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Path - Histo > Liver > Flashcards

Liver Flashcards

1
Q

what provides blood supply to the liver

A

hepatic portal vein

hepatic arteruy

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2
Q

what are kupffer cells

A

resident macrophages in liver

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3
Q

what are stellate cells and what is their role in the liver

A

store vitamin A

become myofibroblasts > lay down collagen > reponsible for scarring in liver disease

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4
Q

what makes up a portal triad

A

hepatic artery, portal vein, bile duct

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5
Q

what is the ratio of hepatic triads to central vein?

A

6:1

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6
Q

what are the three zones in the liver

A

1: periportal
2: midzone
3: perivenular

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7
Q

describe cells in zone 3 of the liver

A

more metabolically active, but least. oxygen

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8
Q

why are endothelial cells in the liver uniquer

A

they don’t sit on basement membrane

they are discontinuous (large spaces)

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9
Q

what is the space of disse

A

the space between endothelial cells and hepatocytes, where stellate cells sit

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10
Q

what occurs in liver injury

A

kupfer cells activate
gaps in EC collapse
stellate cells secrete collagen in space of disse
leads to inflammation and fibrosis

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11
Q

define cirrhosis

A

fibrosis of the whole liver,

  • nodules of regenerating hepatocytes
  • distortion of vascular architecture
  • intra and extra hepatic shunting
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12
Q

is chirrhosis reversible or irreversible

A

REVERSIBLE

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13
Q

what is seen on histology of ACUTE HEPATITIS

A

spotty necrosis

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14
Q

what does GRADE indicate in chronicv hepatitis

A

the level of inflammation

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15
Q

what does STAGE indicate in chronic hepatitis

A

the SPREAD of fibrosis (F0-F4)

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16
Q

what are the three histological patterns in alcoholic liver disiease

A
  1. Fatty liver
  2. alcoholic hepatitis
  3. cirrhosis
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17
Q

explain features of fatty liver / steatosis

A

pale, fatty liver
fatty pockets on histology
reversible

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18
Q

explain histologycal features of alcoholic heparitis

A

Ballooning of hepatocytes

Mallory denk bodies

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19
Q

what is primary biliary cholangitis

A

AI destruction of intrahepatic bile ducts > buildup of bile > cholestasis > slow cirrhosis over many years

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20
Q

what is PBC findings on histology

A

bile duct loss associated with chronic INFLAMMATION and granuloma

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21
Q

what is the diagnostic. test for PBC

A

antimitochondrial anribodies (AMA)

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22
Q

what is primary sclerosing cholangitis

A

Ai destruction of INTRA and EXTRA hepatic bile ducts

23
Q

what is histology of PSC

A
  • periductal bile duct FIBROSIS (concentric rings) leading to SCLEROSIS
  • stricture formation
  • bile duct DILATATION
24
Q

what is the histological difference between PBC and PSC

A

PBC=inflammation

PSC=FIBROSIS

25
Q

what disease is PSC associated with

A

Ulcerative cholitis

26
Q

what is haemochromatosis

A

increased iron gut absorption> iron deposition in parenchymal cells > organ damage

27
Q

what gene causes haemochromatosis

A

HFe gene on chr 6

28
Q

what is haemosiderosis

A 
iron overload (i.e. from blood transfusion) 
presents as accumulation of iron in macrophages
29
Q

what do you use to see keiser fleisher rings in Wilson

A

slit lamp

30
Q

what stain do you use for wilson disease

A

Rhodanine stain

turns golden brown against blue counter stain

31
Q

what antibodies will be +ve for AI hepatitis

A

ASMA, anti-LMK

32
Q

what does AI hepatitis respond to

A

steroids

33
Q

what is alpha1 antitrypsin deficiency

A

failure to secrete alpha 1 antitrypsin into the blood

excess of a1a in hepatocytes > damges them > chronic hepatitis

ephysema

34
Q

what are associations for hepatocellular carcinoma

A

AFP+
cirrhosis in west
viral infections in developing countries

35
Q

what is cholangiocarcinoma associated with

A

PSC
worm infection
cirrhosis

36
Q

what is the histology in chronic hepatitis

A
  1. portal inflammation
  2. piecemeal necrosis
  3. lobular inflammation
  4. bridging from portal vein to central vein
37
Q

what is piecemeal necrosis

A

cannot see the border between portal tract and partenchyma

38
Q

explain the pathophysiology behind extrahepatic shunting in fibrosis

A

FIBROTIC BRIDGES from PORTAL VEIN to CENTRAL VEIN > extrahepatic shunting

39
Q

what are the main causes of cirrhosis

A
  1. alcoholic liver disease
  2. non-alcoholic fatty liver disease
  3. chronic viral hepatitis
40
Q

explain classification of regenerating nodules in liver disease

A

micronodular: <3mm
macronodular: >3mm

41
Q

what are macroscopic fts of a hepatic steatosis

A

large, pale, yellow, greasy liver

42
Q

what are microscophic fts of a hepatic steatosis

A

fat droplets in hepatocytes

43
Q

what are macroscopic fts of an alcoholic hepatitis

A

large, fibrotic liver

44
Q

what are microscopic fts of an alcoholic hepatistis

A

ballooning of hepatocytes

Mallory denbk

45
Q

what are macroscopic fts of an alcholic cirrhosis

A

yellow-tan, fatty, enlarged

transforms into shrunken non-fatty brown organ

46
Q

what are microscopic fts of alcoholic cirrhosis

A

Micronodular cirrhosis (small nodules and bands of fibrous tissue)

47
Q

what does USS show for PBC

A

no dilatgation of bile ducts

48
Q

How do you manage PBC

A

ursodeoxycholic acid

49
Q

What does USS show for PSC

A

bile duct dilatation

50
Q

what does ERCP show for PSC

A

beading of bile ducts

51
Q

what does histology show for PSC

A

onion skinning fibrosis (concentric)

52
Q

what do people with PSC have a higher risk for (in terms of malignancy)

A

cholangiocarcinoma

53
Q

what are causes of hepatocellular carcinoma

A

cirrhosis (so all causes of cirrhosis)
aflatoxin
aspergillus

Path - Histo (19 decks)

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