FINAL Study Guide: Hepatic Flashcards
What are characteristics of Cholecystitis?
- Acute, often caused by gallstones and obstruction
- Present in 10-20% of the population in the US
What are gallstones made of?
- Cholesterol (most)
- billirubinate or hemolysis (pigmented type)
What are five diseases that affect the liver?
Fatty Liver Hepatitis Biliary Disease Metabolic Disease Vascular
What causes Fatty liver?
ETHOH, obesity, and Diabetes Mellitus
What causes Hepatitis?
Virus, drugs, or autoimmunity.
What 3 components make up the liver?
Hepatocytes
Duct cells
blood vessels
Portal tracts contain what?
the triad of Bile ducts
What do portal veins do?
bring blood from gut with nutrients and recently consumed drugs.
Where does blood go to enrich the hepatocytes?
Sinusoids
Blood from different sources mix here
After going to the sinusoids where does blood flow in the liver go?
To the central vein which leads back to the heart
What cells do all of the metabolic work of the liver?
Hepatocytes
What is the number one cause of liver toxicity?
DRUGS
What happens with Fatty Liver-Steatosis?
-It leads to a collagen scar and permanent injury
- Worst destruction is fibrosis
- End stage is Cirrhosis
What happens if hepatocytes die in large sheets?
The areas fill up with blood which can then build up due to heart failure and back flow.
What happens if cannuliculi in the liver fill with bile due to cholestasis?
The person become Jaundiced
If Hepatitis is caused by a virus what do you have to worry about.
Spread because it is contagious
What are other causes of Hepatitis other than a virus?
Toxins and drugs
ETHOH and acetaminophen
What are the differences between acute and chronic hepatitis?
Acute can resolve itself
Chronic is less likely to recover (fibrosis is often involved)
What types of Hepatitis cause acute?
Hep. A and E viruses
*do not tend to go to chronic Hep.
What types of Hepatitis cause Chronic?
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.
What are characteristics of acute hepatitis?
- < 6months
- lobular inflammation (surrounding Hepatocytes)
- No Fibrosis
- Caused by viral A and E
What are characteristics of Chronic Hepatitis?
- > 6 months
- Portal inflammation (necroinflammatory, and hepatocytes the target.
- Fibrosis bridging to Cirrhosis
- Caused by viral B, C, and D (D rarely expressed)
What are characteristics of Hep C Virus?
- Easily transmitted to blood and needles
- During the acute stage usually no symptoms
- Low incidence in U.S/ High in China
What are characteristics of Hep B Virus?
- Transmitted by blood and needles
- Acute w/out symptoms
- Frequently goes on to Chronic
What is Cirrhosis?
Regenerative hepatocyte nodules; Fibrosis surrounding nodules.
What are Characteristics of Autoimmune hepatitis?
- unusual
- Found in obese middle aged females mainly
- Typically responds well to steroids
- Often goes on to advanced fibrosis
What Color does the liver turn from Fatty liver disease?
-Liver tends to yellow
What is Steatosis?
Fat accumulation in the liver is temporary, w/ no cellular damage.
What is Steatohepatitis?
Damage to the liver with fibrosis present (Chronic)
What are characteristics of metabolic disease?
- Often associated with iron overloads- can progress to cirrhosis
- Wilson’s disease
What is Wilson’s Disease?
Copper metabolic defect goes to hepatitis then cirrhosis
What is Billary Disease?
Destruction of bile ducts, bile backs up into the liver and causes inflammatory cells to surround ducts
*may form granulomas
How much of the population is affected by by Hep B
2-10%
What cancer is associated with Hep B?
-1/2 of hepatocellular carcinomas are associated with Hep B infections
What is the Treatment for Hep B?
- Treat with pre/post exposure to immunization to prevent/antivirals
- Important to get vaccinated
What is the Treatment for Hep C?
- Treatment is effective with combo antivirals (ribavirin)
- No immunizations available to prevent-Hep C virus found in > 170 Million carriers world wide
What two conditions can be seen with Fatty liver disease?
Steatosis
Steatohepatitis
What type of inflammation is associated with acute hepatitis?
Lobular inflammation
Surrounding Hepatocytes
What type of inflammation is associated with Chronic Hepatitis?
Portal inflammation
(Necroinflammatory)
*Hepatocytes are the target
