Hepatobiliary Pathology Flashcards
Main functions of the Liver
carbohydrate metabolism, fat metabolism, protein metabolism, bile synthesis, storage of glycogen, copper iron, vitamins, detoxification
what is jaundice
yellowing of the skin and conjunctivae due to raised bilirubin
causes of jaundice
hepatitis, alcoholic liver disease, haemachromotosis
causes of hepatitis
non infectious - drugs, toxins, autoimmune
infectious - viral, bacterial (staph, salmonella, TB)
viruses that cause heptitis
hep A - faeco oral, acute, resolve
hep B - parenteral, 4% become chronic
hep C - parenteral, 85% become chronic
histological presentation of chronic viral heptitis
ground glass hepatocytes, viral inclusion bodies
possible outcomes of viral hepatitis infection
acute infection then clearance
acute infection followed by possible massive necrosis with liver failure
chronic infection resulting in liver damage
cirrhosis increasing risk for carcinoma
signs of alcoholic liver disease
steatosis (fatty change), hepatitis, fibrosis, cirrhosis
hepatocyte necrosis, mallorys hyaline filaments
pathogenesis of alcoholic liver disease
ATP diverted from fat metabolism to alcohol, fat accumulates, alcohol stimulates collagen synthesis leading to fibrosis, acetaldehyde causes inflammation, irreversible architectural disturbance
what is primary haemochromatosis
excessive absorption of iron in the small intestine, deposited in many organs and tissues as haemosiderin
what happens to the liver in cirrhosis
failure of synthesis - albumin, clotting factors
failure of catabolism - persistence of hormones
failure of flow - hypertension, varices, ascites
most common type of tumor in the liver
metastatic liver - colon, pancreas, lung, breast
diagnostic marker of hepatocellular carcinoma
a fetoprotein in blood
liver function tests
AST and ALT - non specific liver injury
gamma glutamyltransferase - alcohol induced
alkaline phosphatase
serum bilirubin
proteins
what does bile consist of
lipids, cholesterol, bile salts, bilirubin
