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Pathology II Exam II > Liver 2 > Flashcards

Liver 2 Flashcards

1
Q

What are 4 histological features of acute steatohepatitis?

A
  1. fat
  2. ballooned hepatocytes
  3. mallory bodies
  4. acute inflammation (neutrophils)
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2
Q

What pattern of fibrosis do we see on trichome stain of alcoholic steatohepatitis damage?

A

spider web (sinusoidal)

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3
Q

What is the recommended drinks per day for men? women? what is the individual susceptibility for ETOH liver damage?

A
  • 2
  • 1
  • 1 in 6 heavy ETOH users
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4
Q

What is it called when there is just fatty change without inflammation or liver damage?

A

steatosis

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5
Q

What do mallory bodies look like?

A

pink, ropey material

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6
Q

T-f—damage from steatohepatitis first leads to portal fibrosis?

A

False, central vein

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7
Q

What is the AST:ALT ratio in steatohep.?

A

2:1

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8
Q

T_F– Alk phos is often elevated out of proportion to GGT in steatohepatitis?

A

False- the other way around

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9
Q

Amyloidosis affecting the liver would look like what histologically?

A

waxy pink material filling the sub sinusoidal spaces

poor prognoses (in the case his alk phos was huge compared to the GGT even though AST:ALT was 2:1

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10
Q

NASH is related to what other metabolic issues?

A

insulin resistance and metabolic syndrome

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11
Q

What might explain cryptogenic cirrhosis?

A

NASH

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12
Q

What are the differences histologically between NASH and alcohol damage?

A

Similar but more fat and glycogenated nuclei and less inflammation, ballooning and mallory hyaline

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13
Q

What is the AST ALT ratio in NASH?

A

Usually ALT will be higher

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14
Q

Is NASH or alcoholic steatohepatitis related to macrocytic anemia?

A

alc. steatohep.

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15
Q

T-F—NASH usually has a high titre positive ANA?

A

False- low

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16
Q

What histo features do we see in acute heart failure? Chronic?

A
  1. centrilobar congestion and necrosis

2. nutmeg liver

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17
Q

What is buds chiari syndrome?

A

obstruction of hepatic vein—associated with hypercoaguable state

18
Q

Where do we see the fibrosis in chronic congestive heart failure?

A

centrilobar fibrosis leading to cirrhosis

19
Q

what is the mottled color of nutmeg liver due to?

A

combination of congestion and pale fibrous tissue

20
Q

In budd chiari what do we see histologically around the central vein?

A

marked congestion with surrounding sinusoidal congestion.

[hepatocytes get choked off and undergo necrosis

21
Q

In budd chiari- do light pink areas or dark pink areas mean more necrosis?

A

light pink

22
Q

T-F– ferritin is an acute phase reactant?

A

True

23
Q

In hemochromatosis, the liver is often first to accumulate…what follows?

A 
pancreas-->diabetes
heart-->cardiomyopathy
joints-->arthralgia
pituitary-->infertile
thyroid-->hypothyroid
skin-->bronze
24
Q

What gene is defective in hemochromatosis?

A

HFE Gene

usually homozygous C282Y (europeans)

25
Q

T-F– hemochromatosis liver disease is often found concurrently with HCV or alcohol which accelerates the fibrosis?

A

True

26
Q

Is hemochromatosis a risk factor for developing hepatocellular carcinoma?

A

YEs

27
Q

how do we treat hemochromatosis?

A

phlebotomy

28
Q

is alpha-1 antitrypsin deficiency autosomal dominant?

A

no- recessive

29
Q

what abnormal protease inhibitor alleles are associated with liver disease in alpha-1 antitrypsin deficiency?

A

Z and M

PIMM is wild type.

30
Q

how do we visualize histologically alpha-1 antitrypsin deficiency?

A

PAS-D stain- globules are bright pink inside hepatocytes

31
Q

is alpha-1 antitrypsin deficiency less treatable than hemochromatosis? is it a risk factor for hepatocellular carcinoma?

A

yes, yes

32
Q

Is wilson’s disease autosomal dominant?

A

No recessive

33
Q

What is wilson’s disease?

A

impaired copper excretion into bile and a failure to incorporate copper into ceruloplasmin

34
Q

Where is copper accumulation highest?

A

liver, brian and eye.

also kidney

35
Q

What is bland cholestasis?

A

only bile stasis is seen without other findings of liver damage

in his to you just see brown bile blobs in normal looking hepatocytes

36
Q

can bland cholestasis lead to jaundice?

A

yes

37
Q

what is the classic cause of bland cholestasis?

A

drugs–> oral contraceptives

also gilbert’s, pregnancy, post-operative and infection

38
Q

Does gilbert’s syndrome lead to unconjugated or conjugated hyperbilirubinemia?

A

unconjugated

39
Q

how does one become jaundiced when they have gilbert’s syndrome?

A 
illness
fasting/eating low calories
dehydration
menstruation
stress
lack of sleep
exercise
40
Q

What is the most common cause of obstruction of extra hepatic duct? what are some others?

A
  1. gallstone

2. tumor in bile duct, ampulla, head of pancreas, also congenital problems

Pathology II Exam II (16 decks)

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