hepato-billary pathology

Question 1

What is liver cirrhosis

Answer 1

Essentially fibrosis of the liver

Question 2

What causes liver failure

Answer 2

Acute liver injury
chronic liver injury

Question 3

What causes acute liver injury

Answer 3

Hepatitis VAD
V - virus
A - alcohol
D - drug

Bile duct obstruction

Question 4

What is hepatitis

Answer 4

Inflammation of the liver which can cause liver cell death and cause liver failure

Question 5

What are the causes of hepatitis

Answer 5

V - virus
A - alcohol
D - drugs

Question 6

What kinds of hepatitis resolve

Answer 6

Hepatitis A and E

Question 7

What kind of hepatitis lead to liver failure

Answer 7

Hep A,B,E

Question 8

Which hepatitis lead to chronic hepatitis and cirrhosis

Answer 8

Hep B and C

Question 9

What is jaundice

Answer 9

Increased circulating bilirubin

Question 10

How is bilirubin taken to the liver

Answer 10

pre-hepatic - haemoglobin is broken down and haem is converted into bilirubin where it is then released into the circulation

hepatic - uptake of the bilirubin by the hepatocytes
Excretion of the bilirubin into biliary system

post-hepatic - transported bilirubin in the biliary system and reabsorption in the small intestine

Question 11

How does pre-hepatic jaundice occur

Answer 11

Haemolysis occurring so excess breakdown of red blood cells leading to excess haem and bilirubin production

Question 12

What colour is the urine in pre-hepatic jaundice

Answer 12

pre-hepatic jaundice - bilirubin bound to albumin so pee is normal coloured

Question 13

What are the hepatic causes of jaundice

Answer 13

Cholestasis - build up of bile in the liver

Intra-hepatic bile duct obstruction

Question 14

What causes cholestasis

Answer 14

Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs

Question 15

What is cholangitis

Answer 15

Inflammation of the bile duct system

Question 16

describe primary billiary cholangitis

Answer 16

Auto-immune disease - granulomatous inflammation involving bile ducts with a loss of intra-hepatic bile ducts which leads to cirrhosis

Female>male

Anti michondrial auto-antibodies

Raised serum ALP - alk phosphotase

Question 17

What is primary sclerosing cholangitis

Answer 17

Chronic inflammation and fibrous obliteration of bile ducts

Loss of intra-hepatic bile ducts

Question 18

What condition is primary sclerosing cholangitis associated with

Answer 18

Inflammatory bowel disease

Question 19

What does primary sclerosing cholangitis increase the risk of

Answer 19

Cholangiocarcinoma

Question 20

What is the main treatment for hepatic cirrhosis

Answer 20

liver transplant

Question 21

What can cause cirrhosis

Answer 21

Hep B,C
Alcohol
primary biliary cholangitis
Primary sclerosing cholangitis
Haemochromatosis - excess iron
Wilson’s disease - excess copper
Diabetes melitus

Question 22

What is looked at to check liver function

Answer 22

Prothrombin time since the clotting factors are produced in the liver

Question 23

What is a hepatocellular carcinoma

Answer 23

Malignant tumour of the hepatocytes

Question 24

What is a cholangiocarcinoma

Answer 24

Malignant tumour of the bile duct epithelium

Question 25

What are the post-hepatic causes of jaundice

Answer 25

Cholelithiasis (gallstones)
Extra-hepatic duct obstruction

Question 26

What are the risk factors for gallstones

Answer 26

Obesity
Diabetes

Question 27

What is acute cholecystitis

Answer 27

Gallstones ulcerate

Question 28

What colours the stool and urine in pre-hepatic jaundice

Answer 28

Normal stool and urine

Question 29

What colours the stool and urine in hepatic jaundice

Answer 29

Dark urine

Question 30

What colours the stool and urine in post-hepatic jaundice

Answer 30

Pale stool and dark urine