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GI System > Hepato-Biliary Pathology > Flashcards

Hepato-Biliary Pathology Flashcards

1
Q

What two structures supply the liver to give it a dual blood suppply?

A

Hepatic artery

Hepatic portal vein

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2
Q

What are the three functions of the liver?

A

Protein synthesis
Fat and carbohydrate metabolism
Detoxification of drugs and toxins including alcohol

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3
Q

What causes jaundice?

A

Increased circulating bilirubin caused by an altered metabolism making the skin yellow

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4
Q

Where is haemoglobin broken down in the body?

A

Spleen

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5
Q

What is converted to bilirubin and what causes pre-hepatic jaundice?

A

The haem part of haemoglobin

Increased release of haemoglobin from red cells

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6
Q

Where is bile from hepatocytes first excreted into and where after that?

A

Bile canaliculi

Duodenum

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7
Q

What causes hepatic jaundice?

A

Cholestasis

Intra-hepatic bile duct obstruction

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8
Q

What causes cholestasis?

A

Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs

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9
Q

What causes an intra-hepatic bile duct obstruction?

A

Primary biliary cirrhosis
Primary sclerosing cholangitis
Liver tumours

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10
Q

What is primary biliary cirrhosis (PBC)?

A

Organ specific auto-immune disease that causes granulomatous inflammation involving bile ducts with the loss of intra-hepatic bile ducts leading to cirrhosis

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11
Q

What is primary sclerosing cholangitis (PSC)?

A

Chronic inflammation with fibrous obliteration of bile ducts leading to a loss of intra-hepatic bile ducts leading to cirrhosis and it is associated with IBD

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12
Q

What do PBC and PSC have in common?

A

They both lead to the loss intra-hepatic bile ducts and the progression of cirrhosis

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13
Q

What does PBC show on LFT blood results?

A

Raised Alk phos

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14
Q

What are the three types of liver tumour that present?

A

Hepatocellular carcinoma
Cholangiocarcinoma
Metastatic tumours

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15
Q

Where does a hepatocellular carcinoma affect?

A

Malignant hepatocyte tumour

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16
Q

Where does a Cholangiocarcinoma affect?

A

Malignant tumour of the bile duct epithelium

17
Q

What do most tumours present in combination with?

A

Some stage of cirrhosis

18
Q

What are the risk factors for cholelithiasis (Gallstones)?

A

Obesity

Diabetes

19
Q

What can gallstones lead to?

A

Inflammation

*Acute/Chronic Cholecystitis

20
Q

What can acute inflammation of the gallbladder lead to?

A

Empyema which could result in gallbladder perforation and biliary peritonitis Ending in chronic inflammation

21
Q

What does chronic cholecystitis cause?

A

Thickening of the gallbladder wall with pain in the RUQ and gallstones can cause obstruction if they leave the gallbladder

22
Q

What can cause a bile duct obstruction?

A

Bile duct tumour
Gallstones
Benign structre & External compression - Tumour elsewhere

23
Q

What are the effects of a bile duct obstruction?

A

No bile excreted into the duodenum
Ascending cholangitis - Infection of biliary tract
Secondary biliary cirrhosis if obstruction is prolonged

24
Q

What happens in liver failure in terms of hepatocytes?

A

Effectively you run out of functioning hepatocytes and you have to rely on the liver to regenerate itslef
Acute or Chronic causes

25
Q

What are acute causes of LF?

A

Hepatitis (A, B, C, E & Others) from Viruses
Alcohol or Drugs
Bile duct obstruction

26
Q

What is a chronic cause of LF?

A

Cirrhosis

27
Q

What does hepatitis cause?

A

Liver cell damage and death of individual liver cells

28
Q

What are the three possible outcome from Hepatitis?

A

Resolution - Hep A & E
Liver failure if severe - Hep A, B & E
Progression to chronic hepatitis and cirrhosis - Hep B & C

29
Q

What is hepatic cirrhosis?

A

End stage chronic liver disease in response of liver to chronic injury

30
Q

What are the causes of Cirrhosis? (6)

A

Alcohol
Hepatitis B & C
PBC & Auto-immune hepatitis
Metabolic disorders - Haemachromatosis & Wilson’s disease
Obesity
Cryptogenic - Unknown cause and most common

31
Q

What structural come about from cirrhosis?

A

Loss of normal structure which is replaced by nodules of hepatocytes and fibrous tissue

32
Q

How large is a cerotic liver compared to that of a healthy liver?

A

Much smaller

33
Q

What are the complications of cirrhosis?

A

Altered liver function
Abnormal blood flow
Increased risk of hepatocellular carcinoma

34
Q

What is the abnormal blood flow like in cirrhosis?

A

Portosystemic anastomoses dilate in portal hypertension giving large dilated distended vascular structures, aka varices

35
Q

What are the five stages in the development of gastric cancer?

A 
Normal and H. pylori infection 
Atrophic gastritis
Intestinal metaplasia
Dysplasia
Gastic cancer - Adenocarcinoma

GI System (38 decks)

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