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Year 5 Pathology Revision > Histopathology 8: Liver pathology > Flashcards

Histopathology 8: Liver pathology Flashcards

1
Q

Aspergillus produces …………. which causes hepatocellular carcinoma

A

Aflatoxin

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2
Q

Which tumour marker indicates hepatocellular carcinoma ?

A

AFP

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3
Q

List 4 causes of hepatocellular carcinoma ?

A
  • Hepatitis B or C
  • Alcoholic cirrhosis
  • Haemochromatosis
  • Aflatoxin
  • NAFLD
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4
Q

Which cancer is caused by liver flukes ?

A

Cholangiocarcinoma

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5
Q

Which syndrome is associated with cholangiocarcinoma ?

A

Lynch syndrome type II

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6
Q

What are the macrophages in the liver called ?

A

Kupffer cells

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7
Q

Where do stellate cells reside in the liver ?

A

Space of disse

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8
Q

Is alcoholic cirrhosis micronodular or macronodular ?

A

Micronodular

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9
Q

Is cirrhosis due to viral hepatitis micronodular or macronodular ?

A

Macronodular

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10
Q

List 3 histological features of alcoholic liver disease ?

A
  • Ballooning
  • Mallory denk bodies
  • Fibrosis
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11
Q

What causes NAFLD ?

A

Insulin resistance e.g due to diabetes or obesity

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12
Q

What is the characteristic histological features of PBC ?

A

Granulomatous destruction of bile ducts secondary to chronic inflammation

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13
Q

Which auto antibody is associated with PBC ?

A

anti-mitochondrial antibodies

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14
Q

Describe the characteristic histological features of PSC ?

A
  • Periductal bile duct cirrhosis leading to bile duct loss

- “Onion skinning”

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15
Q

Which disease is associated with PSC ?

A

Ulcerative colitis

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16
Q

Is cirrhosis due to biliary tract disease micronodular or macronodular ?

A

Micronodular

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17
Q

List 5 genetic causes of liver cirrhosis ?

A 
haemochromatosis 
wilson's disease
alpha 1 antitrypsin deficiency 
galactosaemia 
glycogen storage disease
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18
Q

What is the most common benign liver tumour ?

A

Haemangioma

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19
Q

Which zone in liver lobules is the first to be affected by alcoholic liver disease ?

A

Zone 3

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20
Q

Which HLA is associated with autoimmune hepatitis ?

A

HLA-DR3

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21
Q

List 3 auto antibodies seen in autoimmune hepatitis ?

A

ANA
Anti-SMA
Anti-LKM

22
Q

ERPC shows beading of bile ducts.

Most likely diagnosis ?

23
Q

What is Budd-Chiari syndrome ?

A

Compression/ Occlusion of the hepatic vein

24
Q

Which stain is used to identify copper in Wilson’s disease “

A

Rhodanine stain

25
What happens to Caeruloplasmin levels in Wilson's disease ?
They are reduced
26
Which genetic disease causes both Emphysema and liver cirrhosis ?
Alpha 1 antitrypsin deficiency
27
Which auto-immune disease is associated with PBC ?
Sjogrens
28
What is the triad for PBC ?
Jaundice xanthelasma pruritus
29
Give 2 causes of haemosiderosis ?
alcohol | blood transfusions
30
describe the dual blood supply of the liver
hepatic portal vein | hepatic artery
31
what are stellate cells
store vitamin A when activated - become myofibroblasts and lay down collagen responsible for most of the scarring in liver disease
32
which liver zone has the most metabolically active enzymes
3 (closest to central vein)
33
describe the process of stellate activation
normal hepatocytes have microvilli endothelial cells have no BM and have spaces between stellate cells sit in the space between endothelial cells (space of disse) blood gets through the endothelial cells ``` liver injury - kupffer cells activate endothelial cells stick together blood struggles to get through hepatocytes lose their microvilli stellate cells secrete BM type collagen into space of disse ```
34
what is cirrhosis
whole liver involvement fibrosis intra- and extra-hepatic shunting of blood intrahepatic shunting = blood comes through liver but not in contact with hepatocytes extrahepatic = blood backlogs into porto-systemic anastamoses
35
2 complications of cirrhosis
portal hypertension hepatic encephalopathy liver cell cancer
36
features of acute hepatitis
hep A and E drugs spotty necrosis
37
features of chronic hepatitis
viral hepatitis drugs AI
38
features of alcoholic liver disease
fatty liver alcoholic hepatitis cirrhosis
39
list histological features of alcoholic hepatitis
``` ballooning Mallory denk bodies (pink deposits) apoptosis pericellular fibrosis mainly in zone 3 ```
40
features of NASH
hepatitis resulting from NAFLD caused by insulin resistance associated with raised BMI and diabetes one of commonest causes of liver disease ww
41
features of PBC
F>M bile duct loss associated with chronic inflammation (with granulomas) diagnostic test = AMA bile ducts surrounded by epithelioid macrophages
42
features of PSC
``` M>F periductal bile duct fibrosis leading to loss associated with UC increased risk of cholangiocarcinoma diagnostic = bile duct imaging ```
43
features of haemochromatosis
genetically determined increased gut iron ab HFe gene on chr 6 iron deposition in parenchymal cells 'bronzed diabetes' - skin and pancreas
44
what is haemosiderosis
iron overload accumulation of iron in macrophages result of blood transfusions
45
what is wilsons disease
accumulation of copper due to failure of excretion of copper by hepatocytes into bile chr 13 accumulates in liver and CNS and iris (KF rings)
46
antibodies in AI hepatitis
anti-smooth muscle antibodies (ASMA) | responds to steroids
47
what is alpha-1 antitrypsin deficiency
failure to secrete alpha- 1 antitrypsin deficiency in the blood, excess in hepatocytes chronic hepatitis emphysema
48
causes of hepatic granulomas
specific - PBC, drugs | general - TB, sarcoidosis
49
list benign liver tumours
liver cell adenoma bile duct adenoma haemangioma
50
list malignant liver tumorus
``` secondary (most common) hepatocellular carcinoma hepatoblastoma cholangiocarcinoma (associated with PSC, worm infections, cirrhosis) hemangiosarcoma ```

Year 5 Pathology Revision (106 decks)

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