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Pathophysiology > Lecture 17: Hepatitis > Flashcards

Lecture 17: Hepatitis Flashcards

1
Q

How does the liver get blood?

A

Portal Vein*
Hepatic Artery

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2
Q

True or False: The liver stores minerals and Vit B12 and detoxifies Bilirubin, Ammonia, Drugs, and Bacteria

A

True

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3
Q

What is the role of Kupffer cells in the liver?

A

Removes bacteria

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4
Q

True or False: The liver is important for synthesis of plasma proteins (albumin), clotting factors, bile salts, and hematopoesis

A

True

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5
Q

Sex hormones, cortisol/aldosterone, fat, and protein are metabolized by the ___

A

liver

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6
Q

Which part of the liver has blood flow differences? Which has the richest blood flow vs. limited?

A

Acinus
- Zone 1 = richest
- Zone 3 = limited ; more sensitive to injury

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7
Q

Fat containing stellate cells of the liver can be converted to ____, contributing to sclerosis

A

Macrophages

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8
Q

Hepatocellular carcinoma, NAFLD, alcoholic liver disease, and viral hepatitis are examples of….
A. Secondary Liver Disease
B. Major Primary Disease

A

B. Major Primary Disease

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9
Q

Cardiac decompensation, disseminated cancer, and extrahepatic infections are examples of…
A. Secondary Liver Disease
B. Major Primary Disease

A

A. Secondary Liver Disease

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10
Q

___ is the most severe clinical result of liver disease

A

Hepatic Failure

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11
Q

What are four signs/symptoms of acute liver failure?

A
  1. Nausea, vomit
  2. Jaundice
  3. Coag defects
  4. Liver enlarges, then shrinks
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12
Q

Elevated bilirubin leads to ___

A

jaundice

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13
Q

Patients with liver failure can have hypoalbuminemia due to impaired albumin production, which can cause….

A
  1. Peripheral Edema
  2. Ascites
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14
Q

Hyperammonemia is a clinical manifestation of liver failure and can result in…

A
  1. Confusion
  2. Rigidity
  3. Hepatic encephalopathy
  4. CNS Dysfunction
  5. Flapping tremor
  6. Hyper-reflexia
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15
Q

Palmar erythema, spider angiomas of skin, and hypogonadism/gynecomastia are clinical manifestations of…

A

Liver failure

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16
Q

Why can fector hepaticus develop during liver failure?

A

Mercaptans form due to GI bacteria
- Accompanied by shunting of portal blood to systemic circulation
- Goes directly to lungs

17
Q

What can contribute to development of cirrhosis/liver scarring?

A
  1. ETOH abuse
  2. Viral Hepatitis
  3. Non-alcoholic steatohepatitis
  4. Bil disease/iron overload
18
Q

True or False: Liver cirrhosis is associated with hepatocyte death, deposition of ECM, and vascular reoragnization

A

True

19
Q

What are the three major consequences of liver cirrhosis?

A
  1. Collagen deposits in Space of Disse
  2. Blood shunted
  3. Impaired sinusoidal fxtion
20
Q

Fibrosis is associated with increased vascular resistance within the level, as well as proliferation of ____ cells and their transition into fibrinogenic cells and fibroblasts (secrete collagen)

A

stellate

21
Q

A patient has anorexia, weight loss, and ascites. What does he most likely have?
A. Liver failure
B. Portal Hypertension
C. Cirrhosis

A

C. Cirrhosis

22
Q

True or False: Portal HTN is associated with increased resistance to portal blood flow

A

True

23
Q

A patient with splenomegaly, narrowing of portal vein, or obstructive thrombosis has which kind of portal hypertension?
A. Post-Hepatic
B. Pre-Hepatic
C. Intra-Hepatic

A

B. Pre-Hepatic

24
Q

Obstruction of hepatic v outflow, as well as pericarditis, and right sided heart failure is associated with which type of portal hypertension?
A. Post-Hepatic
B. Pre-Hepatic
C. Intra-Hepatic

A

A. Post-Hepatic

25
Q

Clinical manifestations of portal hypertension?

A
  1. Ascites
  2. Portosystemic shunt
  3. Splenomegaly
  4. Testicular atrophy/infertile
26
Q

What’s the difference between unconjugated and conjugated bilirubin?

A

Conjugated Bilirubin is non-toxic and excreted in the urine

Non-conjugated bilirubin is toxic, insoluble in water, and can diffuse into tissues

27
Q

Pro-thrombin time, serum ammonia, galactose elimination test, and aminopyrine breath test can test for..
A. Hepatocyte Function
B. Biliary Excretory Function

A

A. Hepatocyte Function

28
Q

Total, direct, and delta bilirubin levels are used to test for….
A. Hepatocyte Function
B. Biliary Excretory Function

A

B. Biliary Excretory Function

29
Q

What are these serological markers of Hep B?

HBsAg
Anti-HBs
Anti-HBc
IgM anti-HBc

A

HBsAg: hep B surface antigen

Anti-HBs: hep b surface antibody

Anti-HBc: total hep b core antibody

IgM anti-HBc: IgM antibody to hep B core antigen

30
Q

True or False: HBeAg and HBV-DNA specify active viral replication

A

True

31
Q

True or False: In acute and chronic hepatic infection, anti-HB’s don’t rise until acute infection is on the wane; render protection for life

A

True

32
Q

What are the routes of transmission for Hepatitis?

A
  • IV drug use
  • intercourse
  • cuts, scrapes
33
Q

How is an acute infection of hep different from chronic, seriologically?

A

Acute Hep B Infection
- IgM (+)
- Anti hep B surface ab (-)

Chronic Hep B Infection
- IgM (-)
- Anti hep B surface ab (-)

  • Both have positive hepatic B surface antigens and total hep B core antibody
34
Q

What does it mean if total antibody level is elevated, but IgM fraction is negative

A

Chronic infection of Hep B

Pathophysiology (26 decks)

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