FINAL Study Guide: Hepatic

Question 1

What are characteristics of Cholecystitis?

Answer 1

• Acute, often caused by gallstones and obstruction

- Present in 10-20% of the population in the US

Question 2

What are gallstones made of?

Answer 2

• Cholesterol (most)

- billirubinate or hemolysis (pigmented type)

Question 3

What are five diseases that affect the liver?

Answer 3

Fatty Liver
Hepatitis
Biliary Disease
Metabolic Disease
Vascular

Question 4

What causes Fatty liver?

Answer 4

ETHOH, obesity, and Diabetes Mellitus

Question 5

What causes Hepatitis?

Answer 5

Virus, drugs, or autoimmunity.

Question 6

What 3 components make up the liver?

Answer 6

Hepatocytes
Duct cells
blood vessels

Question 7

Portal tracts contain what?

Answer 7

the triad of Bile ducts

Question 8

What do portal veins do?

Answer 8

bring blood from gut with nutrients and recently consumed drugs.

Question 9

Where does blood go to enrich the hepatocytes?

Answer 9

Sinusoids

Blood from different sources mix here

Question 10

After going to the sinusoids where does blood flow in the liver go?

Answer 10

To the central vein which leads back to the heart

Question 11

What cells do all of the metabolic work of the liver?

Answer 11

Hepatocytes

Question 12

What is the number one cause of liver toxicity?

Answer 12

DRUGS

Question 13

What happens with Fatty Liver-Steatosis?

Answer 13

-It leads to a collagen scar and permanent injury

• Worst destruction is fibrosis
• End stage is Cirrhosis

Question 14

What happens if hepatocytes die in large sheets?

Answer 14

The areas fill up with blood which can then build up due to heart failure and back flow.

Question 15

What happens if cannuliculi in the liver fill with bile due to cholestasis?

Answer 15

The person become Jaundiced

Question 16

If Hepatitis is caused by a virus what do you have to worry about.

Answer 16

Spread because it is contagious

Question 17

What are other causes of Hepatitis other than a virus?

Answer 17

Toxins and drugs

ETHOH and acetaminophen

Question 18

What are the differences between acute and chronic hepatitis?

Answer 18

Acute can resolve itself

Chronic is less likely to recover (fibrosis is often involved)

Question 19

What types of Hepatitis cause acute?

Answer 19

Hep. A and E viruses

*do not tend to go to chronic Hep.

Question 20

What types of Hepatitis cause Chronic?

Answer 20

Hep. B and C (rarely D)

*These viruses start with acute hepatitis and frequently progress to chronic and can lead to cirrhosis and even hepatocellular carcinoma.

Question 21

What are characteristics of acute hepatitis?

Answer 21

• < 6months
• lobular inflammation (surrounding Hepatocytes)
• No Fibrosis
• Caused by viral A and E

Question 22

What are characteristics of Chronic Hepatitis?

Answer 22

• > 6 months
• Portal inflammation (necroinflammatory, and hepatocytes the target.
• Fibrosis bridging to Cirrhosis
• Caused by viral B, C, and D (D rarely expressed)

Question 23

What are characteristics of Hep C Virus?

Answer 23

• Easily transmitted to blood and needles
• During the acute stage usually no symptoms
• Low incidence in U.S/ High in China

Question 24

What are characteristics of Hep B Virus?

Answer 24

• Transmitted by blood and needles
• Acute w/out symptoms
• Frequently goes on to Chronic

Question 25

What is Cirrhosis?

Answer 25

Regenerative hepatocyte nodules; Fibrosis surrounding nodules.

Question 26

What are Characteristics of Autoimmune hepatitis?

Answer 26

- unusual - Found in obese middle aged females mainly - Typically responds well to steroids - Often goes on to advanced fibrosis

Question 27

What Color does the liver turn from Fatty liver disease?

Answer 27

-Liver tends to yellow

Question 28

What is Steatosis?

Answer 28

Fat accumulation in the liver is temporary, w/ no cellular damage.

Question 29

What is Steatohepatitis?

Answer 29

Damage to the liver with fibrosis present (Chronic)

Question 30

What are characteristics of metabolic disease?

Answer 30

- Often associated with iron overloads- can progress to cirrhosis - Wilson's disease

Question 31

What is Wilson's Disease?

Answer 31

Copper metabolic defect goes to hepatitis then cirrhosis

Question 32

What is Billary Disease?

Answer 32

Destruction of bile ducts, bile backs up into the liver and causes inflammatory cells to surround ducts *may form granulomas

Question 33

How much of the population is affected by by Hep B

Answer 33

2-10%

Question 34

What cancer is associated with Hep B?

Answer 34

-1/2 of hepatocellular carcinomas are associated with Hep B infections

Question 35

What is the Treatment for Hep B?

Answer 35

- Treat with pre/post exposure to immunization to prevent/antivirals - Important to get vaccinated

Question 36

What is the Treatment for Hep C?

Answer 36

- Treatment is effective with combo antivirals (ribavirin) | - No immunizations available to prevent-Hep C virus found in > 170 Million carriers world wide

Question 37

What two conditions can be seen with Fatty liver disease?

Answer 37

Steatosis | Steatohepatitis

Question 38

What type of inflammation is associated with acute hepatitis?

Answer 38

Lobular inflammation | Surrounding Hepatocytes

Question 39

What type of inflammation is associated with Chronic Hepatitis?

Answer 39

Portal inflammation (Necroinflammatory) *Hepatocytes are the target