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Alimentary System > Hepatobilliary Pathology > Flashcards

Hepatobilliary Pathology Flashcards

1
Q

structure of the liver

A

Dual blood supply
Hepatic artery, portal vein

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2
Q

functions of the liver

A

Protein synthesis

Metabolism of fat and carbohydrate

Detoxification of drugs and toxins including alcohol

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3
Q

what are some pathologies of the liver

A

Liver failure
Jaundice
Intrahepatic bile duct obstruction
Cirrhosis
Tumours

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4
Q

what is the pathology associated with the gall bladder

A

Inflammation

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5
Q

what is the pathology associated with extrahepatic bile ducts

A

Obstruction

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6
Q

what is liver failure caused by

A

Acute liver injury

Chronic liver injury i.e. cirrhosis

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7
Q

Acute liver injury

A

Hepatitis
- Viruses
- Alcohol
- Drugs (particularly paracetomol overdose)

Bile duct obstruction

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8
Q

what are the different types of viral hepatitis

A

Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
Other viruses

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9
Q

what pathologies does viral hepatitis cause

A

inflammation of liver

Liver cell damage and death of individual liver cells

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10
Q

what are the different outcomes from acute inflammation

A

resolution
liver failure
progression to cirrhosis

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11
Q

when is resolution most common

A

hepatitis A and E

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12
Q

when is liver failure most common

A

hepatitis A,B and E

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13
Q

when is progression to chronic hepatitis or cirrhosis most common

A

hepatitis B,C

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14
Q

what is alcoholic liver disease

A

Response of liver to excess alcohol

fatty change

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15
Q

what occurs as a result of Alcoholic hepatitis

A

Acute inflammation
Liver cell death
Liver failure

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16
Q

can alcoholic liver disease progress to cirrhosis

A

yes

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17
Q

what is jaundice caused by

A

Increased circulating bilirubin

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18
Q

when is there Increased circulating bilirubin

A

Caused by altered metabolism of bilirubin

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19
Q

what phases is the pathway of bilirubin metabolism made up of

A

Pre-hepatic
Hepatic
Post-hepatic

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20
Q

what are the characteristic features of jaundice

A

yellow features
particularly eyes

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21
Q

pre-hepatic phase

A

Breakdown of haemoglobin in spleen to form haem and globin

Haem converted to bilirubin

Release of bilirubin into circulation

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22
Q

hepatic phase

A

Uptake of bilirubin by hepatocytes

Conjugation of bilirubin in hepatocytes

Excretion of conjugated bilirubin into biliary system

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23
Q

post-hepatic phase

A

Transport of conjugated bilirubin in biliary system

Breakdown of bilirubin conjugate in intestine

Re-absorption of bilirubin

24
Q

causes of pre-hepatic jaundice

A

Increased release of haemoglobin from red cells (haemolysis)

25
Q

hepatic causes of jaundice

A

Cholestasis

Intra-hepatic bile duct obstruction

26
Q

cholestasis

A

Accumulation of bile within hepatocytes or bile canaliculi

27
Q

causes of cholestasis

A

Viral hepatitis
Alcoholic hepatitis
Liver failure

Drugs:
Therapeutic
Recreational

28
Q

predictable cholestasis

A

dose related

29
Q

unpredictable cholestasis

A

not dose related

30
Q

causes of Intra-hepatic Bile Duct Obstruction

A

Primary biliary cholangitis

Primary sclerosing cholangitis

Tumours of liver

31
Q

what are the different types of tumours of the liver

A

Hepatocellular carcinoma

Tumours of intra-hepatic bile ducts

Metastatic tumours

32
Q

what is primary biliary cholangitis

A

Inflammation of the gall bladder that can lead to liver dysfunction, inherited condition

33
Q

who is mainly affected by primary biliary cholangitis

A

females

34
Q

what does primary biliary cholangitis raise

A

serum alkaline phosphatase

35
Q

what are pathologies associated with Primary
Biliary Cholangitis

A

Granulomatous inflammation involving bile ducts

Loss of intra-hepatic bile ducts

Progression to cirrhosis

36
Q

what would be the symptoms of Primary Sclerosing Cholangitis 1

A

Chronic inflammation and fibrous obliteration of bile ducts

Loss of intra-hepatic bile ducts

Associated with inflammatory bowel disease

37
Q

what would be the symptoms of Primary Sclerosing Cholangitis 2

A

Progression to cirrhosis

Increased risk of development of cholangiocarcinoma

38
Q

hepatic cirrhosis

A

End stage chronic liver disease

Response of liver to chronic injury

39
Q

what are causes of cirrhosis 1

A

Alcohol

Hepatitis B, C

Immune mediated liver disease

40
Q

immune mediated liver disease

A

Auto-immune hepatitis

Primary biliary cholangitis

41
Q

what are causes of cirrhosis 2

A

Metabolic disorders

Obesity

42
Q

metabolic disordees

A

Excess iron [Primary haemochromatosis]

Excess copper [Wilson’s disease]

43
Q

obesity cause

A

diabetes mellitus

44
Q

what pathologies are associated with cirrhosis

A

Diffuse process involving whole liver

Loss of normal liver structure

Replaced by nodules of hepatocytes and fibrous tissue

45
Q

what are complications of cirrhosis

A

Altered liver function [Liver failure]

Abnormal blood flow [Portal hypertension]

Increased risk of hepatocellular carcinoma

46
Q

liver tumours

A

Hepatocellular carcinoma
Cholangiocarcinoma
Metastatic tumours

47
Q

Hepatocellular carcinoma

A

Malignant tumour of hepatocytes

48
Q

Cholangiocarcinoma

A

Malignant tumour of bile duct epithelium

49
Q

Metastatic tumours

A

Common site of metastases

50
Q

post hepatic jaundice pathologies

A

Cholelithiasis (gallstones)

Diseases of gall bladder

Extra-hepatic duct obstruction

51
Q

what are risk factors for gall stones

A

obesity
diabetes

52
Q

what is characteristic of diseases of the gall bladder

A

Inflammation;
Acute cholecystitis
Chronic cholecystitis

53
Q

Acute Cholecystitis

A

Acute inflammation of gall bladder

can progress to chronic inflammation

54
Q

what can accompany acute inflammation of the gall bladder

A

Empyema;
Perforation of gall bladder
Biliary peritonitis

55
Q

Chronic Cholecystitis

A

Chronic inflammation and fibrosis of gall bladder

56
Q

Causes of Common Bile Duct Obstruction

A

Gallstones

Bile duct tumours

Benign stricture [passing gall stones]

External compression
Tumours

57
Q

effects of common bile duct obstruction

A

jaundice

No bile excreted into duodenum

Infection of bile proximal to obstruction
Ascending cholangitis

Secondary biliary cirrhosis if obstruction prolonged

Alimentary System (44 decks)

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