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General Pathology > Liver > Flashcards

Liver Flashcards

1
Q

damage/blockage of either intra-hepatic or extra-hepatic bile ducts

A

cholestasis

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2
Q

systemic retention of not only bilirubin, but also other elimination products (bile salts, cholesterol)

A

cholestasis

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3
Q

characterized by conjugated bilirubin

A

cholestasis

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4
Q

Two types of cholestasis:

A

intra-hepatic or extra-hepatic

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5
Q

Intra-hepatic or extra-hepatic cholestasis? decrease in bile secretion within the liver

A

intra-hepatic

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6
Q

Intra-hepatic or extra-hepatic cholestasis? blockage of the main bile duct

A

extra-hepatic

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7
Q

Intra-hepatic cholestais is due to 2 things:

A
  • abnormalities in hepatocytes

- disease of intra-hepatic bile ducts

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8
Q

Causes of intra-hepatic cholestasis:

A

viral hepatitis, drugs, alcoholic liver disease, pregnancy-related cholestasis, septicemia

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9
Q

Causes of extra-hepatic cholestasis:

A

primary biliary cirrhosis, sclerosing cholangitis, tumor within the liver

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10
Q

yellow discoloration of the sclera and skin

A

jaundice

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11
Q

the result of abnormalities in bilirubin metabolism and excretion (what is the serum bilirubin levels?)

A

jaundice (levels above 2.0 mg/dL)

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12
Q

2 most common causes of jaundice:

A
  • hepatitis
  • obstruction of bile flow

*specifically the accumulation of conjugated bilirubin

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13
Q

the amount of bilirubin present has exceeded the liver’s capacity to conjugate and secrete

A

unconjugated hyperbilirubinemia (jaundice)

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14
Q

Gilbert syndrome

A

unconjugated hyperbilirubinemia (jaundice)

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15
Q

neonatal jaundice

A

unconjugated hyperbilirubinemia (jaundice)

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16
Q

80-90% of liver function is lost

A

acute liver failure

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17
Q

Clinical signs:
o Jaundice
o Coma
o Bleeding tendency

A

acute liver failure

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18
Q

3 main etiologies:
o Severe hepatocyte damage (drug induced toxicity—acetaminophen)
o Systemic shock (multiorgan system failure)
o Acute decline in slowly progressing but relatively stable chronic liver disease (chronic hepatitis or cirrhosis)

A

acute liver failure

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19
Q

treatment for acute liver failure

A

transplant

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20
Q

two groups of fatty liver disease

A

alcoholic and non-alcoholic

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21
Q

stats for alcoholic fatty liver disease

A
  • 90-100% of heavy drinkers with develop a fatty liver
  • 10-35% develop alcoholic hepatitis
  • 8-20% develop cirrhosis

*each condition may develop independently, thus not representing a continuum

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22
Q

commonly associated with insulin resistance and metabolic syndrome (obesity, insulin resistance, dyslipidemia, and hypertension)

A

non-alcoholic fatty liver disease (NAFLD)

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23
Q

chronic, progressive, sometimes fat cholestatic liver disease

A

primary biliary cirrhosis

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24
Q

due to the destruction of intra-hepatic bile ducts, portal inflammation, and scarring, and the development of cirrhosis and liver failure over years to decades

A

primary biliary cirrhosis

25
Q

more than 90% of sufferers have high titers of autoantibodies directed against several mitochondrial dehydrogenases

A

primary biliary cirrhosis

26
Q

symptomatic patients present with pruritus and advanced disease

A

primary biliary cirrhosis

27
Q

untreated leads to hepatic decomposition with portal hypertension, variceal bleeding, and hepatic encephalopathy

A

primary biliary cirrhosis

28
Q

early treatment with oral ursodeoxycholic acid dramatically improves outcome

A

primary biliary cirrhosis

29
Q

hyperbilirubinemia is a late feature, usually signifying incipient hepatic decompensation

A

primary biliary cirrhosis

30
Q

associated extra-hepatic conditions include Sjogren syndrome, scleroderma, thyroiditis, rheumatoid arthritis, Raynaud phenomenon, and celiac disease

