LIVER AND BILE DUCTS Flashcards
LIVER FAILURE
_______ is defined as an acute liver illness associated with encephalopathy and coagulopathy that occurs within 26 weeks of the initial liver injury in the absence of preexisting liver disease
acute liver failure
ACUTE LIVER FAILURE MORPHOLOGY
acute liver failure is usually associated with ____________ with broad regions of parenchymal loss surounding islands of preserved or regenerating hepatocytes
massive hepatic necrosis
ACUTE LIVE FAILURE CLINICAL MANIFESTATIONS
____________. hepatocytes are responsible for synthesis of clotting factors II (prothrombin), V, VII, IX, X , XI, and XII as well as fibrinogen
coagulation
LIVER FAILYRE
_________ is often associated with advanced fibrosis/cirrhosis, a condition marked by diffuse remodeling of the liver into parenchymal nodules (often regenerative) surrounded by fibrous bands and a variable degree of vascular shunting
chronic liver failure
MORPHOLOGY CIRRHOSIS
Cirrhosis is marked by the presence of parenchymal nodules surrounded by dense bands of fibrosis throughout the liver, converting the normally smooth liver capsule into a __________ surface with depressed areas of scarring and bulging regenerative nodules
bumpy
(BUMPING DAT)
4 MAJOR CONSEQUENCES OF PORTAL HYPERTENSION
1. H
2. A
3. P
4. C
Hepatic encephalopathy
Ascites
Portosystemic shunts
Congestive splenomegaly
CAUSES OF ACUTE LIVER FAILURE
A
B
C
D
E
F
Acetaminophen, hepatitis A, Autoimmune disease
hepatitis B
hepatitis C, Cryptogenic
hepatitis D, Drugs
hepatitis E, esoteric causes (wilson disease, budd chiari)
Fatty change
VIRAL HEPATITIS A
_____ infection is a self-limited disease and does not lead to chronic hepatitis or a carrier state
hepatitis A
VIRAL HEPATITIS B
major clinical presentations include
1.) _________- followed by recovery and clearance of the virus
2.) _________ with massive liver necrosis
3.) _________ with/without progression to cirrhosis
4.) asymptomatic “______” carrier state
acute hepatitis
acute hepatic failure
chronic hepatitis
healthy carrier state
HEPATITIS B proteins
__________ which refers to 3 related viral envelope glycoproteins, large, middle, and small HBsAg
__________ the nucleocapsid protein which plays a role in assembly of complete virions and a longer polypeptide transcript with a precore and core region designated hepatitis B antigen (HBeAg)
__________ which exhibits both DNA polymerase and reverse transcriptase activities
__________ which is not necessary for virus replication but act as a transcriptional transactivator of both viral genes
hepatitis B surface antigen
hepatitis B core antigen
HBV polymerase
Hepatitis B X protein
HEPATITIS C
most common cause of ______________
chronic viral hepatitos
HEPATITIS D
delta agent is a unique RNA virus that is dependent for its life cycle on ___________
HBV
HEPATITIS MORPHOLOGY
the defining histologic feature of chronic viral hepatis is _________ or ___________ with fibrosis
In hepatitis B, the swollen endoplasmic reticulum of hepatocytes are swollen with HBsAg leading to a ______- appearance
portal lymphocytic, or lymphoplasmacytic, inflammation with fibrosis
ground glass
AUTOIMMUNE HEPATITIS is based on the combination of 4 features:
A E S
autoantibodies
elevation of serum IgG
Supportive histologic findings
FATTY LIVER DISEASE
Excessive alcohol intake causes steatosis, dysfunction of mitochondria, microtubules, and cellular membranes and oxidative stress, and the resulting injury leads to varying degrees
__________. High levels of alcohol consumption induce liver microsomes, that contain CYPE21 a component of cytochrome P-450 system
CYP2E1
