Ch 18 - Liver & Gallbladder Flashcards

1
Q

small and shrunken liver

A

liver failure

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2
Q

diffuse of liver cells w/out obvious death and parenchymal collapse

A

diffuse microvesicular statosis

  • fatty liver of preg
  • idiocsyncratic rxns to toxins
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3
Q

50% of acute liver failure in the US is d/t?

A

acetaminophen

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4
Q
  • N/V
  • jaundice/icterus
  • itching
  • coagulation abnormalities
  • elevated LFTs
  • possible portal HTN
  • aserixis
A

acute liver failure

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5
Q
  • ascites
  • formation of portosystemic venous shunts
  • congestive splenomegaly
  • hepatic encephalopathy
A

portal HTN

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6
Q

hepatitis ass’d with carrier state

A

HBV ( somtimes HCV)

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7
Q

early HBV infection confers high risk of what later in life?

A

HCC

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8
Q

progressive chronic HBV leads to?

A

cirrhosis

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9
Q

hepatitis ass’d w/ needle sticks and IVDA

A

HCV

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10
Q

chronic disease occurs in the majority of what kind of hepatitis inf?

A

HCV

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11
Q

dx of HCV is done with what serum marker?

A

elevated serum transaminases

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12
Q

hepatits that can have normal serum transaminase levels?

A

HBV

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13
Q

2 settings ass’d with HDV

A
  • superinfection: get HDV when you already have HBV

- coinfection: getting inf with HBV and HDV at the same time

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14
Q

ground glass cells in the liver

A

HBV

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15
Q

fatty changes to liver cells (type of hep)

A

HCV

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16
Q

dense mononuclear infiltrates in the liver

A

chronic hepatits

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17
Q

expanded lymphoid follicle in the liver

A

HCV

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18
Q

interface hepatitis

A

chronic hepatits

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19
Q
  • severe necroinflammatory activity
  • plasma cell predominance in mononuclear infiltrates
  • hepatocyte “rosettes”
A

autoimmune hepatitis

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20
Q

autoimmune hep ass’d with ANA and ASMA in older F

A

type 1

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21
Q

autoimmune hep ass’d with anti-LKM1 in children and teens

A

type 2

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22
Q
  • fatty chage/steatatosis
  • steatohepatitis
  • steatofibrosis > cirrhosis
A

patterns of injury ass’d with etoh liver dz

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23
Q
  • hepatocyte swelling and necrosis
  • Mallory-Denk bodies
  • neutrophilitis
A

steatohepatitis

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24
Q

hepatomegaly with minimal symptoms, elevated billi and alk phos

A

steatosis

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25
Q
  • tender hepatomegaly
  • +/- cholestasis
  • hyperbilirubinemia
  • ALT:AST = 2:1
  • elevated alk phos
  • nonspecific s/s
A

steatohepatitis

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26
Q

clumped, amorphic, eosinophilic material in ballooned hepatocytes made up of tangled keratins and other proteins like ubiquitin

A

mallory-denk bodies

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27
Q

chicken wire fence pattern

A

etoh steatofibrosis

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28
Q

MCC of chronic liver disease in the US

A

NAFLD/NASH

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29
Q

massion trichrome stain

A

collagen in cirrhosis or steatofibrosis (seen in NAFLD too)

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30
Q
  • hepatomegaly
  • abn skin pigmentation
  • DM
  • cardiac dysfxn
  • hypogonadism
A

