ALL THINGS LIVER- FINAL

Question 1

The dominant primary diseases of the liver are

Answer 1

Viral hepatitis 
Non-viral hepatitis
Alcoholic liver disease
Non-alcoholic fatty liver
Hepatocellular carcinoma

Question 2

________ was associated with the diagnosis of yellow fever. However, they have since been found also to be present in other viral hemorrhagic fevers- in particular, acute viral hepatitis

Answer 2

Councilman bodies

Question 3

With continuing fibrosis, the liver is subdivided into nodules of proliferating hepatocytes surrounded by scar tissue.
At this stage, the fibrotic process of the liver may be termed

Answer 3

Cirrhosis

Question 4

Hepatitis A

Answer 4

is a benign, self-limited disease

does not cause chronic hepatitis

Question 5

Hepatitis B

Answer 5

can produce (1) acute hepatitis with resolution, (2) chronic hepatitis, which may evolve to cirrhosis, (3) fulminant hepatitis with massive liver necrosis, and (4) the backdrop for hepatitis D virus infection.

Question 6

Hep B is associated with what really bad thing?

Answer 6

hepatocellular carcinoma.

Question 7

What are the primary risk factors for Hep B?

Answer 7

Transfusion, blood products, dialysis, needle-stick accidents among health care workers, intravenous drug abuse, and sexual activity

Question 8

spread from an infected mother to a neonate during birth (vertical transmission) is common

Answer 8

Hep B

Question 9

the most common chronic blood-borne infection in the U.S

Answer 9

Hep C

Chronicity is the rule rather than the exception

Question 10

Hep D is dependent on which other viral hepatitis?

Answer 10

Hep B

Question 11

the signs and symptoms of hepatitis E resolve over the course of approximately 6 weeks.
The important exception to this is when ___________ are infected by the hepatitis E virus.

Answer 11

pregnant women

can lead to fulminant hepatic necrosis (mortality rates of 15-25%)

Question 12

Additional causes of chronic hepatitis (non-viral causes) are

Answer 12

chronic alcoholism, Wilson’s disease, alpha 1 -antitrypsin deficiency, drugs and other hepatotoxins and various autoimmune diseases

Question 13

The classic ground glass appearance of hepatocytes is associated with

Answer 13

Hep B

Question 14

Causes of cirrhosis

Answer 14

Autoimmune hepatitis,

hepatotoxins (carbon tetrachloride, mushroom poisoning), pharmaceutical drugs (i.e. acetaminophen), and alcohol

Question 15

When hepatic insufficiency progresses from onset of symptoms to __________, it is termed fulminant hepatic failure

Answer 15

hepatic encephalopathy

Question 16

Size of liver in fulminant hepatitis

Answer 16

shrinks and fibrosis

Question 17

Alcohol-induced impaired hepatic metabolism of methionine leads to decreased

Answer 17

intrahepatic glutathione (GSH) levels thus sensitizing the liver to oxidative injury

Question 18

Chronic alcohol consumption has a variety of adverse effects. Of greatest impact are three forms of liver disease:

Answer 18

Hepatic steatosis (fatty liver changes)
Alcoholic hepatitis
Cirrhosis

Question 19

______________ are a characteristic but not specific feature of alcoholic liver disease, as they may also be seen in non-alcoholic steatohepatitis (NASH), primary biliary cirrhosis, Wilson’s disease and hepatocellular tumors.

Answer 19

Mallory body inclusions

Question 20

Primary biliary cirrhosis (referred to as PBC) is an autoimmune disease in which there is

Answer 20

T cell mediated destruction of the bile ducts of the liver

Question 21

The primary histologic feature of primary biliary cirrhosis (PBC) is

Answer 21

granulomatous destruction of medium sized intrahepatic bile ducts.

Question 22

In primary sclerosing cholangitis (PSC) there is

Answer 22

segmental stricture and dilatation of bile ducts

Question 23

Approximately 70% of patients with primary sclerosing cholangitis are found to have

Answer 23

ulcerative colitis

Question 24

histologically primary sclerosing cholangitis shows

Answer 24

classic onion skin fibrosis

Question 25

with primary sclerosing cholangitis there is an increased risk of what?

Answer 25

cholangiocarcinoma

Question 26

whats the most common type of primary liver cancer?

Answer 26

hepatocellular carcinoma

Question 27

what tends to occur in young women who are on oral contraceptives?

Answer 27

hepatic adenomas

Question 28

histological features of hepatic adenoma

Answer 28

gross-well circumscribed
histo- composed of cords of cells that are somewhat smaller than normal liver cells. The also have less abundant cytoplasm and are less eosinophilic

Question 29

there is a notable relationship between Hep B infection and the development of _________________

Answer 29

hepatocellular carcinoma

in the US the most frequent cause of HCC is cirrhosis due to alcoholism

Question 30

histological changes of hepatocellular carcinoma reveal

Answer 30

loss of normal liver architecture and nuclear atypia

Question 31

one clue to the presence of hepatocellular carcinoma is an elevated

Answer 31

serum alpha-fetoprotein and elevated serum alkaline phosphatase

Question 32

tumor markers CA 19-9 and CA 50 are usually positive in _______ disease and negative in ___________

Answer 32

cholangiocarcinoma, hepatocellular carcinoma

Question 33

___________ of the liver are associated with the occurrence after exposure to arsenic and polyvinyl chloride

Answer 33

angiosarcomas