Hapatobiliary Disease Flashcards
what changes you see first in liver failure? Albumin or INR?
INR first
Albumin takes weeks to change numbers
what does +ve ANA mean?
primary biliary cirrohosis
what 3 things are in the liver lobule unit?
bile duct
portal vein
hepatic artery
Chronic Hep B does what kind of damage to liver?
severe periportal activity
complications of viral hepatitis
cirrhosis
portal hypertension
liver failure
hepatocellular carcinoma (Hep B higher risk, don’t need cirrhosis first)
cirrhosis defining features
bands of fibrosis that surround nodules
diffuse
distortion of architecture
Autoimmune Hepatitis: 3 kinds
Primary sclerosing cholangitis: large bile ducts
primary biliary cholangitis: small bile ducts
3 types of autoantibodies in autoimmune hepatitis?
Type 1: SMA, ANA (smooth muscle, Antinuclear ABs
Type 2: LKM1 (liver-kidney microsomal abs
Type 3: SLA (soluble liver Ag, liver/pancreas)
how to treat autoimmune hepatitis?
steroids: good response
Primary Biliary Cirrhosis pathology see what 2 things? how to treat?
granulomas
inflammatory small bile ducts
poor response to steroids
treat with ursodeoxycholic acid
which ducts does primary sclerosing cholangitis affect?
larger ducts
how to dx primary sclerosing cholangitis?
ERCP, MRCP
primary sclerosing cholangitis histology?
concentric fibrosis around a large bile duct, strictures, eventually disappears
who gets primary sclerosing cholangitis?
usu. crohn’s or UC
paracetomol overdose histology damage where?
zone 3 necrosis
