Ch. 18

Question 1

Fever, fatigue, jaundice after eating shellfish, no chronic hepatitis

Answer 1

Hepatitis A

Question 2

Elevated ALT/AST with potential for insulin resistance development

Answer 2

Hepatitis C

Question 3

Scarring and rosette formation in hepatocytes with ANA, anti-SLA/LP, anti-LKM1, and ACL-1 abs

Answer 3

Autoimmune hepatitis

Question 4

Elevated bilirubin, yellow liver, AST>ALT, lipid droplets in hepatocytes

Answer 4

Hepatic steatosis

Question 5

Hepatic ballooning, Mallory-Denk bodies with hyperbilirubinemia, and elevated ALT/AST/AlkPhos

Answer 5

Alcoholic hepatitis

Question 6

Chicken wire web formation leading to Laennec cirrhosis of the liver with portal fibrosis

Answer 6

Steatofibrosis

Question 7

Hepatomegaly, abnormal skin pigmentation, arthritis, + Prussian blue stain, HFE or HAMP/HJV mutation

Answer 7

Hemochromatosis

Question 8

Liver disease leading to movement disorders and + Rhodamine or Orcein stains with ATP7B mutation

Answer 8

Wilson disease

Question 9

Cytoplasmic globular inclusions in hepatocytes due to unfolded protein response with PiZZ genotype

Answer 9

Alpha1-AntiTrypsin disease

Question 10

Accumulation of bile pigment in the hepatic parenchyma with jaundice, DAKE deficiencies, elevated AlkPhos and GGT, and Feather Degeneration

Answer 10

Cholestasis

Question 11

Influx of neutrophils into the bile duct

Answer 11

Ascending cholangitis

Question 12

Hyperbilirubinemia in an infant for > 3 weeks with jaundice, dark urine, and acholic stools

Answer 12

Neonatal cholestasis

Question 13

Florid duct lesions, feathery degeneration, Mallory-Denk bodies with elevated AlkPhos and GGT in a middle aged woman

Answer 13

Primary biliary cirrhosis

Question 14

Onion skin fibrosis, biliary beading, pANCA abs, and elevated AlkPhos in middle aged man

Answer 14

Primary Sclerosing Cholangitis

Question 15

Benign neoplasm developing from hepatocytes with no dysplasia

Answer 15

HNF1-a type hepatocellular adenoma

Question 16

Benign neoplasm developing from hepatocytes with a high degree of dysplasia

Answer 16

ß-catenin type hepatocellular adenoma

Question 17

Malignant growth with WNT and FOXG1 activations

Answer 17

Hepatoblastoma

Question 18

Malignant growth causing elevated a-fetoprotein, fatigue, weight loss, ab pain, and hepatomegaly with ß-catenin and p53 mutations

Answer 18

Hepatocellular carcinoma

Question 19

What’s the difference between small-cell and large-cell change hepatocellular carcinomas

Answer 19

Small-cell = high Nuc:Cyt ratio with nuclear hyperchromasia
Large-cell = normal Nuc:Cyt ratio

Question 20

Firm gray nodule in bile duct wall causing obstruction, RUQ pain, and cholangitis

Answer 20

Cholangiocarcinoma (adenocarcinoma)