A

primary biliary cirrhosis

31
Q

results in liver congestion due to back-up of blood in central veins

A

right-sided heart failure

32
Q

typically caused by left-sided heart failure

A

right-sided heart failure

33
Q

congestion causes mottled, red appearance of liver sections known as “nutmeg liver”

A

right-sided heart failure

34
Q

increase in portal venous pressure due to blood flow resistance or obstruction, responsible for carrying blood from digestive organs to liver

A

portal HTN

35
Q

results in ascites (fluid accumulation in abdomen) and esophageal and stomach varices, attempts to bypass obstruction

A

portal HTN

36
Q

Causes of portal HTN can depend on where obstruction occurs in portal system:

A

presinusoidal, sinusoidal, postsinusoidal

37
Q

postsinusoidal obstruction in hepatic veins delivering blood to inferior vena cava of heart

A

Budd-Chiari syndrome

38
Q

Name the benign tumor: usually seen in women of child-bearing age who have used oral contraceptives, regression with discontinuation of hormone use has been seen

A

hepatic adenoma

39
Q

Name the benign tumor: lesions are usually well-demarcated, unencapsulated, and may be yellow/tam or bile stained, and up to 30 cm in diameter

A

hepatic adenoma

40
Q

Name the benign tumor: histology composed of sheets and cords of cells that may resemble normal hepatocytes or have minimal variation in cell and nuclear size

A

hepatic adenoma

41
Q

Name the benign tumor: portal tracts are absent and prominent arterial and draining vessels are distributed

A

hepatic adenoma

42
Q

Name the benign tumor: not a true neoplasm, but a hamartoma of peribiliary gland vs ductular proliferation following injury

A

bile duct adenoma

43
Q

Name the benign tumor: characterized grossly by unencapsulated, firm, tan/white nodules

A

bile duct adenoma

44
Q

Name the benign tumor: composed of networks of ducts among fibrous stroma

A

bile duct adenoma

45
Q

Name the benign tumor: often misdiagnosed as adenocarcinoma (malignant mimicker)

A

bile duct adenoma)

46
Q

Name the malignant tumor: common precursors such as cellular changes and nodular lesions are seen in chronic viral hepatitis, alcoholic liver disease, and other diseases

A

hepatocellular carcinoma

47
Q

Name the malignant tumor: more than 85% of cases occur in countries with high rates of chronic HBV infection

A

hepatocellular carcinoma

48
Q

Name the malignant tumor: incidence is rapidly increasing in western countries due to HepC epidemic, has tripled in the US in recent decades

A

hepatocellular carcinoma

49
Q

Name the malignant tumor: rarely seen before age 60 in Western countries, and in 90% of cases the tumor develops in the presence of cirrhosis

A

hepatocellular carcinoma

50
Q

Name the malignant tumor: can manifest with silent hepatomegaly

A

hepatocellular carcinoma

51
Q

Name the malignant tumor: often encountered in persons with symptomatic cirrhosis

A

hepatocellular carcinoma

52
Q

Name the malignant tumor: progressive enlargement of the primary mass until it seriously disturbs hepatic function, or metastasizes (typically to lungs)

A

hepatocellular carcinoma

53
Q

Name the malignant tumor: the 5-year survival of large tumors is dismal, with most patients dying within the first 2 years

A

hepatocellular carcinoma

54
Q

Name the malignant tumor: rare malignancy arising from the epithelial cells of the bile ducts

A

cholangiocarcinoma

55
Q

Name the malignant tumor: chronic inflammation of biliary duct system predisposes individuals to disease (cholangitis, irritable bowel disease)

A

cholangiocarcinoma

56
Q

Name the malignant tumor: highly lethal as disease is typically advanced when detected

A

cholangiocarcinoma

57
Q

Two forms of cholangiocarcinoma:

A

extrahepatic and intrahepatic malignancy

58
Q

Which is more common? metastatic tumors to the liver or primary hepatic neoplasms

A

metastatic tumors to the liver

*common: colon, breast, lung, pancreas

General Pathology (11 decks)

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