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systems- GI > Hepato-Biliary Pathology > Flashcards

Hepato-Biliary Pathology Flashcards

1
Q

structure of liver

A

Dual blood supply

Hepatic artery, portal vein

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2
Q

fuunction of liver

A

Protein synthesis
Metabolism of fat and carbohydrate
Detoxification of drugs and toxins including alcohol

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3
Q

liver diseases

A 
Liver failure
Jaundice
Intrahepatic bile duct obstruction
Cirrhosis
Tumours
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4
Q

gallbladder diseases

A

inflammation

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5
Q

what is liver failure a complication of?

A

acute liver injury

chronic liver injury

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6
Q

wht causes acute liver injuries

A 
Hepatitis
Viruses
Alcohol
Drugs
Bile duct obstruction
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7
Q

viral hepatitis

A 
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
Other viruses
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8
Q

pathology of viral hepatitis

A

Inflammation of liver
Liver cell damage and death of individual liver cells

Outcome of acute inflammation
Resolution-liver returns to normal
Hepatitis A, E
Liver failure if severe damage to liver
Hepatitis A, B, E
Progression to chronic hepatitis and cirrhosis
Hepatitis B, C
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9
Q

what is the response of liver to excess alcohol

A 
Fatty change
Alcoholic hepatitis
Acute inflammation 
Liver cell death
Liver failure
Progress to cirrhosis
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10
Q

what is jaundice and how is it caused

A

Increased circulating bilirubin

Caused by altered metabolism of bilirubin

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11
Q

what are the pathways of bilirubin metabolism

A

Pre-hepatic
Hepatic
Post-hepatic

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12
Q

what happens in pre-hepatic pathway?

A

Breakdown of haemoglobin in spleen to form haem and globin
Haem converted to bilirubin
Release of bilirubin into circulation

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13
Q

what happens in the hepatic pathway?

A

Uptake of bilirubin by hepatocytes
Conjugation of bilirubin in hepatocytes
Excretion of conjugated bilirubin into biliary system

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14
Q

what happens in the post-hepatic pathway

A

Transport of conjugated bilirubin in biliary system
Breakdown of bilirubin conjugate in intestine
Re-absorption of bilirubin
Entero-hepatic circulation of bilirubin

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15
Q

what are the classifications of causes of jaundice

A

Pre-hepatic
Hepatic
Post-hepatic

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16
Q

what is the cause of pre hepatic

A

Increased release of haemoglobin from red cells (haemolysis)

17
Q

what are the hepatic caauses of jaundice

A

Cholestasis

Intra-hepatic bile duct obstruction

18
Q

what is cholestasis?

A

Accumulation of bile within hepatocytes or bile canaliculi

19
Q

causes of cholestasis

A 
Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs
Therapeutic
Recreational
20
Q

what is Primary biliary cholangitis

A

is a chronic disease in which the bile ducts in your liver are slowly destroyed. Bile is a fluid made in your liver. It aids with digestion and helps your body get rid of cholesterol, toxins and worn-out red blood cells

21
Q

who is more likely to get Primary sclerosing cholangitis

A

female

22
Q

pathology of Primary sclerosing cholangitis

A

Granulomatous inflammation involving bile ducts
Loss of intra-hepatic bile ducts
Progression to cirrhosis

23
Q

what is pathology of Primary Sclerosing Cholangitis ?

A

Chronic inflammation and fibrous obliteration of bile ducts
Loss of intra-hepatic bile ducts
Associated with inflammatory bowel disease

Progression to cirrhosis
Increased risk of development of cholangiocarcinoma

24
Q

what is hepatic cirrhosis?

A

End stage chronic liver disease

25
Q

causes of cirrhosis

A 
Alcohol
Hepatitis B, C
Immune mediated liver disease
Auto-immune hepatitis
Primary biliary cholangitis
Metabolic disorders
Excess iron
Primary haemochromatosis 
Excess copper
Wilson’s disease
Obesity
Diabetes mellitus
26
Q

pathology of cirrhosis

A

Diffuse process involving whole liver
Loss of normal liver structure
Replaced by nodules of hepatocytes and fibrous tissue

27
Q

complications of cirrhosis

A 
Altered liver function
Liver failure
Abnormal blood flow
Portal hypertension
Increased risk of hepatocellular carcinoma
28
Q

what are the different liver tumours

A 
Hepatocellular carcinoma
Malignant tumour of hepatocytes
Cholangiocarcinoma
Malignant tumour of bile duct epithelium
Metastatic tumours
Common site of metastases
29
Q

what are the post-hepatic jaundice causes

A

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

30
Q

risk factors of gallstones

A

Obesity

Diabetes

31
Q

pathology of gallstones in gallbladder

A

Inflammation
Acute cholecystitis
Chronic cholecystitis

32
Q

what is Acute Cholecystitis

A 
Acute inflammation of gall bladder
Empyema
Perforation of gall bladder
Biliary peritonitis
Progression to chronic inflammation
33
Q

causes of common bile duct obstruction

A 
Gallstones
Bile duct tumours
Benign stricture
External compression
Tumours
34
Q

effects of common bile duct obstruction

A

Jaundice
No bile excreted into duodenum
Infection of bile proximal to obstruction
Ascending cholangitis
Secondary biliary cirrhosis if obstruction prolonged

systems- GI (40 decks)

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