Inflammatory Diseases Of The Liver Flashcards
Three characteristics of NASH on biopsy?
hepatic steatosis, lobular inflammation and ballooned hepatocytes
Role of vitamin E in NASH?
improves steatosis and inflammation but was not associated with improvements in hepatic fibrosis
Skin condition associated with NAFLD?
Psoriasis
UGT1A1 gene?
Gilbert
Progressive familial intrahepatic cholestasis (PFIC):
Which are characterized by normal GGT levels?
Which is associated with an increased risk for hepatocellular carcinoma?
PFIC type1 and PFIC type 2
PFIC type 2
Hemachromatosis: symptoms that are not improved with chelation therapy?
arthropathy, hypogonadism, cirrhosis
Function of Hepcidin?
Impact on identifying the etiology of the hemachromatosis?
Secreted by the liver and decreases iron release from macrophages and duodenal enterocytes by interacting with ferroportin
Normal to elevated in ferroportin disease. Low in HFE, TfR2 and Hemojuvulin.
PBC - type of portal hypertension? Significance?
pre-sinusoidal portal hypertension in the absence of cirrhosis (varices without cirrhosis)
Ursodeoxycholic acid in the management of PBC - beneficial for?
Does not help with?
reduce LDL levels, variceal bleeding, slow the progression and reduce the risk of needing a liver transplant
Fatigue, osteoporosis
Hepatocyte rosettes with plasma cell infiltrate - suggestive of?
autoimmune hepatitis
Annual screenings for PSC patients?
-colonoscopy
-GB ultrasound
IgG-4 sclerosing cholangitis (vs PSC) - treatment, serology, demographic
Steroid responsive, P-ANCA negative, older men
When should Hepatic sarcoid be treated with steroids?
Mainly if symptomatic
Liver bx: ductulitis and endotheliitis - suggestive of?
Acute cellular rejection
Liver bx: ductopenia and cholestasis suggestive of?
Chronic rejection
Post transplant patient presenting with: fevers, leukopenia, anemia, secretory diarrhea and maculopapular rash - likely dx?
Liver GVHD
the wedged hepatic venous pressure (WHVP), the free hepatic venous pressure (FHVP) and the hepatic venous pressure gradient (HVPG) measurements in
1) pre-sinusoidal disease
2) sinusoidal disease (cirrhosis)
3) cardiac cirrhosis
1) normal WHVP, normal FHVP and normal HVPG
2) elevated WHVP, normal FHVP and elevated HVPG
3) elevated WHVP, elevated FHVP and resultant normal HVPG
Caudate lobe hypertrophy - suggestive of?
Mechanism?
Contrast CT finding?
Budd Chiari syndrome, and is due to the separate venous drainage of the caudate into the inferior vena cava allowing for sparing of the outflow, resulting in compensatory hypertrophy
early homogeneous central enhancement with delayed patchy enhancement of the peripheral liver and prolonged retention of contrast in the hepatic periphery, resulting in inhomogeneous portal perfusion
macrovesicular steatosis, a neutrophilic lobulitis, the presence of Mallory-Denk bodies, and pericellular fibrosis - diagnosis?
Mallory-Denk bodies?
Alcoholic hepatitis or NASH
cytoplasmic hyaline inclusions of hepatocytes
