatic tumours

Question 14

What is end-stage liver disease called?

Answer 14

Cirrhosis

Question 15

Cirrhosis is (reversible / irreversible).

Answer 15

irreversible

Question 16

Cirrhosis is characterised by bands of fibrosis separating the ___ parts of hepatocytes.

Answer 16

regenerative

Question 17

Cirrhosis affects the ___ flow through the liver by altering the vasculature.

Answer 17

blood

Question 18

What does cirrhosis look like?

Answer 18

Compared to smooth liver:

Leathery, craggy, nodular

Question 19

What are the complications of cirrhosis?

Answer 19

Portal hypertension leading to oesophageal/rectal varices and caput medusae

Ascites

Liver failure

Question 20

Low levels of what plasma protein causes ascites in liver disease?

Answer 20

Albumin

Question 21

In alcoholic fatty liver disease, abnormal fat metabolism produces ___ which kill hepatocytes.

Answer 21

toxins

Question 22

Which cells are seen in acute inflammation of the liver?

Answer 22

Neutrophils

Question 23

Which cells lay down the molecule responsible for fibrosis of the liver?

What is this molecule called?

Answer 23

Fibroblasts

Collagen

Question 24

What is seen in hepatocytes in an alcoholic fatty liver?

Answer 24

Steatosis - fatty vacuoles

Question 25

**Fatty** **liver** associated with 2-3 days of drinking is **(reversible / irreversible)**.

Answer 25

**reversible**

Question 26

Is alcohol the only cause of fatty liver disease?

Answer 26

**No**

Question 27

What else causes fatty liver disease (i.e NASH)?

Answer 27

**Pregnancy** **Drugs** **Obesity** **Hepatitis C**

Question 28

What is seen in hepatocytes of those with **alcoholic hepatitis** (week-months of drinking)?

Answer 28

**Necrosis** **NEUTROPHILS** **Mallory bodies** **Fibrosis**

Question 29

The laying down of which molecule by fibroblasts signals the beginning of **liver fibrosis**?

Answer 29

**Collagen**

Question 30

What name is given to the spaces between **hepatocytes** and **sinusoids** (blood vessels where hepatic artery and hepatic portal vein mix)?

Answer 30

**Space of Disse**

Question 31

Where is **collagen** laid down during fibrosis of the liver?

Answer 31

**Space of Disse**

Question 32

Necrosis of the liver is often described by pathologists as \_\_\_.

Answer 32

**nodular**

Question 33

What can occur in the liver after cirrhosis?

Answer 33

**Hepatocellular carcinoma** liver cancer