hepato-billary pathology Flashcards
What is liver cirrhosis
Essentially fibrosis of the liver
What causes liver failure
Acute liver injury
chronic liver injury
What causes acute liver injury
Hepatitis VAD
V - virus
A - alcohol
D - drug
Bile duct obstruction
What is hepatitis
Inflammation of the liver which can cause liver cell death and cause liver failure
What are the causes of hepatitis
V - virus
A - alcohol
D - drugs
What kinds of hepatitis resolve
Hepatitis A and E
What kind of hepatitis lead to liver failure
Hep A,B,E
Which hepatitis lead to chronic hepatitis and cirrhosis
Hep B and C
What is jaundice
Increased circulating bilirubin
How is bilirubin taken to the liver
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
How does pre-hepatic jaundice occur
Haemolysis occurring so excess breakdown of red blood cells leading to excess haem and bilirubin production
What colour is the urine in pre-hepatic jaundice
pre-hepatic jaundice - bilirubin bound to albumin so pee is normal coloured
What are the hepatic causes of jaundice
Cholestasis - build up of bile in the liver
Intra-hepatic bile duct obstruction
What causes cholestasis
Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs
What is cholangitis
Inflammation of the bile duct system
describe primary billiary cholangitis
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
What is primary sclerosing cholangitis
Chronic inflammation and fibrous obliteration of bile ducts
Loss of intra-hepatic bile ducts
What condition is primary sclerosing cholangitis associated with
Inflammatory bowel disease
What does primary sclerosing cholangitis increase the risk of
Cholangiocarcinoma
What is the main treatment for hepatic cirrhosis
liver transplant
What can cause cirrhosis
Hep B,C
Alcohol
primary biliary cholangitis
Primary sclerosing cholangitis
Haemochromatosis - excess iron
Wilson’s disease - excess copper
Diabetes melitus
What is looked at to check liver function
Prothrombin time since the clotting factors are produced in the liver
What is a hepatocellular carcinoma
Malignant tumour of the hepatocytes
What is a cholangiocarcinoma
Malignant tumour of the bile duct epithelium
What are the post-hepatic causes of jaundice
Cholelithiasis (gallstones)
Extra-hepatic duct obstruction
What are the risk factors for gallstones
Obesity
Diabetes
What is acute cholecystitis
Gallstones ulcerate
What colours the stool and urine in pre-hepatic jaundice
Normal stool and urine
What colours the stool and urine in hepatic jaundice
Dark urine
What colours the stool and urine in post-hepatic jaundice
Pale stool and dark urine
