Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GIR Test 2 > B5.025 - Liver Disorders 1 > Flashcards

B5.025 - Liver Disorders 1 Flashcards

1
Q

Identify the bile duct, hepatic artery and the portal vein

A

String of pearls - bile duct

hepatic artery - bottom right

Portal vein - big one in the middle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is cholestasis

A

Impaired bile formation and bile flow

acccumulation of bile pigment in hepatic parenchyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of cholestasis

A

intrahepatic obstruction

extrahepatic obstruction

defects in bile secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of obstruction or obliteration of the bile ducts

A

Cholelithiasis

cholangitis

PSC

post surgical strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of compression of the bile ducts outside the liver

A

pancreatic cancer

pancreatitis

extrahepatic biliary tract cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A

Canalicular cholestasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a lab study for obstructive liver disease

A

Alk phos, bilirubin, GGTP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute hepatitis pattern lab studies

A

AST, ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cirrhosis pattern lab studies

A

decreased albumin, platelets, prolonged PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens histologically in obstruction of bile ducts

A

Other bile ducts form around the obstructed one from the canals of herring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are canals of herring

A

they have pluripotent cells that can become other types of liver cells they are found in the ductular cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are stellate cells

A

Lead to fibrosis in cirrhotic livers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe labs for cholestasis

A

Alkaline phosphatase

present in bile duct epithelium and canalicular membrane of hepatocytes

released due to detergent action of retained bile salts on hepatocyte membranes

GGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical signs and symptoms of cholestasis

A

Jaundice/icterus

pruritis

skin xanthomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of chronic cholestasis of the liver

A

PBC

PSC

obstructive cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is PBC

A

Chronic bile destructive disease

autoimmune in genetically predisposed people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of PBC

A

Aberrant expression of MHC class 2 molecules on bile duct epithelial cells and autoreactive T cells around ducts

AMA is increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Epidemiology of PBC

A

90% female

Peak incidence 40-50 yo

ealry labs - elevated GGT, alk phos,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Histo of PBC

A

destructive cholantitis

florid duct lesions

disruption of BM, intraepithelial lympsh and plasma cells, cytoplasmic vacuolizationl regenerative hyperplasia, occasional mitosis

granulosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A

Damaged bile ducts from PBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
A

Florid duct lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
A

T cells infilatrating the bile duct

note the longitudinal x section of the hepatic artery to the right

PBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment for PBC

A

Oral UDCA

slows progression

mech uncertain

24
Q

What is PSC

A

Involvement of extrahepatic and in most cases intrahepatic biliary tree

25
Q

Epidemiology of PSC

A

20-40

M>F

3rd-5th decade

Ulcerative colitis

p-ANCA

26
Q
27
Q
28
Q

Describe PSC linkage to UC

A

T cells activated in damaged mucosa of patients with UC migrate to the liver and recognize a cross reacting bile duct antigen

29
Q

Serum tests for PSC

A

chronic choestatic process - increased GGT, alk phos,

hallmark - cholangiogram - beaded areas

progressive concentric periductal fibrosis “onion skin”

30
Q

PSC histo

A

Fibrous cholangitis

adjecent mixed inflammatory infiltrate

lesions are focal, patchy

can just have ductopenia without ductal scars

31
Q
A

Periductal fibrosis in PSC

32
Q
A

Periductal fibrosis in PSC

33
Q

Clinical sequalae of PSC

A

Acute bouts of ascending cholangitis

persistent elevation of alk phos

cholelithiasis

annual risk of developing cholangiocarcoma .6-1/5%

34
Q

Large duct obstructions

A

gallstones

malignancy

stricture from previous injury

35
Q

Large duct obstructions in children

A

Biliary atresia

CF

Choledochal cyts

syndromes with insufficient intrahepatic bile ducts

36
Q
A

Ductular proliferation

37
Q
A

Ductular proliferation and acute periductal inflammation seen in large obstruction

38
Q
A

Ductular proliferation seen in obstruction

39
Q

Describe cholestasis of sepsis

A

direct effect of intrahepatic bacterial infection

ischemia related to hypotension caused by sepsis

circulating microbial products

40
Q
A

Cholangitis lenta seen in cholestasis of sepsis

41
Q

Drug induced liver injury drug types

A

Abx

psychotropic

anticonvulsants

OCPs

anti inflammatories

42
Q

Describe histo of acute injury from predominant cholestasis

A

Centrilobular hepatocytes, formation of canalicular plugs

Abx or contraceptive use

43
Q

Describe liver injury from predominantly cytolytic sources

A

spotty necrosis/apoptosis

submassive/massive necrosis

acetaminphen, psychotropic, herbal medicines, cocaine, carbon tetrachloride

44
Q
A

Canalicular cholestasis

45
Q
A

Cholestatic bile plugs, from acute injury

46
Q

Choledochal cysts

A

Congenital dilation of common bile duct

most present in kids < 10 yo

jaundice and abdominal pain

increased risk of stones, stricture, stenosis, obstructive biliary complications, bile duct carcinoma

47
Q

What is fibropolycystic disease

A

Congenital malformations of biliary tree

von meyenburg complexes, small bile duct

polycystic liver disease often associated

caroli disease

congenital hepatic fibrosis

48
Q
A

Bile duct hemartoma - von mayenburg complex seen in fibropolycystic disease

note abnormally formed bile ducts

49
Q
A

Congenital hepatofibrosis

* note large regions of scarring and fibrosis

50
Q

Risk factors of gallstones - cholesterol and pigmented

A

Cholesterol - female, fat, forty

pigment - chronic hemolytic syndrome

biliary infection

51
Q

Organisms associated with pigment stones

A

E. Coli, ascaris, liver fluke

52
Q

Clinical features of gallstones

A

majority asymptomatic

colicky pain

smaller stones cause more pain

53
Q

Risk factors of cholangiocarcinoma

A

Primary ascending cholangitis

congenital fibropolycystic disease

previous exposure to thorotrast

opisthorchis sinesis (liver fluke)

54
Q
A

Adenocarcinoma

cholangiocarcinoma

55
Q
A

Cholangiocarcinoma note the glands

56
Q
A

Cholangiocarcinoma

associated with ulcerative colitis - think p ANCA

GIR Test 2 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions