Circulatory liver path Flashcards
Liver infarct is due to obstruction of this vessel or its branches
Hepatic artery
Pale parenchyma surrounded by hyperemia rim usually occurs in this liver condition
Infarct
Centrilobular necrosis and preservation of periportal areas is morphologically seen in this liver condition
Ischemic necrosis
(due to severe hypoperfusion)
Thrombosis of this vessel produces the triad of hepatomegaly, severe abdominal pain, and ascites
Hepatic vein
Hepatic vein thrombosis often produces this triad
Hepatomegaly
Severe abdominal pain
Ascites
What is Budd-Chiari syndrome?
Hepatic vein thrombosis
What causes hepatic vein thrombosis?
Underlying condition
Congestion and hypoperfusion occur in this part of the liver in hepatic vein thrombosis
Centrilobular
In hepatic vein thrombosis, this zone undergoes congestion and sinusoidal dilatation, necrosis
Zone 3
Are the majority of cases of hepatic vein thrombosis subacute or chronic?
Subacute/more gradually
What are the levels of AST/ALT in hepatic vein thrombosis?
Very high
(due to hepatic necrosis)
Myeloproliferative disorders, hypercoagulable states, paroxysmal nocturnal hemoglobinuria, and mass lesions are risk factors for this
hepatic vein thrombosis
Most cases of portal vein thrombosis are due to this
Cirrhosis
Is a sudden complete occlusion of portal vein asymptomatic or fatal?
Often fatal
(occludes gastric/esophageal varices, mesenteric veins)
Is hepatic artery flow preserved in portal vein thrombosis?
Yes = so usually no liver necrosis
Is there liver necrosis in portal vein thrombosis?
Usually no
(since hepatic artery flow is preserved)
Is there liver necrosis in hepatic vein thrombosis?
Yes
(due to centrilobular congestion)
Does this describe hepatic or portal vein thrombosis:
Thrombus obstructs portal drainage (causing splenomegaly, esophageal varices, ischemic bowel disease/sepsis)
portal vein thrombosis
Most cases of this liver vascular condition are due to an underlying condition, and majority are from cirrhosis
portal vein thrombosis
Local vascular damage (splanchnic infections), pancreatitis, and umbilical vein thrombosis can cause this liver vasculature condition
portal vein thrombosis
In neonates, thrombosis of this vein can occur due to infection
Umbilical vein thrombosis
(which may lead to portal vein thrombosis)
Does this describe hepatic or portal vein thrombosis:
Venous congestion causes intestinal ischemia if extensive
portal vein thrombosis
Does this describe hepatic or portal vein thrombosis:
Sequelae of portal hypertension
portal vein thrombosis
This is congestion around central vein due to heart failure
Central passive congestion
Central passive congestion is congestion around central vein due to this
Heart failure
In Central passive congestion, there is high outflow pressure because this part of the heart cannot fill
Pressure transmits to central vein
Right atrium
In Central passive congestion, this part of the heart cannot perfuse liver
Left ventricle
Does Central passive congestion involve right or left heart failure?
Both
(results in centrilobular hemorrhagic necrosis)
In Central passive congestion, there is necrosis in this part of the liver
Centrilobular
In Central passive congestion, the right atrium cannot fill, resulting in pressure that transmits to this liver vessel
Central vein
In Central passive congestion, the left ventricle cannot perfuse liver, so this vessel has less blood
Hepatic artery
“Cardiac cirrhosis” describes this condition
Central passive congestion
Hepatomegaly with blunt edges, mild increase AST/ALT, and mild bilirubin elevation are seen in this condition
Central passive congestion
What are the levels of AST/ALT in Central passive congestion?
Mild increase
What are the levels of bilirubin in Central passive congestion?
Mild elevation
Nutmeg liver describes this condition
Central passive congestion
(chronic passive congestion shows hemorrhage around central veins)
Do periportal areas have congestion in Central passive congestion?
No
(centrilobular congestion/necrosis is seen)
This is the most common cause of portal hypertension
Cirrhosis
What causes transudative effusion in ascites as seen in cirrhosis?
Portal HTN and low albumin
