Lec 23 LIver Path Flashcards

1
Q

What are the 2 blood supplies to the liver?

A

portal vein = 70%

hepatic artery = 40%

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2
Q

Of periportal hepatocytes, midzonal hepatocytes, centrilobular hepatocytes:

  • where is most oxygen/nutrients?
  • where is most metabolism?
  • where is most susceptible to ischemia
A

periportal = rich in ox and nutrients

midzonal = middle

centrilobular = poorest ox/nutrients; highly susceptible to ischemia; major zone of drug metabolism

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3
Q

What do you see histologically with acute hepatitis?

A
  • panlobular liver cell balooning and acdiophil body formation
  • lymphocytes
  • DON’T SEE NEUTROPHILS
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4
Q

What is cause of fulminant hepatitis?

A

2/3 due to viral hepatitis

1/3 due to drugs or chemicals

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5
Q

What defines chronic hepatitis pathologically?

A

dense lymphoplasmacytic infiltrate in portal tracts

- may or may not be associated with hepatocyte necrosis and scarring

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6
Q

What do you see grossly in fulminant hepatitis?

A

liver is shrunken and soft

capsule is wrinkled

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7
Q

What do you see grossly in acute hepatitis?

A

liver swollen and red
capsule edematous
focal depression due to subcapsular necrosis
color bright yellow or green

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8
Q

What is the reserve progenitor cell compartment of the liver?

A

canal of hering

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9
Q

What histo findings mark regeneration?

A
  • mitoses
  • thickening of hepatocyte cords
  • disorganization of structure
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10
Q

What do you see on histology with hep A infection?

A

prominent plasma cells [w/ hoff body]

- cholestatic hepatitis

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11
Q

What do you see in acute hep B infection histologically?

A
  • apoptotic bodies
  • macrophages
  • inflammation
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12
Q

What do you see in chronic hep B infection histologically?

A
  • ground glass hepatocytes = finely granular eosinophilic cytoplasm containing HBsAg
  • nucleus pushed to the side
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13
Q

What is the cause of liver cell injury in chronic hep C?

A

attributed to cytotoxic T cells

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14
Q

What do you see on pathology with chronic Hep C?

A
  • lymphoid aggregates or lymphoid follicles

- steatosis

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15
Q

What do you see on histology with autoimmune hepatitis?

A
  • hepatocyte necrosis
  • prominent plasma cells
  • interface hepatitis
  • necrosis

= similar to chronic viral hepatitis

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16
Q

What defines type 1 autoimmune hepatitis?

A
  • positive ANA and smooth muscle antibody
  • women < 40 yo
  • 1/3 have other autoimmune disease
  • 80% of AIH cases
17
Q

What defines type 2 autoimmune hepatitis?

A
  • children 2-14 yo
  • positive liver kidney muscle antibody [LKM1]
  • associated wtih type 1 DM, thyroiditis
18
Q

What do you see on pathology in alcoholic hepatitis?

A
  • hepatocyte sweeling and necrosis [baloooning]
  • mallory denk bodies = tangled cytokeratin filaments
  • lobular inflammation w/ neutrophils
  • chiken wire fibrosis
19
Q

What do you see in NASH histologically?

A
mimics alcoholic hepatitis
- macrovesicular steatosis
- ballooning hepatocytes
- mallory bodies
fibrosis