hemochromatosis

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31
Q
  • def in ATP7B

- failure to encorporate Cu in ceruloplasmin

A

wilson dz

32
Q

inheritance of wilson dz

A

AR

33
Q

MCly dx’ed inherited hepatic disorder of infants and children

A

A1-AT deficiency

34
Q

inheritance pattern of A1-AT def

A

AR

35
Q

glu342 > lys342

A

A1-AT deficiency

36
Q

magenta cytoplasmic granules on PAS

A

A1-AT deficiency

37
Q

HFE mutation

A

hereditary hemachromatosis

38
Q
  • absent UGT1A1 activity

- fatal in neonatal period

A

Cigler-Najjar I

39
Q

inheratence of Crigler-Najjar I

A

AR

40
Q

jet black liver

A

rotor syndrome

41
Q

pigmented cytoplasmic globules in the liver

A

Dubin-Johnson syndrom

42
Q
  • jaundice
  • puritis
  • xanthomas
  • malabsorption
  • elevated alk phos & GGT
A

cholestasis

43
Q

cause of cholestasis in adults

A

large duct obst

44
Q

cause of cholestasis in children

A

CF and other syndromes

45
Q

cause of cholestasis in neonates

A

biliary atresia

46
Q
  • jaundice
  • RUQ pain
  • fever
A

charcot’s triad: acute cholagitis

47
Q

complete or partial obst of lumen of extrahepatic biliary tree w/in first 3 mo of life

A

biliary atresia

48
Q

biliary atreasia ass’d with other anomalies

A

fetal form

49
Q

biliary atresia thougth to be ass’d with viral inf and/or autoimmune dz

A

perinatal form

50
Q

florid features of extrahepatic biliary obst

A

biliary atresia

51
Q
  • MC in F
  • high ass’t with Sjogren synd
  • AMA +
  • florid duct lesions
  • loss of small ducts
A

PBC

52
Q
  • MC in M
  • high ass’t with IBD (MC in UC)
  • 65% are ANCA +
  • strictures and beading of large bile ducts
  • pruning of smaller bile ducts
  • onion skin lesions
A

PSC

53
Q
  • hepatic vv obst
  • abd pain
  • ascites
  • hepatomegaly
A

budd-chiari syndrome

54
Q

MCC of jaundice in pregnancy

A

infection

55
Q

3 hepatic diseases ass’d with preg

A
  • pre-eclampsia and eclampsia
  • chlolestasis of pregnancy (++conj bili)
  • acute fatty liver
56
Q
  • HTN
  • edema
  • proteinuria
  • coag abn
  • pregnant!
  • +/- seizures
A

pre/eclampsia

57
Q
  • puritis
  • dark urine
  • light stools
  • pregnant!
A

cholestasis of preg

58
Q

preg with + oil red O stain on liver biopsy

A

fatty liver of preg

59
Q
  • singe wide demarcated lesion
  • young - middle aged
  • liver is normal
  • central scar
  • loss of normal architecture
A

focal nodular hyperplasia

60
Q
  • looks like cirrhosis w/ no fibrous septa
  • can devo portal HTN
  • ass’d with HIV, rheumatologix dz, SLE
A

nodular regerative hyperplasia

61
Q
  • MC benign neoplasm of the liver

- MC in F

A

cavernous hemagioma

62
Q

adenomas are ass’d with what drug in women?

A

OCs

63
Q

type of adenoma that confers v high risk of malignant transformation

A

beta-catenin activated adenoma

64
Q
  • MC liver tumor of early childhood

- ass’d with wnt signaling ptwy

A

hepatoblastoma

65
Q
  • MC primary malignancy of hepatocytes

- inc AFP

A

HCC

66
Q

MC sites of HCC mets

A

lung, R heart

67
Q

-young adult (

A

fibrolamellar carcinoma

68
Q

perihilar cholangiocarcinoma

A

klaskin tumor

69
Q

MC sites liver gets mets from

A
  • colon
  • breast
  • lung
  • pancreas
70
Q

MODY-3

A

NHF1-alpha inactivated adeomas

71
Q

liver fluke

A

cholangiocarcinoma

72
Q

black stone

A

hemolytic anemia

73
Q

brown stones

A

infected bile

74
Q

ABCG8 gene

A

cholesterol stones

75
Q

ERBB2

A

gallbladder carcinoma

76
Q

MC typer of gallbladder ca

A

adenocarcinoma