Intestinal and Liver Pathology II Flashcards
80% of obstructions in the intestines are due to?
- herniations
- adhesions
- intussusception
- volvulus
10-20% of obstructions in the intestines are due to?
tumours or infarcts
what is a hernia
weakness or defect in abdominal wall -> protrusion of peritoneum
what is the termed for trapped bowel
incarceration
what is the term for trapped and ischemic bowel
strangulated
intussusception in adults usually occurs due to a ? in the small bowel that disrupts motility
tumour
what is ileus
painful obstruction of the ileum that greatly decreases motility
what are the two phases of intestinal ischemia
hypoxic injury and reperfusion injury
what is hypoxic injury
epithelium, muscular layers are relatively resistant to ischemia, so damage is relatively limited early on
what is reperfusion injury
as blood supply is re-established, free radical production, neutrophil infiltration and release of inflammatory mediators
what is coagulative necrosis
perforation and inflammation of the serosa or peritoneum
what is angiodysplasia
malformed submucosal and mucosal blood vessels
what is the most common abdominal surgical emergency
appendicitis
what are the different phases of hepatitis infection
- incubation period
- symptomatic preicteric phase
- symptomatic icteric phase
- convalescence
what is the genome of hepatitis A
ssRNA
what is the genome of hepatitis B
dsDNA
what is the genome of hepatitis C
ssRNA
what is the genome of hepatitis D
ssRNA
what is the route of transmission for hepatitis A
Fecal-oral
what is the route of transmission for hepatitis B
parenteral, sexual transmission
what is the route of transmission for hepatitis C
parenteral
what is the route of transmission for hepatitis D
parenteral
what is the incubation period for hepatitis A
2-6 weeks
what is the incubation period for hepatitis B
2-26 weeks
what is the incubation period for hepatitis C
4-26 weeks
what is the incubation period for hepatitis D
2-26 weeks
is chronic liver disease associated with hepatitis A
never
is chronic liver disease associated with hepatitis B
5-10%
is chronic liver disease associated with hepatitis C
> 80%
is chronic liver disease associated with hepatitis D
10-90%
what is the most prevalent form of hepatitis in the world
hepatitis B
which hepatitis needs coinfection with hepatitis B for its life cycle
hepatitis D
which hepatitis is associated with a very high mortality in pregnant women and is associated with zoonosis that results in self-limited acute hepatitis
hepatitis E
what are the 3 distinct but overlapping forms of alcoholic liver injury
- hepatitis
- hepatic steatosis
- steatofibrosis
alcohol promotes movement of ? from the gut into the portal circulation which leads to ?
bacterial endotoxin
liver inflammation
what is non-alcoholic fatty liver disease
steatosis in the absence of significant alcohol consumption
what is the most common cause of liver disease in US
NAFLD
what happens with low doses of acetaminophen toxicity
conjugated and excreted in urine
what happens with high doses of acetaminophen toxicity
increased production of NAPQI, if glutathione reserves are insufficient, then this reactive molecule damages hepatocytes
what are the two types of autoimmune hepatitis
type 1: presence of ANA(antinuclear antibodies) and anti-smooth muscle antibodies
type 2: presence of anti-cytochrome antibodies
portal hypertension is caused by ?
a combination of increased resistance to blood flow through the portal circulation, and a “hyperdynamic circulation”
what is cholangitis
bacterial infection of the bile ducts
what is the main concern for diseases of the extrahepatic ducts
sepsis, the patient can go into septic shock
