Feb23 M2-Liver Pathology

Question 1

3 path charact of cirrhosis

Answer 1

• Diffuse liver involvement
• Fibrous septation
• Nodular regeneration

Question 2

microvesicular steatosis: important association

Answer 2

acute liver failure (potentially life-threatening)

Question 3

steatohepatitis: specific charact important to remember

Answer 3

ballooned cells, Mallory-Denk bodies (and have fibrosis, etc.)

Question 4

important autoimmune hepatitis (AIH) charact on histology

Answer 4

plasma cells

Question 5

diagnostic test for primary biliary cholangitis + def of this disease

Answer 5

AMA (positive). (anti-mt Ab). PBC=autoimmune attack on intrahepatic bile ducts

Question 6

disease linked with primary sclerosing cholangitis + def of PSC

Answer 6

UC (ulcerative colitis). PSC = fibrosis and inflamm of bile ducts intra and extra hepatic

Question 7

PBC and PSC increased risk for what

Answer 7

cholangiocarcinoma (very bad cancer)

Question 8

microvesicular steatosis pathogenesis + features

Answer 8

patho: pregnancy, reye syndrome (child taking too much ASA), drugs
features: uncommon, fulminant failure

Question 9

steatohepatitis patho and features

Answer 9

patho: macrovesicular steatosis, ballooned cells, Mallory Denk bodies
features: ETOH or NASH (metab syndrome)

Question 10

autoimmune hepatitis patho and features

Answer 10

patho: plasma cells
features: ANA and SMA +, more in females, rx=steroids

Question 11

most common autoimmune hepatitis and its charact

Answer 11

type 1. high ANA and SMA, give steroids, more in women

Question 12

PBC (primary biliary cholangitis) patho and features (including rx)

Answer 12

patho: florid duct lesion (granuloma) on intrahepatic ducts
features: AMA +, more in females, pruritus (itchiness), osteporosis, rx = urso

Question 13

primary sclerosing cholangitis patho and features (including how to dx)

Answer 13

patho: onion-skin fibrosis (periductal fibrosis) (intra and extra hep ducts)
features: more in males, assoc with UC, dx by ERCP, risk of cholangioCA, pruritus and osteoporosis

Question 14

2 things in common in PSC and PBC

Answer 14

pruritus (itchiness) and osteoporosis

Question 15

NASH vs simple steatosis

Answer 15

simple steatosis = no inflamm and no balloon cells. macrovesicular steatosis alone

Question 16

PSC important charact on patho to diff from PBC

Answer 16

PSC has no granulomas

Question 17

hereditary hemochromatosis def + most common gene in adults

Answer 17

recessive disorders of excessive Fe abso.

HFE gene most common in adults

Question 18

HFE gene hemochromatosis: specific mutation

Answer 18

C282Y (cysteine to tyrosine)

Question 19

HFE gene hemochromatosis symptoms (4), specific sentence to remember it

Answer 19

bronzed diabetic with cirrhosis and CMP

Question 20

hereditary hemochromatosis = increased risk of what

Answer 20

200x higher risk of HCC (hepatocellular CA)

Question 21

Wilson’s disease pathophgy

Answer 21

recessive mutation in a gene for copper excretion in bile. copper excess in body: liver toxicity (+ brain, etc.)

Question 22

Budd-Chiari syndrome def + main association

Answer 22

thrombosis of major hepatic veins (outflow obstruction)

**risk factor is a myeloproliferative disease, especially PRV (polycythemia rubra vera)

Question 23

number 1 cause of fulminant hepatic failure + def of that

Answer 23

acetaminophen overdose. means liver failure within 2 wks of onset of symptoms

Question 24

hereditary hemochromatosis pathogenesis + features (including treatment)

Answer 24

patho: Fe in hepatocytes, C282Y mutation
features: bronzed diabetic cirrhosis CMP, HCC risk, phlebotomize (drain blood)

Question 25

AAT (alpha 1 antitrypsin) patho and features

Answer 25

patho: PAS-D droplets in zone 1
features: PiZZ mutation. emphysema. in adults or children.

Question 26

Wilson’s disease: patho and features

Answer 26

patho: copper in zone 1
features: Kayser-Fleischer rings (cornea), Parkinson-like brain damage, hemolytic anemia, renal injury

Question 27

Budd Chiari syndrome patho and features

Answer 27

patho: hepatic vein thrombosis
features: more in females. associated with myeloproliferative syndromes like PRV (polycythemia rubra vera)

Question 28

fulminant hepatic failure patho (with no1 cause) and features (diff associations and causes)

Answer 28

patho: no 1 cause is acetaminophens (massive hepatic necrosis)
features: drugs, HAV, HBC, autoimmune hepatitis, Wilson’s, ischemia, Budd-Chiari syndrome, microvesicular steatosis, malignancy

Question 29

1 most common tumor of the liver (neoplasm)

Answer 29

hemangioma (is benign neoplasm)

Question 30

no1 malignancy (malignant tumor) in the liver (no1 tumor is hemangioma)

Answer 30

liver metastases (lung, colon, breast)

Question 31

HCC associated with what most importantly

Answer 31

hepatitis B

Question 32

3 things associated with portal htn

Answer 32

ascites, splenomegaly, esophageal varices

Question 33

2 things associated with hepatic encephalopathy

Answer 33

elevated ammonia, asterixis,

Question 34

patho features seen on liver with alcohol consumption

Answer 34

steatosis, mallory-denk bodies, balloon cells

Question 35

autoimmune hepatitis patho feature + dx test

Answer 35

plasma cells. dx = ANA + (antinuclear ab)

Question 36

PBC patho and dx test

Answer 36

patho: granulomatous florid duct lesions

dx test = AMA +

Question 37

PSC patho and assoc disease

Answer 37

onion skin fibrosis

associated with ulcerative colitis

Question 38

hereditary hemochromatosis cause

Answer 38

excessive iron in the body (excessive Fe abso)

Question 39

Wilson’s disease: disease of what mineral

Answer 39

copper

Question 40

hepatocellular adenoma type of cancer + assoc with what

Answer 40

benign neoplasm. associated with OCP (oral contraceptive pill)

Question 41

hepatocellular carcinoma: stains for what on patho

Answer 41

alpha fetoprotein

Question 42

HCC associated with what

Answer 42

• hereditary hemochromatosis

- hepatitis B

Question 43

hep C vs hep A associations

Answer 43

HAV: fulminant hepatic failure, travelling,
HCV: cirrhosis