carnevalle 2 Flashcards
1
Q
Primary biliary cirrhosis
A
- Pts present with fatigue and itching that PROGRESSES OVER 10-15 yrs
- present with progressive jaundice
- affects small bile ducts
- SYMPTOMS
- pruritus, jaundice, steatorrhea, xanthomas, hepatic failure
- LABS
- INCREASE in AMA, anti M2,
- INCREASE IgM, AP/5’-NT/GGT
- increase CHOLESTEROL
- Florid duct lesion –> granulomas
2
Q
Primary sclerosing cholangitis
A
- Fibrous obliterative cholangitis
- M > F; < 50 years old
- common in ulcerative collitis
- Can be asymptomatic to fatigue, itching, diarrhea, fever, chills, jaundice, abdominal pain
- may be acute or chornic
- may cause liver failure and cholangitis
- affects LARGer bile ducts
- DX
- Increase in AP, GGT, 5’-NT (bile caniculi tests)
- increase ALT/ASt
- Incerase p ANCA +, ANA, Anti SMAb
- diagnosed with endocsopy
3
Q
Complications of Primary sclerosing cholangitis
A
- Chronic cholestasis
- cholangitis
- Secondary biliary cirrhosis
- liver failure
- cholangiocarcinoma
4
Q
Autoimmune hepatitis
A
- Pts immune system attacks the liver causing inflammation and liver cell death
- chronic and progressive
- present acutely with jaundice, fever and hepatic dysfunction
- GENERALLY RAPID
- Occurs F > M
- Autoantibodies = ANA, SMA, anti-LKM1
- INCREASE GLOBULINs/IgG
- increase ass with HLA DR4
5
Q
complications of autoimmune hepatits
A
- no treatment will lead to:
- cirrhosis
- hepatocellular carcinoma
- TX
- immune suppressors
- liver transplants
6
Q
Drug-Induced liver disease
A
- very common
- may cause any type of liver injury
- may mimic any clinical liver disease
- WILL RECOVER WHEN DRUG IS STOPPED
- Zone 3 (centrilobular) region usually affected first if hepatic injury occurs
7
Q
Types of drug-induced liver disease
A
- Intrinsic
- predictable
- dose-dependent
- short latency
- specific lesions
- Idosyncratic
- unpredictable
- dose-independent
- variable latency
- variable lesions
- hypersensitivity
8
Q
Clinicopathologc syndromes of viral hep
A
- ACUTE ASYMPTOMATIC with recovery
- Hep A, most of B, C, D with coinfection, E
- Acute symptomatic hepatitis with recovery (feel sick)
- Hep A, B, C, D coinfection, E
- Chronic hepatitis: without or with progression to cirrhosis
- few Hep B
- 85% of Hep C
- most superinfections of Hep D
- Fulminant hepatitis (with massive to submassic hepatic necrosis
- RARE = hep A, B, C
- D co and super infection
- Hep E when pregnant
9
Q
Hep B
A
- Most common cause of cirrhosis (worldwide) and hepatocellular carcinoma infection
10
Q
Hep D
A
- Defective RNA virus that requires Hep B surface antigen (HBsAg) to replciate
- Coinfection = HDV infection at same time as HBV
- most recovery with immunity
- 3-4% develop fulminant hepatitis
- rarely develop chronic hepatitis
-
Superinfection WORST!!!
- previous exposure to HBV and now exposed to HDV
- 7-10% develop fulminant hepatitis
- 80% develop chronic HBV/HDV hepatitis
- previous exposure to HBV and now exposed to HDV
11
Q
Hep C
A
- results in acute infection
- 15% resolve
- 80% develop chronic hepatitis
- 80% develop stable (recurrent symptoms)
- 20% develop cirrhosis
- leads to death, stable cirrhosis, or hepatocellular carcinoma
- Form lymphoid aggregates
12
Q
pyogenic ascending cholangitis
A
lots of neutrophils in the ducts
13
Q
hydatid cyst
A
- Echinococcus (do not stick a needle in it –> person will go into anaphylactic shock)
- cyst has a very layered like appearance
*
14
Q
Tetreacycline
A
Microsteatosis
15
Q
methotrexate
A
macrosteatosis
