Acute And Chronic Hepatitis Flashcards
What is the hepatic lobule composed of?
Hepatocytes radiating outwards from the central vein, to the portal triad
What does the portal triad contain?
Portal vein, hepatic artery and bile duct
What is the Functional unit of the liver?
The Hepatic acinus
The hepatic acinus has 3 zones, the first zone has which type of hepatocytes?
Periportal, they are metabolically active
Zone 2 has what type of hepatocytes?
Midzonal, they’re of regenerative potential
Zone 3 has what type of hepatocytes?
Centrilobular, they receive the lowest oxygen and nutrient supply
What’s the duration of acute hepatitis vs chronic?
Chronic if 6 months or more
What damage can chronic hepatitis cause?
Liver fibrosis, cirrhosis, or hepatocellular carcinoma
Most common cause of acute hepatitis?
Viral infection
Acute viral hepatitis is caused by 2 types of viruses, what are they?
Hepatotropic and non-hepatotropic
Difference between hepatotropic and non hepatotropic?
Hepatotropic infect the liver cells only
What is the most common cause of acute viral hepatitis?
Hepatotropic
All hepatotropic viruses are RNA viruses except…?
Hepatitis B
Hepatitis A and E virus are transmitted via?
Enterically via feco-oral route
Hepatitis B,C,D are transmitted via?
Parentally
What is the mechanism of hepatocytes injury?
immune-mediated
How does yhe hepatocyte injury in HBV and C become chronic?
The virus specific T-cells are exhausted, thus allowing the virus to exist indefinitely
What is histologically seen with the hepatitis?
Hepatocytic swelling, focal spotty necrosis
Explain the histological feature called bridging
When the necrosis extends from zone 3 to 1, the reticulum collapses and leaves connective tissue septa
What is the Clinical presentation of acute hepatitis?
Icteric attack
What is the Pre icteric phase?
The patients feels very unwell a few days or weeks even before the icteric phase
What does the icteric phase present as?
Jaundice, darkening of urine and lightening of stools
What is prolonged cholestasis commonly associated with?
HAV and HEV
What biomarker increases to indicate acute hepatitis?
Serum aminotransferases
What are the values that serum amino transferases reach in hepatitis?
500 and even 1000U/L
What causes chronic hepatitis?
HCV causes 60-70% of cases, with 75% becoming chronic
What do we order to diagnose chronic hepatitis?
Labs and a liver biopsy
What is the gold standard for chronic hepatitis diagnosis?
Liver biopsy
