Lecture 26 - Acute Liver Failure, Chronic Hepatitis, and Cirrhosis

Question 1

Hep___ is the most important hep virus for fulminent liver failure.

Answer 1

HBV

Question 2

In Fulminant liver failure why is a rapid return to normal ALT/AST levels really bad, not good?

Answer 2

It indicates so much of the liver has been destroyed, there’s no more release of the enzymes from dying cells.

Question 3

Bile is not sterile, so when there is obstruction of the bile duct, ______ ______ results from backed up non-sterile bile into the liver.

Answer 3

Ascending Cholangitis

Question 4

People older than _____ and ____ (gender?) are at higher risk for DILI (Drug Induced Liver Injury).

Answer 4

50

Women

Question 5

Ethanol and Phenobarbital (a drug given to epileptics) are examples on non-specific inducers of ______ (enzyme) –> this increases the chance for _____-______ related DILI.

Answer 5

CytP450

Toxic-metabolite related

Question 6

Anabolic steroids, Phenothiazine derivatives, and Total Parenteral Nutrition can cause ______, bc the liver is less able to excrete bile –> build up in the bile duct –> jaundice.

Answer 6

Cholestasis

Question 7

Steroids (not anabolic) can cause ____ change –> keep in mind this doesn’t affect liver function. Which liver disease does this occur in?

Answer 7

Fatty change

Hep C

Question 8

INH (Isoniazid –> anti-tuberculin drug), Augmentin, and Phenytoin can cause ______ hepatitis.

Answer 8

Acute hepatits

Question 9

Acetominophen and Halothane can cause _____ liver failure.

Answer 9

Fulminant liver failure

Question 10

Alpha-methylDOPA and INH can cause _____ hepatitis.

Answer 10

Chronic

Question 11

Methotrexate can cause ______/______.

Answer 11

Fibrosis/Cirrhosis

Question 12

Allopurinol and Sulfa drugs can cause ___________ hepatitis.

Answer 12

Granulomatous

Question 13

Oral Contraceptives can cause Hepatic Cell ______.

Answer 13

Adenomas

Question 14

Anabolic steroids can also cause ______ ______.

Answer 14

Hepatocellular Carcinoma

Question 15

Chronic hepatitis will almost always present with chronic inflammatory cells around the portal _____.

Answer 15

Triads

Question 16

Autoimmune Hepatitis is characterized by presence of anti-_____, increased gamma-globulin, or anti-_____/_____ microsomes.

Answer 16

Anti-Smooth muscle (Anti-SMA)

Anti-Liver/Kidney microsomes

Question 17

AMA (anti-mitochondrial antibodies) are indicative of _____ ______ ______.

Answer 17

Primary Biliary Cirrhosis

Question 18

Chronic HBV infection can cause _____ _____ appearance of hepatocytes due to hyperplasia of SER (from overproduction of HBsAg)

Answer 18

Ground Glass

Question 19

Fatty change, Ballooning, Mallory bodies, and acute inflammatory cells comprise ____________ associated with Alcohol (alcohol hepatitis).

Answer 19

Steatohepatitis

Question 20

Repeated bouts of alcohol hepatitis can result in _____ _____ sclerosis, unlike viral liver disease which typically involves the _____ _____ area.

Answer 20

Central Vein sclerosis

Portal Triad

Question 21

What are the component Hepatic changes of Cirrhosis?

Answer 21

Nodules of regenerating hepatocytes.

Fibrous tissue Septa (those fibrous bridges that form)

Bile duct proliferation (usually)

Portal venous hypertension from shunting between hepatic artery and portal vein –> leads to esophageal varices