ALL THINGS LIVER- FINAL Flashcards
The dominant primary diseases of the liver are
Viral hepatitis Non-viral hepatitis Alcoholic liver disease Non-alcoholic fatty liver Hepatocellular carcinoma
________ 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
Councilman bodies
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
Cirrhosis
Hepatitis A
is a benign, self-limited disease
does not cause chronic hepatitis
Hepatitis B
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.
Hep B is associated with what really bad thing?
hepatocellular carcinoma.
What are the primary risk factors for Hep B?
Transfusion, blood products, dialysis, needle-stick accidents among health care workers, intravenous drug abuse, and sexual activity
spread from an infected mother to a neonate during birth (vertical transmission) is common
Hep B
the most common chronic blood-borne infection in the U.S
Hep C
Chronicity is the rule rather than the exception
Hep D is dependent on which other viral hepatitis?
Hep B
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.
pregnant women
can lead to fulminant hepatic necrosis (mortality rates of 15-25%)
Additional causes of chronic hepatitis (non-viral causes) are
chronic alcoholism, Wilson’s disease, alpha 1 -antitrypsin deficiency, drugs and other hepatotoxins and various autoimmune diseases
The classic ground glass appearance of hepatocytes is associated with
Hep B
Causes of cirrhosis
Autoimmune hepatitis,
hepatotoxins (carbon tetrachloride, mushroom poisoning), pharmaceutical drugs (i.e. acetaminophen), and alcohol
When hepatic insufficiency progresses from onset of symptoms to __________, it is termed fulminant hepatic failure
hepatic encephalopathy
Size of liver in fulminant hepatitis
shrinks and fibrosis
Alcohol-induced impaired hepatic metabolism of methionine leads to decreased
intrahepatic glutathione (GSH) levels thus sensitizing the liver to oxidative injury
Chronic alcohol consumption has a variety of adverse effects. Of greatest impact are three forms of liver disease:
Hepatic steatosis (fatty liver changes)
Alcoholic hepatitis
Cirrhosis
______________ 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.
Mallory body inclusions
Primary biliary cirrhosis (referred to as PBC) is an autoimmune disease in which there is
T cell mediated destruction of the bile ducts of the liver
The primary histologic feature of primary biliary cirrhosis (PBC) is
granulomatous destruction of medium sized intrahepatic bile ducts.
In primary sclerosing cholangitis (PSC) there is
segmental stricture and dilatation of bile ducts
Approximately 70% of patients with primary sclerosing cholangitis are found to have
ulcerative colitis
histologically primary sclerosing cholangitis shows
classic onion skin fibrosis
with primary sclerosing cholangitis there is an increased risk of what?
cholangiocarcinoma
whats the most common type of primary liver cancer?
hepatocellular carcinoma
what tends to occur in young women who are on oral contraceptives?
hepatic adenomas
histological features of hepatic adenoma
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
there is a notable relationship between Hep B infection and the development of _________________
hepatocellular carcinoma
in the US the most frequent cause of HCC is cirrhosis due to alcoholism
histological changes of hepatocellular carcinoma reveal
loss of normal liver architecture and nuclear atypia
one clue to the presence of hepatocellular carcinoma is an elevated
serum alpha-fetoprotein and elevated serum alkaline phosphatase
tumor markers CA 19-9 and CA 50 are usually positive in _______ disease and negative in ___________
cholangiocarcinoma, hepatocellular carcinoma
___________ of the liver are associated with the occurrence after exposure to arsenic and polyvinyl chloride
angiosarcomas
