Hepatic pathology

Question 1

What is the name of the small, hexagonal functional units of the liver?

Answer 1

Lobules

Question 2

Lobules consist of what?

Answer 2

A central vein (hepatic venule) surrounded by 6 hepatic portal veins and hepatic portal arteries

Question 3

The hepatic venule is connected to surrounding veins and arteries by what?

Answer 3

Sinusoids

Question 4

What are the different cell types found within the sinusoids?

Answer 4

Kupffer cells
Hepatocytes
Stellate cells

Question 5

What are kupffer cells?

Answer 5

Macrophages that capture and break down old, worn out red blood cells

Question 6

What are hepatocytes? Include their epithelium type

Answer 6

Cuboidal epithelial cells that line the sinusoids

- They perform most of the livers functions

Question 7

What is the role of stellate cells?

Answer 7

Stellate cells AKA perisinusoidal cells - In normal liver they are in a quiescent state, they store vitamin A, APC.

Question 8

What happens to stellate cells in liver impairment?

Answer 8

When the liver is damaged they become activated and secrete collagen scar tissue, leading to cirrhosis

Question 9

What are the functions of the liver?

Answer 9

1. Storage of glycogen, release of glucose and gluconeogenesis
2. Protein synthesis e.g. albumin and coagulation factors
3. Catabolism of amino acids and production of urea
4. Detoxification of nitrogenous molecules from the gastrointestinal tract
5. Drug and steroid metabolism
6. Lipoprotein synthesis
7. Conjugation and excretion of bilirubin
8. Production and excretion of bile salts
9. Participation in immune processes

Question 10

Signs of chronic liver disease (ABCDEFGHIJ)

Answer 10

A) Ascites & acute abdomen atrophy & asterexis
B) Bruising
C) Clubbing & colour change of nails
D) Duputren's contracture
E) Encephalopathy & Palmar erythema
F) Fetor hepaticus
G) Gyneocomastia
H) Hepatomegaly
I) Increase in parotid size
J) Jaundice

Question 11

What is fetor hepaticus?

Answer 11

The characteristic breath of patients with severe parenchymal liver disease, which has been said to resemble the odour of a mixture of rotten eggs and garlic

Question 12

What is non-alcoholic fatty liver disease? (NAFLD)

Answer 12

NAFLD is the term for a range of conditions caused by a build-up of fat in the liver

Question 13

What is the medical term for fatty liver?

Answer 13

Steatosis

Question 14

NOTE SLIDE: NAFLD can range from steatosis on the most clinically- benign end of the spectrum to cirrhosis on the opposite extreme where most liver related morbidity and mortality occur

Question 15

What is non-alcoholic steatohepatitis? (NASH)

Answer 15

Intermediate form of liver damage that sometimes progresses to cirrhosis

Question 16

Patients who become cirrhotic from NAFLD can develop what?

Answer 16

Hepatocellular cancer