Hepato-biliary Pathology Flashcards
What are the functions of the liver?
Protein synthesis
Fat and carbohydrate metabolism
Detoxification of drugs and toxins
What are the causes of acute liver failure ?
Hepatitis Viruses Alcohol Drugs Bile duct obstruction
What is the pathology of viral hepatitis?
Inflammation of the liver
Liver cell damage and cell death
What are the outcomes of viral hepatitis?
Resolution (hep A, E)
Liver failure (hep A, B, E)
Progression to chronic hepatitis and cirrhosis (hep B, C)
What is the pathology of alcoholic liver disease?
Fatty change Acute inflammation Liver cell death Liver failure Progression to cirrhosis
What is the pathway of pre hepatic bilirubin metabolism?
Breakdown of haemoglobin in spleen
Haem converted to bilirubin
Release of bilirubin into circulation
What is the pathway of hepatic bilirubin metabolism?
Uptake of bilirubin by hepatocytes
Conjugation of bilirubin in hepatocytes
Excretion of conjugated bilirubin into biliary system
What is the pathway of post hepatic bilirubin metabolism?
Transport of conjugated bilirubin in biliary system
Breakdown of bilirubin conjugate in intestine
Re absorption of bilirubin
What are the hepatic causes of jaundice?
Cholestasis
Intra hepatic bile duct obstruction
What is the pathology of cholestasis jaundice?
Bile accumulates within hepatocytes or bile canaliculi
What are the cause of cholestasis?
Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs
What are the causes of intra hepatic bile obstruction?
Primary biliary cholngitis
Primary sclerosing cholangitis
Liver tumours
What are the pathological features of primary biliary cholangitis?
Granulomatous inflammation
Loss of intra hepatic bile ducts
Raised serum alkaline phosphatase
What are the patholigal features of primary sclerosing cholangitis?
Chronic inflammation and fibrous obliteration of bile ducts
Loss of intra hepatic bile ducts
What are the causes of cirrhosis?
Alcohol Hepatitis B and C Immune mediated liver disease Metabolic disorders (excess iron or copper) Obesity (diabetes) Cryptogenic
What is the pathology of cirrhosis?
Loss of normal liver structure
Replaced by nodules of hepatocytes and fibrous tissue
What are the complications of cirrhosis?
Altered liver function
Abnormal blood flow
Increased risk of hepatocellular carcinoma
More susceptible to bleeding (portal venous supply at low pressure)
What are the different types of liver tumours?
Hepatocellular carcinoma
Cholangiocarcinoma
Metatatic tumours
What are the risk factors for gallstones?
Obesity
Diabetes
What is acute cholecystitis?
Acute inflammation of the gallbladder which may lead to perforation of the gall bladder or biliary peritonitis
What is chronic cholecystitis?
Chronic inflammation and fibrosis go the gall bladder
What are the cause of common bile duct obstruction?
Gallstones
Bile duct tumours
Benign strictures
External compression
What are the effects of a common bile duct obstruction?
Jaundice
No bile excreted into the duodenum
Infection of bile proximal to obstruction
Secondary biliary obstruction
