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Block 15 Ellen > L6: Hepatic pathology > Flashcards

L6: Hepatic pathology Flashcards

1
Q

describe how liver disease often develops

A

silently

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2
Q

name 3 major risk factors for liver disease

A

alcohol
obesity
HepC virus

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3
Q

what percentage of first liver admissions have liver disease

A

90%

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4
Q

where does the liver sit

A

RUQ

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5
Q

liver is made up of

A

> 90% hepatocytes

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6
Q

portal triad made up of

A

hepatic artery proper
portal vein
biliary duct

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7
Q

what drains the liver

A

central vein

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8
Q

where does blood travel in the liver

A

in the sinusoids from portal triad to central vein

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9
Q

basic unit of the liver=

A

acinus

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10
Q

special feature of hepatocytes

A

regenerative capacity

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11
Q

why do hepatocytes have multiple glycogen stores

A

high metabolic rate

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12
Q

what does the endoplasmic reticulum do in the hepatocyte

A

excretory functions such as bile

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13
Q

what does the hepatocyte need to be in close contact with

A

sinusoid (blood)

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14
Q

kupffer cell=

A

specialised macrophages

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15
Q

functions of the liver (7)

A
  • glucogen storage and glucose release
  • protein synthesis (albumin/ coagulation factors)
  • catabolism of AA and urea production
  • drug and steroid metabolism
  • lipoprotein synthesis
  • production and excretion of bile salts
  • immune response
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16
Q

hepatitis=

A

inflammation of the liver

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17
Q

5 common causes of hepatitis

A 
alcohol 
viral 
NASH/ NAFLD 
drugs 
autoimmune hepatitis
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18
Q

viral hepatitis causes acute symptomatic disease (4)

A

Hep A
Hep B
Hep B + D
Hep E

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19
Q

which viral hepatitis causes most chronic disease

A

Hep C

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20
Q

which hepatitis never cause chronic disease

A

Hep E

Hep A

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21
Q

5 other non Hepatitis viruses causes hepatitis

A 
CMV
EBV
Herpes 
Varicella
Reo virus
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22
Q

transmission route of Hep A

A

Faeco-oral route (mainly through food)

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23
Q

what can happen in Hep A before the symptomatic phase

A

faecal load of HAV is high

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24
Q

what is the consequence of Hep A

A

self limiting majority recover

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25
what is protracted hepatitis
lingering
26
what is cholestatic hepatitis
bilirubin build up and jaundice
27
what is fluminant hepatitis
very rare either recover or die
28
Hep B mode of transmission (7)
``` blood sexual unsterile needles mother--> baby razors toothbrushes tattooing ```
29
biggest Hep B risk factor
heterosexual activity
30
when are you at an increased risk of carrier state after an acute infection
the younger you are the higher the risk
31
where does Hep B live
within genome of the cell
32
drugs to suppress Hep B
Tinofovir | entecavir
33
outer surface of Hep B virus
HBSaAg coat
34
inner surface of Hep B coat
HBcAg coat
35
Hep B treatment/ prevention sequence
vaccination antivirals transplant
36
treatment of Hep C
ribavirin
37
mode of Hep C transmission (3)
blood vertical sex/ household contact
38
when can cirrhosis occur after HepC infection
10-30 years
39
how to test HepC
HCV antibody and PCR
40
commonest cause of acute viral hepatitis
HepE
41
primary host of HepE
pig
42
symptoms of most HepE cases
asymptomatic / unrecognised
43
NAFLD=
non-alcoholic fatty liver disease
44
process of NAFLD
build- up of fat in the liver
45
range of severity of NAFLD
from fatty liver (steatosis) to cirrhosis
46
in some cases what can cirrhosis from NAFLD lead to
hepatocellular carcinoma
47
NASH=
non-alcoholic steatohepatitis
48
pathology of hepatic cirrhosis
fibrosis --> nodules --> loss of hepatocyte microvilli --> activated stellate cells --> scar matrix --> loss of fenestrae --> kupffer cell activation
49
causes of liver cirrhosis
- alcohol - viral hepatitis - NASH - drugs - autoimmune liver disease - cholestatic liver disease - metabolic liver disease - hepatic venous congestion - cryptogenic
50
4 complications of cirrhosis
- portal hypertension - hepatorenal syndrome - ascites - hepatic encephalopathy
51
what causes portal hypertension
back up of blood down portal venous system
52
variceal bleeds=
patient vomits large volumes of blood
53
what causes variceal bleeds
varicose veins in the gullet due to increased pressure of blood entering liver
54
hepatorenal syndrome=
rapid deterioration in kidney function with liver cirrhosis/ liver failure
55
what causes ascites
fluid produced by the liver not being recycled by the unhealthy liver
56
hepatic encephalopathy symptoms=
confusion altered level of consciousness coma
57
cause of hepatic encephalopathy
ammonia accumulation
58
3 branches leading into the portal vein
-superior mesenteric vein -inferior mesenteric vein splenic vein
59
does hepatocellular cancer usually cause pain
no
60
loss of function due to hepatic failure
- unable to filter toxins and drugs - metabolism reduced - reduced immunity - reduction in clotting factors - unable to store nutrients so body may experience shortage
61
loss of function due to hepatic failure
- unable to filter toxins and drugs - metabolism reduced - reduced immunity - reduction in clotting factors - unable to store nutrients so body may experience shortage - reduced protein production - reduced bile production
62
reduced bile production leads to
reduced absorption of ADEK - fat soluble vitamins
63
clinical consequences of hepatic failure
- cerebral oedema - Bleeding - infections - kidney failure - jaundice - ascities - melena - hypotension/ tachycardia

Block 15 Ellen (11 decks)

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