Hepatobillary pathology Flashcards
what is the general cause of hepatitis A, B, C and E?
viruses
is hepatis is an example of acute or chronic liver injury?
acute liver injury
what hepatitis infections can result in resolution of the liver?
hep A and E
What type of hepatitis infection can cause liver failure if there is severe damage?
hep A, B and E
what type of hepatitis results in chronic hepatitis and cirrhosis?
hep B and C
hepatitis D is considered the same infection as hep?
hep B
what is the main pathological features of alcohol related liver disease?
fatty change
progression to cirrhosis
what is jaundice and generally what is it cause by?
jaundice is increased circulation billirubin
it is caused by altered metabolism of bilirubin
what are the 3 pathways of bilirubin metabolism?
pre hepatic
hepatic
post hepatic
describe the pre hepatic pathway for billirubin metabolism.
breakdown of haemoglobin in the spleen into haem and globin
Haem is converted in billirubin and it is released into the circulation
describe the hepatic pathway for billirubin metabolism
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
describe the post hepatic pathway for billirbuin metabolism.
breakdown of conjugated billirubin in the small intetsine
billirubin rebasorbed and enters the enterohepatic circulation
what are the pre hepatic causes of jaundice?
haemolysis
increased release of haemoglobin from RBC
what are the hepatic causes of jaundice?
cholestasis (accumulation of bile within hepatocytes or bile cannaliculi)
intra-hepatic bile duct obstruction
what are the post hepatic causes of jaundice?
cholelithiasis (gallstones)
diseases of gallbladder
extra-hepatic duct obstruction
what are the causes of cholestasis?
viral hepatits
alcohol hepatitis
liver failure
drugs
what are the causes of intra-hepatic bile duct obstruction?
primary biliary cholangitis
primary sclerosis cholangitis
tumours of the liver
what is the pathology of primary biliary cholangitis?
anti-mitochondrial auto-antibodies in serum raised serum alkaline phosphatase granulomatous inflammation loss of intra-hepatic bile ducts progression to cirrhosis
what is the difference between primary sclerosis cholangitis 1 and 2?
PSC 1 = associated with inflammatory bowel disease
PSC 2 = Progression to cirrhosis and increased risk of developing cholangiocarcinoma
what is the pathology of primary sclerosis cholangitis?
chronic inflammation
fibrous obliteration of bile ducts
loss of intra-hepatic bile ducts
what are the risk factors for cholelithiasis?
obesity
diabetes
what is cholecystitis?
inflammation of the gallbladder
what can acute cholecystitis cause?
what can this result in?
empyema
(pus within the gallbladder)
result in biliary peritonitis
what can chronic cholecystitis result in?
loss of muscle and replaced by fibrosis
results in unable to contract to release bile due to fibrosis
