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Gastrointestinal pathology > Hepatic pathology > Flashcards

Hepatic pathology Flashcards

1
Q

Functions of the liver:

A
  • Store glycogen
  • Release glucose
  • Gluconeogenesis
  • Protein synthesis
  • Break down amino acids, detoxify nitrogenous molecules
  • Drug and steroid metabolism
  • Lipoprotein synthesis
  • Conjugation and exrection of bilirubin
  • Production of bile salts
  • Immune
  • Coagulation
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2
Q

Ex of proteins synthesised by the liver

A

Albumin
Coagulation factors
Ceruloplasmin (copper binding)

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3
Q

Lipoproteins synthesised in the liver:

A

vLDLs

HDLs

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4
Q

AST =

A

Aspartine amino transferase

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5
Q

ALT =

A

Alanine amino transferase

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6
Q

Is ALT or AST more specific to the liver?

A

ALT

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7
Q

PT =

A

Prothrombin time

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8
Q

What happens to PT in liver disease?

A

Increases

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9
Q

Which pathway is PT a measure of?

A

Extrinsic

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10
Q

GGT =

A

Gamma - GT

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11
Q

PT will be confounded in

A

Warfarin

VItamin K deficiency

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12
Q

GGT is a measure of

A

Alcohol

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13
Q

Causes of hepatitis =

A 
Alcohol
Viral
Drugs
Autoimmune
Non-alcoholic fatty liver
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14
Q

Viruses which can cause hepatitis =

A 
Hepatits A-E
CMV
Toxoplasmosis
EBV 
Cocksackie
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15
Q

Alcoholic hepatitis is caused by:

A

Reactive oxygen sepcies and neutrophils against acetylaldehyde adducts

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16
Q

What is characteristicly found on histology in alcoholic hepatitis?

A

Mallory bodies

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17
Q

Mallory bodies =

A

Intermediate filaments

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18
Q

AST : ALT in alcoholic hepatitis

A

AST>ALT

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19
Q

Autoimmune hepatitis has what ratio female:male

A

4:1

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20
Q

Symptoms of autoimmune hepatits =

A

Fatigue
Malaise
Jaundice
Splenomegaly

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21
Q

AST: ALT in autoimmune hepatitis

A

ALT>AST

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22
Q

Types of autoimmune hepatitis =

A

Type 1

Type 2

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23
Q

Type 1 autoimmune hepatitis =

A

Antinuclear antiboides

Antismooth muscle antibodies

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24
Q

Type 2 autoimmune hepatitis occurs in

A

Young females with other autoimmune conditions

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25
Q

Antiboides in type 2 autoimmune hepatitis

A

ALKM-1

ALC-1

26
Q

Acute hepatitis’

A

A

E

27
Q

Most common cause of acute viral hepatitis =

A

HEV

28
Q

Spread of HAV

A

Fecal-oral

29
Q

Chronic viral hepatitis =

A

B (30%)

C

30
Q

Antibodies in HAV

A

IgM: active
IgG: protective

31
Q

Symptoms of HAV and HEV

A

Fever, nausea, vomiting, malaise, anorexia, distaste for cigarrettes

32
Q

What % of patients recover from HAV

A

99%

33
Q

Transmission of HBV

A

Blood-borne

34
Q

Hepatitis B genome =

A

Ds DNA

35
Q

Hepatitis A genome

A

ss +RNA

36
Q

Meds for HBV

A

Tenofovir

Entecavir

37
Q

Tenofovir

A

NRTI

38
Q

Entecavir

A

Protease inhibitor

39
Q

What increases risk of HBV becoming chronic?

A

Young age

40
Q

HEV transmission

A

Fecal-oral

41
Q

HCV transmission

A

Blood

42
Q

HCV genome

A

Enveloped, +ve RNA

43
Q

Serology of HCV

A

Anti-HCV antiboides

PCR

44
Q

Clinical features of HCV

A

Asymptomatic acutely

Fatigue, anorexia, nausea, weight loss

45
Q

What can HCV and HBV lead to

A

Cirrhosis

Hepatocellular carcinoma

46
Q

HDV transmission

A

Blood

47
Q

HDV needs

A

HBV

48
Q

Hep D + B as same time

A

Coinfection

49
Q

Hep B + D at different times

A

Superinfection

50
Q

NAFLD =

A

Non-alcoholic fatty liver disease

51
Q

NAFLD usually occurs in which patients?

A

Obese
Hypertension
Diabetes
Hyperlipidemia

52
Q

Steatosis =

A

Fatty liver, fat deposition in hepatocytes

53
Q

Steatosis can lead to

A

Steatohepatitis

54
Q

LFT in NAFLD

A

ALT raised

Sometimes AST

55
Q

Alcoholic fatty liver disease is due to:

A

Acetylaldehyde metabolism causes increased storage, reduced beta oxidation, increased production

56
Q

LFT in AFLD

A

AST>ALT

57
Q

What cells are important for cirrhosis?

A

Stellate cells

58
Q

Stellate cells normal function

A

Store Vit A

59
Q

Stellate cells function in injury

A

Release collagen

60
Q

Complications of cirrhosis =

A 
Portal hypertension
Hepatic enchealopathy 
Thombocytopenia
Hypoalbumimia
Splenomegaly
Acities
Kidney failure
61
Q

Portal hypertension can cause

A

Acities
Kideny failure
Varicies
Splenomegaly

Gastrointestinal pathology (6 decks)

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