Hepatobilliary Tract

Question 0

Biliary

Liver dsea

Answer 0

Inc.bilirubin, alkphos, GGT

Question 1

Hepatocyte Integrity

Liver disease

Answer 1

Increase AST, ALT, LDH

Question 2

Synthetic function of hepatocyte

Answer 2

Inc. Prothrombin time, serum ammonia

Dec.serum albumin, aminopyrine breath test, galactose elimination

Question 3

Ballooning degeneration (empty cytoplasm w/ remnants of cytoplasmic orgnelles)

Councilman bodies (eosinophilic globules)

Apoptosis

Bridging necrosis

Answer 3

Acute hepatitis

Question 4

Ground glass hepatocyte
Bridging necrosis
Bridging fibrosis— hallmark

Answer 4

Chronic hepatitis

Question 5

True or false

Fulminant hepatitis occurs 2-3wks after onset
Occurs in individuals who do not have chronic liver dsea.

Answer 5

Fulminant Hepatitis

Question 6

Pyogenic vs nonpyogenic liver abscess

Answer 6

Pyogenic– bacteria

           - - neutrophilic infiltrate
           - - liquefactive necrosis

Nonpyogenic– echinococcal > (+) hooklets
amebic > anchovy paste
– eosinophilic

Question 7

Unknown etiology
(+) anti-smooth muscle antibodies
Interface hepatitis with prominent plasma cells

Answer 7

Autoimmune hepatitis

Question 8

True or false

Hepatic steatosis is completely reversible

Answer 8

True

Question 9

Laennec cirrhosis
Mallory bodies
Brown shrunken, non fatty liver

Answer 9

Alcoholic hepatitis

Question 10

Acquired hemochromatosis

Answer 10

Hemosiderosis

Question 11

Triad of hemochromatosis

Answer 11

Hepatomegaly
DM
Bronze skin pigmentation

Question 12

Deposition of hemosiderin is detected using what stain?

Answer 12

Prussian blue

Question 13

Autosomal recessive
Impaired copper excreation
Failure to incorporate copper into Ceruloplasmin

Answer 13

Wilsons disease

Question 14

Panlobular giant-cell transformation of hepatocyte

Prominent hepatocellular and canalicular cholestasis

Answer 14

Neonatal hepatitis

Question 15

Non suppurative, inflammatory destruction of medium sized intrahepatic bile ducts

Inc. alkphos, cholesterol

(+) antimitochondrial antibodies

Answer 15

Primary billiary cirrhosis

Question 16

Inflam. and obliterative fibrosis of intrahepatic and extrahepatic bile ducts

Charac. beading of contrast medium

Answer 16

Primary sclerosing cholangitis

Question 17

Autoantibodies in primary sclerosing cholangitis

Answer 17

Atypical p-ANCA

Question 18

Centrilobular necrosis

nutmeg liver, cardiac sclerosis

Answer 18

Chronic passive hepatic congestin

Question 19

Obstruction of 2 or more hepatic veins

Tense liver capsule

Answer 19

Budd-chiari syndrome

Question 20

Benign neoplasm of the liver asso.with oral contraceptive

Answer 20

Hepatic adenoma

Question 21

Malignancy of the billiary tree arising from the bile ducts

Answer 21

Cholangiocarcinoma

Question 22

Clonorchis and opistorchis infection is asso.with what malignancy

Answer 22

Cholangiocarcinoma

Question 23

Perihilar extrahepatic form of cholangiocarcinoma

Answer 23

Klatskin tumor

Question 24

True or false

Liver metastases is more common than primary hepatic neoplasia

Answer 24

True

Question 25

Cholesterol vs pigment stone in cholelithiasis

Answer 25

Cholesterol stone– 90%, glistening radiating crystalline pallisade, radio opaque

Pigment stone
Black- sterile GB, oxidized Ca salts of Unconjugated bilirubin, radio opaque
Brown- infected intra and extrahepatic ducts, RadioLUCENT

Question 26

Acute calculous vs acalculous

Answer 26

Calculous - chemical irritation and inflamm, no bacterial infection

Acalculous - ischemia (sepsis, trauma, burn etc.)

Question 27

Rokitansky aschoff sinuses

Answer 27

Chronic cholecystitis

Question 28

Most impt risk factor asso.with GB adeno ca

Answer 28

Gallstone

Question 29

Common site of GB adeno ca

Answer 29

Fundus and neck