GIT 5TH ASSESSMENT

Question 1

Classify the Circulatory Disorders of the Liver according to their causes.

Subclinical thrombosis of the portal vein (Banti syndrome)
Hepatic Vein Thrombosis (Budd-Chiari Syndrome)
sickle cell disease
cirrhosis

• Impaired blood flow through the liver
• Impaired blood flow into the liver
• Hepatic vein outflow obstruction

Answer 1

Subclinical thrombosis of the portal vein (Banti syndrome)- IBFIL
Hepatic Vein Thrombosis (Budd-Chiari Syndrome)- HVOO
sickle cell disease- IBFTL
cirrhosis- IBFTL

Question 2

Give the pathogenisis of the Electrocyte Depletion in Alcoholism.

hyponatremia -
hypomagnesemia-
hypokalemia-

• phosphorus deficiency
• leaky membranes; from extracellular to intracellular
• increased cellular uptake
• massive uptake of solute-free fluid

Answer 2

hyponatremia - MASSIVE UPTAKE of solute-free fluid
hypomagnesemia- phosphorus deficiency
hypokalemia- leaky membranes; from extracellular to intracellular

Question 3

Describe the Biliary Tumors according to their clinical manifestation.

jaundice, acholic stools, nausea & vomiting, weight loss -
cause symptoms only when much of the liver is replaced by tumor-

• ExtrahepatIc biliary tumors
• Intrahepatic biliary tumor

Answer 3

• jaundice, acholic stools, nausea & vomiting, weight loss - ExtrahepatIc biliary tumors
• cause symptoms only when much of the liver is replaced by tumor- Intrahepatic biliary tumor

Question 4

Excessive iron directly toxic to tissues by the ff mechanism except:

• Direct irreversible oxidative damage Fe to DNA
• Lipid peroxidation by Fr-catalyzed free radical reactions
• stimulation of collagen formation
• acts as xenobiotics & triggers from the immune response

Answer 4

acts as xenobiotics & triggers from the immune response

Question 5

Describe the morphologic appearance of the different stages of Cholecystitis.

Gangerous Cholecystitis -
Chronic Cholecystitis -
Acute Cholecystitis -

• edamatous & hyperemic to green-black necrotic organ
• contracted or enlarged, thickened from fibrosis
• gallbladder enlarged, tense, bright red or blotchy, covered by fibronous exudate

Answer 5

Gangerous Cholecystitis - edamatous & hyperemic to green-black necrotic organ
Chronic Cholecystitis - contracted or enlarged, thickened from fibrosis
Acute Cholecystitis - gallbladder enlarged, tense, bright red or blotchy, covered by fibronous exudate

Question 6

Characteristic Gross Features of Liver Condition.

Focal Nodular Hyperplasia-
Intrahepatic thrombosis of portal vein radicle-
Passive congestion of the liver-

Answer 6

Focal Nodular Hyperplasia- Hyperplastic area w/ central stellate fibrous scar
Intrahepatic thrombosis of portal vein radicle- Infarct of Zhan
Passive congestion of the liver- Nutmeg Liver

Question 7

Silent features of autoimmune hepatitis except:

• Female predominance (70%)
• presence of other autoimmune disease
• no serologic evidence of viral infection
• elevated serum IgM

Answer 7

elevated serum IgM CHECK (IgG)

Question 8

Distingush the different cholestatic liver diseases as to their morphology.

Neonatal Cholestasis-
Primary schlerosing cholangitis-
Cholestasis of Sepsis-

• extrahepatic biliary atresia w/ idiopathic hepatitis
• prominent Kupffer cells; canals of Hering w/ prominent bile plugs
• chronic inflammation of largest ducts; onion skinning of smaller ducts

Answer 8

Neonatal Cholestasis- extrahepatic biliary atresia w/ idiopathic hepatitis
Primary schlerosing cholangitis- chronic inflammation of largest ducts; onion skinning of smaller ducts
Cholestasis of Sepsis- prominent Kupffer cells; canals of Hering w/ prominent bile plugs

Question 9

Describe the characteristic liver diases induced by these toxins.

Isoniazid-
Aspirin-
Minocyclin-

Answer 9

Isoniazid- mimics chronic viral hepatitis
Aspirin- Reye syndrome
Minocyclin-induces an autoimmune-like hepatitis

Question 10

This is a characteristic of Chronic Heptitis.

• widespread scarring
• slithly mottled
• wrinkled, baggy capsule
• muddy-red, mushy appearance

Answer 10

widespread scarring

Question 11

Portal Hypertension Effects on Lungs.

Portopulmunary Hypertension-
Hepatopulmonary syndrome-

Answer 11

Portopulmunary Hypertension- dyspnea on extertion w/ clubbing of fingers
Hepatopulmonary syndrome- Platypnea & orthodeoxia

Question 12

Copper cause toxic injury to different organs by these mechanisms except:

• displacing other metal in hepatic metalloenzymes
• apocerulopasmin conver sion to ceruloplasma is inhibited
• Promoting the formation of free radicals
• binding to sulfhydryl groups of cellular proteins

Answer 12

apocerulopasmin conver sion to ceruloplasma is inhibited

Question 13

State how the ff Alcohols are metabolized by the liver alcohol dehydrogenase.

Isopropyl alcohol -
Ethylene glycol-
Methanol-

Answer 13

Isopropyl alcohol -acetone
Ethylene glycol- gycol-aldehyde, glycolic acid, glyoxylic acid
Methanol- formaldehyde & formic acid