Brainscape's Knowledge GenomeTM

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


See full index

Gastrointestinal System > EXAM #2: LIVER PATHOLOGY II > Flashcards

EXAM #2: LIVER PATHOLOGY II Flashcards

1
Q

Which Hepatitis viruses are transmitted via the fecal-oral route?

A

1) HAV

2) HEV

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

How is HAV commonly acquired?

A

Traveling

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

How is HEV commonly acquired?

A

1) Contaminated water

2) Undercooked seafood

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

What is the clinical manifestation of HAV or HEV infection?

A

Acute hepatitis; no chronic state

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

What marks active infection with HAV or HEV?

A

anti-HAV or HEV IgM

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

What marks prior exposure (or immunization) to HAV/ HEV?

A

anti-HAV or HEV IgM

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

In a patient with anti-HAV IgG antibodies, what are the possible interpretations?

A

1) Prior infection

2) Immunization

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

In what patient population can HEV infection lead to fulminant hepatitis?

A

Pregnant women

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

How is HBV transmitted?

A

Parenterally

  • Childbirth
  • Unprotected intercourse
  • ID drug abuse (IVDA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the clinical manifestation of HBV infection?

A

Acute hepatitis (only 20% chronic)

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

How is HCV transmitted?

A

Parenterally

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

What is the clinical manifestation of HCV infection?

A

BOTH acute and chronic hepatitis

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

How is HCV infection diagnosed?

A

HCV-RNA

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

In evaluating a patient with HCV, what do declining HCV-RNA level indicate? What is levels remain the same?

A

Recovery vs. persistence/ chronic infection

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

How does then HBV virus differ from the other hepatitis viruses?

A
  • dsDNA virus vs. ssRNA

- Hepadnavirus vs. picorna virus

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

What is HDV infection dependent on? Why?

A

HDV infection requires infection with HBV

- Requires HBsAg to infect (Hepatitis B Surface Antigen)

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

What is HDV coinfection?

A

HBV + HDV infect at the same time

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

What is HDV superinfection?

A

Pre-existing HBV infection THEN HDV infection

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

Which is worse, coinfection of superinfection with HDV?

A

Superinfection–chronic hepatitis and cirrhosis are common complications

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

What are the extrahepatic manifestations of Hepatitis B? How do these differ in adults and children?

A

Children= glomerulonephritis

Adults= polyarteritis nodosa

*Antigen/antibody complexes are deposits in the nephrons or medium sized vessels.

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

What are the extrahepatic manifestations of Hepatitis C?

A

1) Cryoglobulinemia (cold temperature induced agglutination of RBCs)
2) Thyroiditis
3) Glomerulonephritis
4) Thrombocytopenia

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

Which genotype of HCV is associated with more severe inflammation?

A

HCV-2

Note that HCV-1 in the US is associated with resistance to treatment

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

What happens with HCV and Alcoholism?

A

Accelerated progression to cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What factors predispose HCV infection to HCC?

A
  • Cirrhosis
  • Age
  • Male sex
  • Alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does Acute Viral Hepatitis appear microscopically?

A
  • Swelling of hepatocytes
  • Cholestasis (jaundice)
  • Lobular disarray (with impaired blood flow and bile flow)
26
Q

What is a Councilman Body?

A

Apoptotic hepatocyte

27
Q

How does Chronic Viral Hepatitis appear microscopically?

A
  • Piecemeal necrosis
  • Bridging fibrosis
  • Nodules/ cirrhosis
28
Q

What is the classic appearance of HBV histologically?

A

“Ground-glass”

29
Q

What histologic feature is associated with HCV?

A

Lymphoid aggregates in portal tracts

30
Q

What are the serologic markers for HBV infection?

A

1) HBsAG

2) HBcAB (core antibody) –IgM

31
Q

What serologic marker will be present in the window period of HBV infection?

A

HBcAB–IgM

32
Q

What serologic marker indicates resolution of HBV infection?

A

HBsAB–IgG

33
Q

What are the serologic markers for chronic HBV infection?

A

1) HBsAG
2) HBeAG (envelope) or HBV DNA
3) HBcAB–IgG

34
Q

What serologic markers indicate infectivity in HBV infection?

A

HBeAG or HBV DNA

35
Q

What serologic marker is indicative of HBV immunization? How can you tell the difference between immunization and resolved infection?

