Hepato-biliary pathology Flashcards
Which two blood vessels supply the liver?
Hepatic portal vein
Hepatic artery
What does the liver do?
Protein synthesis
Metabolism of fats and carbs
Detoxifies drugs and alcohol
Is there any artificial way to support an injured liver?
No
Which hep viruses are considered from food and faecal contamination?
A, E
Which hep viruses are bloodborne?
B, C
What causes jaundice?
Increased circulating bilirubin
What is the pre-hepatic stage in bilirubin metabolism?
Takes place in spleen
Haemoglobin broken down
Haem converted to bilirubin
Bilirubin released into circulation
What is the hepatic stage of bilirubin metabolism?
Uptake of bilirubin by hepatic cells
Conjugation of bilirubin to hepatocytes
Excretion of conjugated bilirubin
What is the post-hepatic stage in bilirubin metabolism?
Transport of conjugated bilirubin in biliary system
Breakdown of bilirubin conjugate in intestine
Reabsorption of bilirubin
What are some pre-hepatic causes of jaundice?
Increased release of bilirubin from red cells
What are some hepatic causes of jaundice?
Accumulation of bile within hepatocytes or bile cannaliculi (Cholestasis)
Intra-hepatic bile obstruction
What is primary biliary cholangitis?
Organ specific autoimmune disease
Anti-mitochondrial auto-antibodies in serum
Granulomatous inflammation involving bile ducts
Loss of intra-hepatic bile ducts
May progress to cirrhosis
What is a significant sign of primary biliary cholangitis?
Raised serum alkaline phosphatase
What are some causes of hepatic cirrhosis?
Alcohol Hep B/C Autoimmune hepatitis Primary biliary cholangitis Obesity DM
What metabolic conditions may cause hepatic cirrhosis?
Excess iron (Primary haemochromatosis) Excess copper (Wilson's disease)
