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GI PATHOLOGY > Hepato-biliary Pathology > Flashcards

Hepato-biliary Pathology Flashcards

1
Q

Liver failure is a complication of what?

A

Acute or Chronic liver injury

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2
Q

Acute causes of liver injury?

A

Hepatitis

Bile duct obstruction

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3
Q

What are the main types of hepatitis?

A

Viral
Autoimmune
Drug
Alcohol

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4
Q

What viruses cause Hepatitis?

A

Hep A, B, C, E

Epstein Barr

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5
Q

How does viral hepatitis cause damage?

A

Inflammation

Damage/death of individual liver cells

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6
Q

Possible outcomes of acute Hepatitis A, E?

A

Resolution - return to normal

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7
Q

Possible outcomes of acute Hep A, B, E?

A

Liver failure in severe damage

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8
Q

Possible outcomes of acute Hep B, C?

A

Progression to chronic hepatitis - cirrhosis

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9
Q

Which forms of hepatitis are blood borne?

A

Hep B, C

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10
Q

What is the process to cirrhosis in alcoholic liver disease

A

Fatty change in liver
Alcoholic hepatitis
(acute inflam, liver cell death)
Cirrhosis

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11
Q

What is the cause of jaundice?

A

Increased circulating bilirubin

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12
Q

What is the pre-hepatic metabolism of bilirubin?

A

Haemoglobin broken down in spleen -> haem and globin
Haem -> bilirubin
Bilirubin released

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13
Q

What is the hepatic metabolism of bilirubin?

A

Bilirubin -> hepatocytes
Conjugation of bilirubin
Excretion into biliary system

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14
Q

Why is bilirubin conjugated in the hepatocytes?

A

Increase solubility

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15
Q

What is the post-hepatic metabolism of bilirubin?

A

Biliary system –> intestine

Broken down and re-absorbed

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16
Q

What is the cause of pre-hepatic jaundice?

A

Increased haemolysis, not related to the liver

17
Q

What are the hepatic causes of jaundice?

A

Cholestasis

Intra-hepatic bile duct obstruction

18
Q

What is cholestasis?

A

Accumulation of bile within the hepatocytes or canaliculi

19
Q

What causes Cholestasis?

A

Viral, Alcoholic Hep
Liver failure
Drugs (must be excluded)

20
Q

Causes of Intra-hepatic bile duct obstruction

A

Primary biliary Cholangitis
Primary sclerosing cholangitis
Liver tumours

21
Q

What is Primary Biliary Cholangitis?

A

Autoimmune disease, causing granulomatous inflammation in bile ducts
Progresses to cirrhosis

22
Q

What are the tests for primary biliary cholangitis?

A

Anti-mitochondrial auto-antibodies in serum

Raised serum alkaline phosphatase

23
Q

What is primary sclerosing cholangitis?

A

Chronic inflammation leading to fibrotic obliteration of bile ducts

24
Q

Primary sclerosing cholangitis is associated with what?

A

Chronic Inflammatory Bowel disease

25
Q

Primary sclerosing cholangitis can progress to what?

A

Cirrhosis

Cholangiocarcinoma

26
Q

What is hepatic cirrhosis?

A

End stage liver disease

27
Q

What are the causes of cirrhosis?

A 
Alcohol
Hep B, C
Immune mediated liver diseases
Excess iron, copper
Obesity
Cryptogenic (most common)
28
Q

What are the complications of cirrhosis?

A

Liver failure
Portal hypertension
Hepatocellular carcinoma

29
Q

Hepatocellular carcinoma are tumours of what?

A

Malignant tumour of hepatocyte

30
Q

Cholangiocarcinoma are tumours of what?

A

Malignant tumours of bile ducts

31
Q

What are the post-hepatic causes of jaundice?

A

Cholelithiasis (gallstones)
Diseases of gall bladder
Extra-hepatic duct obstruction

32
Q

Risk factors for Gallstones

A

Obesity

Diabetes

33
Q

What are the outcomes of acute cholecystitis

A

Empyema leading to perforation - peritonitis

Progression to chronic disease

34
Q

Chronic cholecystitis leads to what?

A

Fibrosis of the gallbladder wall leading to impairment of gallbladder contraction (pain)

35
Q

Causes of common bile duct obstruction?

A

Gallstones
Bile duct tumours
Stricture
Compression (tumours)

36
Q

Effects of common bile duct obstruction

A

Jaundice
Infection of proximal bile duct
Seconday biliary cirrhosis

GI PATHOLOGY (20 decks)

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