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Alimentary Pathology > Hepatobillary pathology > Flashcards

Hepatobillary pathology Flashcards

1
Q

what is the general cause of hepatitis A, B, C and E?

A

viruses

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2
Q

is hepatis is an example of acute or chronic liver injury?

A

acute liver injury

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3
Q

what hepatitis infections can result in resolution of the liver?

A

hep A and E

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4
Q

What type of hepatitis infection can cause liver failure if there is severe damage?

A

hep A, B and E

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5
Q

what type of hepatitis results in chronic hepatitis and cirrhosis?

A

hep B and C

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6
Q

hepatitis D is considered the same infection as hep?

A

hep B

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7
Q

what is the main pathological features of alcohol related liver disease?

A

fatty change

progression to cirrhosis

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8
Q

what is jaundice and generally what is it cause by?

A

jaundice is increased circulation billirubin

it is caused by altered metabolism of bilirubin

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9
Q

what are the 3 pathways of bilirubin metabolism?

A

pre hepatic
hepatic
post hepatic

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10
Q

describe the pre hepatic pathway for billirubin metabolism.

A

breakdown of haemoglobin in the spleen into haem and globin

Haem is converted in billirubin and it is released into the circulation

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11
Q

describe the hepatic pathway for billirubin metabolism

A

uptake of billirubin by hepatocytes in the liver
billirubin is conjugated with an acid to make is soluble (by hepatocytes)
soluble billirubin is then released into the circulation

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12
Q

describe the post hepatic pathway for billirbuin metabolism.

A

breakdown of conjugated billirubin in the small intetsine

billirubin rebasorbed and enters the enterohepatic circulation

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13
Q

what are the pre hepatic causes of jaundice?

A

haemolysis

increased release of haemoglobin from RBC

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14
Q

what are the hepatic causes of jaundice?

A

cholestasis (accumulation of bile within hepatocytes or bile cannaliculi)
intra-hepatic bile duct obstruction

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15
Q

what are the post hepatic causes of jaundice?

A

cholelithiasis (gallstones)
diseases of gallbladder
extra-hepatic duct obstruction

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16
Q

what are the causes of cholestasis?

A

viral hepatits
alcohol hepatitis
liver failure
drugs

17
Q

what are the causes of intra-hepatic bile duct obstruction?

A

primary biliary cholangitis
primary sclerosis cholangitis
tumours of the liver

18
Q

what is the pathology of primary biliary cholangitis?

A 
anti-mitochondrial auto-antibodies in serum
raised serum alkaline phosphatase 
granulomatous inflammation
loss of intra-hepatic bile ducts
progression to cirrhosis
19
Q

what is the difference between primary sclerosis cholangitis 1 and 2?

A

PSC 1 = associated with inflammatory bowel disease

PSC 2 = Progression to cirrhosis and increased risk of developing cholangiocarcinoma

20
Q

what is the pathology of primary sclerosis cholangitis?

A

chronic inflammation
fibrous obliteration of bile ducts
loss of intra-hepatic bile ducts

21
Q

what are the risk factors for cholelithiasis?

A

obesity

diabetes

22
Q

what is cholecystitis?

A

inflammation of the gallbladder

23
Q

what can acute cholecystitis cause?

what can this result in?

A

empyema
(pus within the gallbladder)
result in biliary peritonitis

24
Q

what can chronic cholecystitis result in?

A

loss of muscle and replaced by fibrosis

results in unable to contract to release bile due to fibrosis

25
Q

what are causes of bile duct obstruction?

A

gallstones
bile duct tumours
benign stricture (i.e. fibrosis)
external compression i.e. tumours

26
Q

what are the effects of bile duct obstruction?

A

jaundice
no bile excreted into duodenum
infection of bile proximal to obstruction (known as ascending cholangitis)
secondly biliary cirrhosis if obstruction is prolonged

27
Q

what is cholangiocarcinoma?

A

malignant tumour of bile duct epithelium

28
Q

what is the name for a malignant tumour of hepatocytes?

A

hepatocellular carcinoma

29
Q

what are the different causes hepatic cirrhosis?

A

alcohol
hepatitis B and C
immune mediated liver disease (autoimmune hepatitis , primary biliary cholangitis)
metabolic disorders (excess iron - haemochromatosis & excess copper- wilsons disease)
obesity (i.e. diabetes)
cryptogenic

30
Q

what is the pathology of cirrhosis?

A

diffuse process involving the whole liver
loss of normal structure
replaced by nodules of hepatocytes and fibrous tissue

31
Q

what are the complications of cirrhosis?

A

altered liver function
abnormal blood flow
increased risk of hepatocellular carcinoma

32
Q

what 2 main complications of portal hypertension?

A

splenomegaly

dilatation of portosystemic anastomoses which can bleed = gastrointestinal haemorrhage

33
Q

what is the appearance of a cirrhotic liver compared to a normal one?

A

nodular
scarred
often shrunken
weights less

Alimentary Pathology (3 decks)

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