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Pathology > Liver > Flashcards

Liver Flashcards

1
Q

Liver Anatomy

A
  • portal triad

- Kupffer cells = liver macrophages

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2
Q

Bilirubin metabolism

A
  • Heme catabolism
  • unconjugated bilirubin binds to albumin
  • conjugated bilirubin binds with glucuronic acid
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3
Q

Hyperbilirubinemia

A 
Normal = 0.3 - 1.2 mg/dL
jaundice = bilirubin > 2 - 2.5 mg/dL
cholestasis = thick bile
kernicterus = bilirubin > 20 mg/dL
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4
Q

Cholestasis

A
  • decreased bile flow
  • obstruction: gallstones, bile duct cancer, etc.
  • severe itching
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5
Q

Acute Liver Failure

A
  • encephalopathy
  • AST/ALT&raquo_space; 1,000
  • 50% from excess acetaminophen ingestion
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6
Q

Liver Failure Complications: portal hypertension

A
  • increased portal venous pressure due to obstruction in portal circuit
  • esophagogastric varices
    ascites
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7
Q

Liver failure complications: ascites

A
  • tense skin
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8
Q

Liver Failure Complications: endocrine

A
  • Males undergo feminization

- compression of central area causes the entire lesion to blanch

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9
Q

Cirrhosis

A
  • end stage of chronic liver disease
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10
Q

Hepatitis A Virus

A
  • no carrier state
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11
Q

Hepatitis B Virus

A
  • core antigen (HBcAg)
  • e antigen (HBeAg)
  • indicates ongoing viral replication; infectivity
  • surface antigen: envelope glycoprotein (HBsAg) (immunologic but not infectious)
  • 2 billion infected worldwide
  • 400 million chronic carriers worldwide
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12
Q

Chronic Hepatitis B

A
  • 2-3% hepatocellular carcinoma

- 0.1-0.5% develop fulminant hepatitis

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13
Q

Hepatitis C Virus

A

170 million worldwide

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14
Q

Hepatitis D Virus

A
  • HDV infection requires HBV coinfection
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15
Q

Chronic Viral Hepatitis

A
  • cirrhosis
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16
Q

Alcoholic Liver Disease

A
  • 60% of alcoholics develop chronic liver disease
  • females often experience more severe outcomes
  • spectrum: hepatic steatosis, alcoholic hepatitis, cirrhosis
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17
Q

Fatty Liver Disease

A
  • steatosis (accumulation of fat in hepatocytes)
18
Q

Alcoholic Hepatitis

A
  • 5-year (90%) if stop drinking AND without jaundice, ascites, hematemesis (vomit blood)
  • causes of death: hepatic failure, GI bleed, infection, renal failure, hepatocellular carcinoma (3-6%)
19
Q

Nonalcoholic Fatty Liver Disease

A
  • resembles alcoholic liver disease
20
Q

Liver Transplantation

A

MELD score (model for end-stage liver)

21
Q

Hemochromatosis

A
  • excessive iron accumulation

- 200X risk for hepatocellular carcinoma

22
Q

Wilson Disease

A
  • excessive copper accumulation
23
Q

alpha1-anti-trypsin deficiency

A
  • most common genetic cause of liver disease in infants/children
  • with cirrhosis 2-3% risk for hepatocellular carcinoma
24
Q

Gilbert Syndrome

A
  • jaundice
  • medications: Irinotecan (camptosar), protease inhibitors
  • any patient who has jaundice needs to undergo a comprehenseive medical assessment
25
Q

Primary Biliary Cholangitis

A

increase in serum cholesterol: severe

26
Q

Primary Scleorsing Cholangitis

A
  • inflammation and fibrosing of bile ducts
27
Q

Cholestatic Syndromes of Infancy

A
  • giant cell hepatitis
28
Q

Cavernous Hemangioma

A
  • most common benign liver tumor
29
Q

Hepatocellular Adenoma

A
  • benign
  • oral contraceptives, anabolic steroids
  • usually solitary encapsulated expanding mass
  • some risk for malignant transformation
30
Q

Hepatocellular Carcinoma

A
  • malignant; primary liver cancer
31
Q

Cholangiocarcinoma

A
  • intrahepatic/extrahepatic bile duct cancer

- endemic liver fluke = parasite

32
Q

Metastatic Carcinoma to the Liver

A
  • most common malignant liver tumor
33
Q

Relevant Information Needed for a Patient with Liver Disease

A 
- current lab values for:
PT
INR
CBC
LFTs (ALT, AST)
34
Q

Gallbladder features

A
  • release of bile
35
Q

Cholecystitis

A
  • severe abdominal pain (upper right quadrant) lasts greater than 6 hours
36
Q

Pancreas general information

A
  • only 2% of pancreas maintains glucose homeostasis
37
Q

Acute Pancreatitis

A
  • abdominal pain (cardinal symptom)
  • pseudocysts (50% of cases)
  • increase serum amylase within first 24 hours
  • increased serum lipase next 72 hours - 96 hours
38
Q

Chronic Pancreatitis

A
  • chronic alcoholism (most common cause)
  • increased risk of pancreatic cancer
  • 40-55% in hereditary pancreatitis
39
Q

Pancreatic Cystic Neoplasms

A
  • increased malignant potential
40
Q

Pancreatic Cancer

A
  • highly invasive/rapidly progressive

- # of cases in US in the past 50 years tripled

Pathology (17 decks)

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