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Alimentary System > Hepatobiliary Pathology > Flashcards

Hepatobiliary Pathology Flashcards

1
Q

What are examples of pathologies of the liver?

A

Liver failure

Jaundice

Intrahepatic bile duct obstruction

Cirrhosis

Tumours

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2
Q

What is pathology of the gallbladder usually?

A

Inflammation

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3
Q

What is pathology of the extrahepatic bile ducts normally?

A

Obstruction

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4
Q

What 2 broad categories is liver failure a complication of?

A

Acute liver injury

Chronic liver disease (such as cirrhosis)

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5
Q

What are examples of acute liver injury?

A

Hepatitis

Bile duct obstruction

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6
Q

What can cause hepatitis which causes acute liver injury?

A

Viruses such as hep A, B, C, E, other viruses

Alcohol

Drugs

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7
Q

What is the pathology of virus hepatitis?

A

Inflammation of the liver

Liver cell damage and death of the individual liver cells

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8
Q

What are the possible outcomes of acute liver injury?

A

Resolution (liver function returns to normal)

Liver failure (if severe damage to the liver)

Progression to chronic hepatitis and cirrhosis

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9
Q

What hepatitis viruses can cause acute liver injury but then lead to resolution?

A

Hepatitis A and E

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10
Q

What hepatitis can cause acute liver injury and lead to liver failuer?

A

Hepatitis A, B and E

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11
Q

What hepatitis can cause acute liver injury and lead to chronic hepatitis?

A

Hepatitis B and C

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12
Q

What is alcohol liver disease?

A

Result of consuming too much alcohol, leading to build up of inflammation, fat and scar tissue

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13
Q

What is the pathology of alcoholic hepatitis?

A

Acute inflammation

Liver cell death

Liver failure

Progress to cirrhosis

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14
Q

What is alcoholic hepatitis?

A

Inflammation of the liver caused by drinking to much alcohol

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15
Q

What is jaundice caused by?

A

Increased circulating bilirubin due to altered metabolism of bilirubin

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16
Q

What are the 3 broad areas of the body involved in bilirubin metabolism?

A

Pre-hepatic

Hepatic

Post-hepatic

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17
Q

Explain the pathway of bilirubin metabolism?

A

1) Breakdown of haemoglibin in spleen to form haem and globin (prehepatic)
2) Haem converted to bilirubin (prehepatic)
3) Release of bilirubin into circulation (prehepatic)
4) Uptake of bilirubin by hepatocytes (hepatic)
5) Conjugation of bilirubin in hepatocytes (hepatic)
6) Excretion of conjugated bilirubin into biliary system (hepatic)
7) Transport of conjugated bilirubin in biliary system (posthepatic)
8) Breakdown of bilirubin conjugate in intestine (posthepatic)
9) Reabsorption of bilirubin (posthepatic)

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18
Q

What are the 3 broad categories of causes of jaundice?

A

Pre-hepatic

Hepatic

Post-hepatic

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19
Q

What are pre-hepatic causes of jaundice?

A

Increased release of haemoglobin from red cells (haemolysis)

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20
Q

What is the rupture or destruction of red blood cells called?

A

Haemolysis

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21
Q

What are some causes of cholestasis?

A

Viral hepatitis

Alcoholic hepatitis

Liver failure

Drugs (therpeutical, recreation, can be predictable so dose related or unpredictable so not dose related)

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22
Q

What are some

A
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23
Q

What are hepatic causes of jaundice?

A

Cholestasis

Intra-hepatic bile duct obstruction

24
Q

What is cholestasis?

A

Accumulation of bile within hepatocytes or bile canaliculi

25
Q

What are causes of intra-hepatic bile duct obstruction?

A

Primary biliary cholangitis

Primary sclerosing cholangitis

Tumours of the liver

26
Q

What kind of condition is primary biliary cholangitis?

A

Autoimmune disease

27
Q

How does the incidence of primary biliary cholangitis change between males and females?

A

Affects males to females 1:9 ratio

28
Q

What is the pathology of primary biliary cholangitis?

A

Granulomatous inflammation involving bile ducts

Loss of intra-hepatic bile ducts

Progression to cirrhosis

29
Q

What does PBC (primary biliary cholangitis) change in the blood?

A

Raises serum alkaline phosphatase

30
Q

What does PBC stand for?

A

Primary biliary cholangitis

31
Q

What does PSC stand for?

A

Primary sclerosing cholangitis

32
Q

What is the pathology of primary sclerosing cholangitis?

A

Chronic inflammation and fibrous obliteration of bile ducts

Loss of intra-hepatic bile ducts

Progression to cirrhosis

33
Q

What does PSC increase the risk of?

A

Developing cholangiocarcinoma

34
Q

What are examples of tumours of the liver?

A

Hepatocellular carcinoma

Tumours of intra-hepatic bile ducts

Metastatic tumours

35
Q

What are some post-hepatic causes of jaundice?

A

Cholelithiasis 9gallstones)

Diseases of the gallblader

Extrahepatic duct obstruction

36
Q

What is cholelithiasis?

A

The formation of gallstones

37
Q

What are risk factors for cholelithiasis?

A

Obesity

Diabetes

38
Q

What is inflammation of the gallbladder called?

A

Cholecystitis

39
Q

What are examples of diseases of the gallbladder?

A

Acute cholecystitis

Chronic cholecystitis

40
Q

What is an empyema?

A

Pocket of pus collected inside body cavity

41
Q

What causes acute cholecystitis?

A

Empyema (due to perforation of gallbladder or biliary peritonitis)

42
Q

What are some causes of extra-hepatic obstruction?

A

Gallstones

Bile duct tumours

Benign stricture

External compression (such as due to tumours)

43
Q

What are some of the consequences of extra-hepatic bile duct obstruction?

A

Jaundice

No bile excreted into duodenum

Infection of bile proximal to obstruction (ascending cholangitis)

Secondary biliary cirrhosis if obstruction prolonged

44
Q

What is hepatic cirrhosis?

A

End stage chronic liver disease

45
Q

What is hepatic cirrhosis the response of the liver to?

A

Chronic injury

46
Q

What are some examples of causes of hepatic cirrhosis?

A

Alcohol

Hepatitis B and C

Immune mediated liver disease (such as auto-immune hepatitis or PBC)

Obesity (diabetes mellitus)

47
Q

What is the pathology of cirrhosis?

A

Diffuse process involving whole liver

Loss of normal liver structure

Replaced by nodules of hepatocytes and fibrous tissue

48
Q

What are some possible complications of liver cirrhosis?

A

Altered liver function (liver failure)

Abnormal blood flow (portal hypertension)

Increased risk of hepatocellular carcinoma

49
Q

What are examples of liver tumours?

A

Hepatocellular carcinoma

Cholangiocarcinoma

Metastatic tumours

50
Q

What is a malignant tumour of hepatocytes called?

A

Hepatocellular carcinoma

51
Q

What are examples of liver function tests (LFT)?

A

Alanine aminotransferase test (ALT)

Asparate aminotransferase test (AST)

Albumin test

Bilirubin test

52
Q

What do ALT and AST tests measure?

A

Enzymes that the liver releases in response to damage or disease

53
Q

What does ALT stand for?

A

Alanine transferase test

54
Q

What does AST stand for?

A

Asparate transferase test

55
Q

What does an albumin test measure?

A

How well the liver creates albumin

56
Q

What does a bilirubin test measure?

A

How well the liver disposes of bilirubin

Alimentary System (41 decks)

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