Hepatology

Question 1

Liver Cirrhosis Bx findings

Answer 1

Excess collagen and extracellular matrix deposition in periportal and pericentral zones -> formation of regenerative nodules

Question 2

Alcoholic steatohepatitis Bx findings

Answer 2

Macrovesicular fatty change with fatty mitochondria, spotty necrosis and fibrosis - reversible at this stage

Question 3

NAFLD Bx findings

Answer 3

Triglyceride accumulation with accumulation of myofibroblasts

Question 4

Viral Hepatitis Bx findings

Answer 4

Mononuclear infiltration of liver lobules with hepatocyte necrosis and Kupffer cell hyperplasia

Question 5

Primary Biliary Cirrhosis Bx findings

Answer 5

Dense lymphoid infiltrates of hepatic portal tracts with chronic inflammation and hepatocyte necrosis

Question 6

Parameters in Child-Pugh scoring system

Answer 6

Bilirubin, Albumin, Prothrombin time, encephalopathy, ascites

Question 7

MELD score parameters

Answer 7

Bilirubin, creatinine, INR

Question 8

MELD >40 3 month mortality

Answer 8

71.3%

Question 9

MELD 30-39 3/12 mortality

Answer 9

52.6%

Question 10

MELD 20-29 3/12 mortality

Answer 10

19.6%

Question 11

MELD 10-19 3/12 mortality

Answer 11

6%

Question 12

MELD 0-9 3/12 mortality

Answer 12

1.9%

Question 13

Risk factors for HCC (8)

Answer 13

Alpha 1 antitrypsin
Hereditary tyrosinosis
Glycogen storage disease
aflatoxin 
Drugs - OCP, anabolic steroids
Porphyria cutanea tarda
Being a bloke
DM/metabolic syndrome