Hepatic Pathophysiology

Question 1

What are the symptoms of hepatitis and what distinguish acute and chronic?

Answer 1

Fever, malaise, nausea, hepatomegaly, possible jaundice. A chronic infection last > 6 weeks and acute is shorter.

Question 2

How many types of hepatitis virus exists?

Answer 2

5 types (A, B, C, D and E)

Question 3

How are HAV/HEV transmitted? What about HBV/HCV?

Answer 3

Fecal-oral route. Via blood or sexual transmission.

Question 4

1) Which types of hepatitis can become chronic?

2) What is special about HDV?

Answer 4

1) Type B and C can become chronic C is the most common.

2) A person can only be infected with type D if they already have type B

Question 5

Why is the hepatitis virus bad for the liver cell?

Answer 5

The viruses induce presentation of their peptides on MHC I. This induces cytotoxic killing of the hepatocytes by CD8+ T-cells.

Question 6

Is there a vaccination for hepatitis?

Answer 6

Yes, but only for types A and B

Question 7

How is alcohol primarily degraded in the liver and what waste products are made?

Answer 7

Alcohol is degraded in multiple ways, but the dominant is by alcohol dehydrogenase. This enzymes degrade alcohol to acetaldehyde using the NAD+ -> NADH shuttle. ROS are also created as a biproduct.

Question 8

Why are acetaldehyde, ROS and increased NADH harmful for the hepatocytes?

Answer 8

Acetaldehyde: Decreases oxidative metabolism and in general blocks detoxification
ROS: Reacts w. DNA and proteins which can damage the cell.
Increased NADH -> increased fatty acid production which are deposited in liver

Question 9

What are the three stages of alcoholic liver disease and which factors influence how much alcohol is needed to cause damage?

Answer 9

1) Fatty liver: Large, yellowish liver with fat deposited in hepatocytes (steatosis)
2) Alcoholic hepatitis: Inflammation of the hepatocytes
3) Chronic damage (fibrosis, cirrhosis and potentially liver failure)

Factors include: Body size, age, gender, ethnicity