Hepatobiliary 2

Question 1

Feathery degeneration is seen in liver cell death ass’d w/ what type of pathology?

Answer 1

Cholestasis

Question 2

How is Chronic Hepatitis Prognosis determined?

Stage vs. Grade?

Answer 2

Needle biopsy

Grade = how “active disease is
- Measured by amount of hepatic necrosis & inflammation seen

Stage = Disease “progression”
- Measured by amount of Fibrosis seen
(irreversible damage)

Question 3

T or F? Autoimmune hepatitis serology often shows viral antibodies.

Answer 3

False, presence of viral antibodies would rule out autoimmune hepatitis as diagnosis

Question 4

Where does the deposition of hemosiderin occur in Primary vs. Secondary Hemochromatosis?

Answer 4

Primary = Hepatocyte cytoplasm

Secondary = Kupffer cells (macrophages in sinusoid space)

Question 5

Genetic mutation responsible for Wilson’s Disease?

Answer 5

ATP7B
- Codes for ATP-dependent transmembrane cation transport

Mutation = ineffective copper transport

Question 6

Wilson’s Disease - results on Serology?

Answer 6

• Deficient biliary excretion

- Reduced Ceroplasmin levels

Question 7

Kayser-Fleischer Rings are seen in what disease/syndrome?

Answer 7

Wilson’s Disease

they are green-brown deposits of copper in Descemet’s membrane in corneal limbus

Question 8

PiZZ phenotype causes what disease?

Answer 8

alpha-1 Antitrypsin Deficiency

• leads to emphysema & liver disease
• chronic hepatitis & cirrhosis in children — buildup of misfiled proteins in Golgi & ER
• Can lead to hepatocellular carcinoma

Question 9

Normal liver:

a) What type of collagen is concentrated in portal tracts & around central vein?
b) What type of collagen is present in the space of Disse?
c) What type(s) are deposited in Cirrhosis?

Answer 9

a) Types 1 & 2
b) thin strands of Type 4
c) Cirrhosis = Types 1 & 3 deposited in Portal Tract & Space of Disse

Question 10

What cells are activated in Cirrhosis?

Answer 10

Stellate cells are activated.
Go from Vitamin A storing cells to Myofibroblasts that lay down ECM & proliferate

**
this is all due to activating cytokines released by Kupffer cells:
TGF-beta -- Fibrogenesis
ET-1 -- Contraction
PDGF & TNF -- Proliferation
**

Question 11

What type of general changes occur to the liver vasculature in cirrhosis?

Answer 11

Sclerosis of the Portal tracts, Sinusoids, & Central veins

Sclerosis = Fibrosis = Collagen deposition