Liver

Question 1

Biliary Atresia

Answer 1

• embyonic (10-35%): jaundice at birth

- perinatal (65-90%): not jaundice at birth, etiology unknown

Question 2

Bile Cannaliculus

Answer 2

• thin tube that collects bile secreted by hepatocytes
• in the liver
• made from hepatocytes

Question 3

Hereditary Hemochromatosis

Answer 3

• homozygous C2A2Y mutation
• iron with hepatocytes
• use iron stain

Question 4

Alpha 1 Antitrypsin Deficiency

Answer 4

• mutated protease inhibitor
• intracytoplasmic globules
• PAS with diastase stain
• diastase resistant globules in hepatocytes
• also emphysema

Question 5

Wilson’s Disease

Answer 5

• ATP7B mutation
• use trichrome stain
• copper is not in hepatocytes

Question 6

Hepatorenal Syndrome

Answer 6

• cirrhosis with ascites (prerequisite)
• kidney function decreases associated with portal hypertension
• serum Cr > 1.5
• characterized by activation of the renin-angiotensin system

Question 7

Cirrhosis

Answer 7

• diffuse regenerative nodularity
• reorganized architecture and vascular flow
• fibrous septation incorporating portal tracts and central veins
• characterized hyperdynamic splanchnic circulation
• can lead to portosystemic shunts, jaundice, inc. risk for hepatocellular carcinoma, ascites, gynecomastia

Question 8

Acetaminophen Liver Injury

Answer 8

• hepatotoxin

- centrilobular necrosis (zone 3)

Question 9

Hepatitis A

Answer 9

• oral-fecal route of transmission
• never progresses to chronic liver disease
• ssRNA

Question 10

Hepatitis B

Answer 10

• dsDNA
• parenteral, sexual contact, perinatal
• 5% progression to chronic liver disease

Question 11

Hepatitis C

Answer 11

• ssRNA
• parenteral, sexual contact, intranasal cocaine use
• 80% progression to chronic liver disease

Question 12

Hepatitis D

Answer 12

-circular ssRNA
-parenteral
-5% progression to chronic liver disease (coinfection)
-

Question 13

Hepatitis E

Answer 13

• ssRNA
• fecal oral route
• never progresses to chronic liver disease
• associated with higher mortality in pregnant women

Question 14

Autoimmune Hepatitis

Answer 14

• anti smooth muscle antibodies
• elevated serum IgG
• plasma cell rich interface and centrilobular hepatitis
• female predominance

Question 15

Hepatocellular Carcinoma

Answer 15

• tumor of hepatocytes
• malignant
• thickened hepatic plates/trabeculae with unpaired arteries
• occurs almost exclusively in cirrhosis

Question 16

Hepatocellular Adenocarcinoma

Answer 16

• tumor of hepatocytes
• benign
• female predominance (OC use)
• normal hepatic plate thickness with unpaired arteries

Question 17

Hemangioma

Answer 17

• tumor of blood vessels
• benign
• most common hepatic tumor

Question 18

Focal Nodular Hyperplasia

Answer 18

• tumor of hepatocytes
• bengin
• proliferation/hyperplasia/nonneoplastic
• central scar and malformed blood vessels
• vascular malformation/anomaly etiology

Question 19

Steatohepatitis

Answer 19

• due to a variety of etiologies
• if due to EtOH, AST is often 2xALT
• biopsy findings include, steatosis, ballooning degeneration, mallory bodies

Question 20

Hepatitis Stage and Grade

Answer 20

• grade= amount of inflammation and injury

- stage= amount of fibrosis deposition