A

Immunization= HBsAB–IgG

Resolved infection= HBcAB AND HBsAB–IgG

36
Q

How does acute Hepatitis present?

A

1) Mixed UCB and CB jaundice
2) Dark urine
3) Fever
4) Malaise
5) Nausea
6) Elevated liver enzyme

37
Q

What is the classic elevation of AST and ALT in Hepatitis?

A

ALT is more elevated than AST

38
Q

What time period is characteristic of acute Hepatitis? Chronic?

A

Less than 6 months vs. more than 6 months

39
Q

Outline the etiology of Hepatitis.

A

1) Viral infection
2) Presentation of viral antigen on MHC class I
3) CD8+ T-cell activation

Cytotoxic effects of CD8+ T-cells mediate the inflammation seen in Hepatitis.

40
Q

Why is there an elevation of both CB and UCB in Hepatitis?

A

Inflammation of BOTH:

1) Hepatocytes–> UCB
2) Small bile ducts–> CB

41
Q

What is Primary Biliary Cirrhosis?

A

Autoimmune disorder that causes inflammation of the small bile ducts

  • Referred to as “granulomatous cholangitis”
  • Granulomas affecting the small bile ducts
42
Q

Describe the etiology of Primary Biliary Cirrhosis.

A

Etiology is unclear, but there is T-cell mediated cytotoxicity

43
Q

What are the clinical associations with Primary Biliary Cirrhosis?

A
  • More frequent in middle-aged females
  • Seen in patients with other autoimmune disorders
  • Anti-mitochondiral antibodies present (AMA)
44
Q

What type of cancer are patients with Primary Biliary Cirrhosis more susceptible to?

A

Hepatocellular Carcinoma

45
Q

What are the clinical features of Primary Biliary Cirrhosis?

A

Patient presents with FATIGUE and PRURITUS that progresses over 10-15 years, and then presents with JAUNDICE. Other symptoms include:

1) Steatorrhea
2) Xanthomas
3) Portal HTN
4) Hepatic failure
5) Osteoporosis/osteomalacia

46
Q

What lab findings are associated with Primary Biliary Cirrhosis?

A
  • AMA, anti-M2, anti PDH-E2
  • IgM
  • ALP/5-NT/GGT
  • Cholesterol
47
Q

What are the buzzwords for the four stages of Primary Biliary Cirrhosis?

A

1) “Florid ductal inflammation” i.e. bile duct inflammation
2) Ductular proliferation
3) Cholestasis
4) Cirrhosis

48
Q

What is Primary Sclerosing Cholangitis?

A

Fibrosis of the large bile ducts

49
Q

What are the clinical associations with Primary Sclerosing Cholangitis?

A

1) More common in males

2) Ulcerative colitis

50
Q

What is pathognmeomic for Primary Sclerosing Cholangitis on ERCP?

A

“Beads on a string” bile duct

Endoscopic Retrograde Cholangiography

51
Q

What lab findings are associated with Primary Sclerosing Cholangitis?

A

Elevations in:

  • ALP
  • GGT
  • 5’-NT
  • ALT/AST
52
Q

What antibody is most specific to Primary Sclerosing Cholangitis?

A

p-ANCA

53
Q

What cell type initially mediates the Fibrosis seen in Primary Sclerosing Cholangitis?

A

Neutrophils

54
Q

What carcinoma is associated with Primary Sclerosing Cholangitis?

A

Cholangiocarcinoma i.e. carcinoma of the bile duct epithelium

55
Q

What is autoimmune hepatitis?

A

Autoimmune “attack” of hepatocytes

56
Q

What antibodies are specific to autoimmune hepatitis?

A

ANA
SMA
LKM1

57
Q

What is Type I autoimmune hepatitis?

A
  • Most common
  • Autoimmune hepatitis seen from 10-elderly
  • SMA and ANA antibody association
58
Q

What is Type II autoimmune hepatitis?

A
  • Less common
  • Seen in young patients, 2-14
  • Anti-LKM1 antibody
  • Poor prognosis
59
Q

What is Type III autoimmune hepatitis?

A
  • Less common
  • 30-50
  • Anti-SLA/LP
60
Q

What is the typically progression seen in autoimmune hepatitis?

A

Very quick progression to cirrhosis

  • Initially managed with corticosteroids
  • If unable to manage with corticosteroids, patient will require liver transplant

Gastrointestinal System (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions