Intro to Pathology Flashcards
What is cirrhosis?
Chronic liver disease causes diffuse fibrosis surrounding architecturally abnormal regenerative nodules
Abnormal regenerative nodules lead to portal htn (ascites) and decreased synthesis of albumin (ascites) & other proteins including complement & clotting factors
Earlier stage of cirrhosis due to alcohol has seatosis (vacuoles of lipid) & no nodules early on. Also has inflammation, hepatocyte swelling, chicken-wire pattern of fibrosis around hepatocyge cords
Can cause portal htn which leads to poor clearance of microorganisms within the gut
What is SBP?
sponteneous bacterial peritonitis
It’s the most common/life threatening infection in cirrhosis.
Defined by presence of >250 PMNs in ascites in the absence of intra-abdominal source of infection/malignancy
Pathogenesis: bacterial translocation (BT) from the intestine to ascitic fluid
E. coli and Klebisella pneumoniae can cause it
Risk factors include: cirrhosis, decreased innate immunity, abnormal intestinal mucosa & motility i.e. with cirrhosis, vascular stasis due to portal htn
How can alcohol suppress innate immunity?
It suppresses cytokine & chemokyne resposes induced by most TLR ligands
Effects function of alveolar macrophages & neutrophils (lazy/less mobile neutrophils)
Acetaldehyde (the metabolic end product) decreases the activity of the anti-microbial peptide lysozyme
In alcoholic cirrhosis, there’s decreased protein synthesis, including complement 3
