Liver and Gallbladder Flashcards

1
Q

reversible liver injury

A

steatosis and cholestasis

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2
Q

irreversible liver injury

A

necrosis and apoptosis

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3
Q

vitamin A storage cells in the liver

A

hepatic stellate cells

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4
Q

markers of hepatocyte integrity

A

AST, ALT, LDH

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5
Q

markers of hepatocyte synthetic function

A

albumin, PT, aPTT, ammonia

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6
Q

[diagnosis]

jaundice, cholestasis, hepatic encephalopathy, asterixis, occurring within 26 weeks post initial insult

A

acute liver injury

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7
Q

most common drug that cause acute liver failure

A

acetaminophen

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8
Q

Acute liver failure causes

ABCDEF

A
A hepatitis, acetaminophen
B hepatitis
C hepatitis, cryptogenic
D hepatitis, drugs/toxins
E hepatitis
F atty liver
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9
Q

hepatitis virus that can cause chronic hep infection

A

HBV, HCV

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10
Q

[diagnosis]
jaundice with pruritus,
palmar erythema, spider angiomas, hypogonadism, gynecomastia, HPO axis abnormalities, portal HPN

A

chronic lover disease

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11
Q

[veins involved]

Portocaval anastomoses causing esophageal varices

A

esophageal branch of the left gastric vein and azygous vein

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12
Q

[veins involved]

Portocaval anastomoses causing hemorrhoids

A

superior, middle, and inferior rectal veins

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13
Q

[veins involved]

Portocaval anastomoses causing caput medusae

A

periumbilical veins and abdominal wall collaterals

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14
Q

hallmark of chronic viral hepatitis

A

portal inflammation

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15
Q

[diagnosis: hepatitis]

ground glass appearance of hepatocytes.

A

hepatitis b

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16
Q

[diagnosis: hepatitis]

lymphoid follicles, bile duct injury and steatosis (fatty change)

A

hepatitis c

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17
Q

[diagnosis: acute vs chronic]

ballooning degerenration, apoptosis, macrophages aggregates, scan mononuclear infiltrate

A

acute hepatitis

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18
Q

[diagnosis: acute vs chronic]
dense mononuclear necrosis, ground glass cells (Hep B) or fatty change (hep C), interface hepatitis, ductular reaction, bridging fibrosis

A

chronic hepatits

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19
Q

this refers to stem cell activation of hepatocyte during regeneration

A

ductular reaction

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20
Q

[diagnosis: autoimmune hepatitis]

female, middle aged, ANA, AntiSMA, anti-SLA/LP, AMA

more favorable prognosis

A

Type 1 Autoimmune Hepatitis

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21
Q

[diagnosis: autoimmune hepatitis

female, children to teenagers, anti LKM, CYP2D6 antibodies, anti ACL1

less favorable prognosis

A

Type 2 autoimmune hepatitis

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22
Q

anesthetic drug that causes dose-dependent hepatitis

A

halothane

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23
Q

this drug causes cholestasis leading to hepatitis

A

chlorpromazine

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24
Q

___ amount of alcohol that is associated with development of ALD

A

80g/day

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25
Q

[form of alcoholic liver disease]

lipid droplets in hepatocytes, fatty changes, perivenular fibrosis

A

hepatocellular steatosis

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26
Q

[form of alcoholic liver disease]

hepatocyte swelling, mallory denk bodies, neutrophilic infiltration

A

alcoholic steatosis

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27
Q

[form of alcoholic liver disease]

fibrosis at central vein, perisinusoidal, chicken-wire fence pattern

A

steatofibrosis

28
Q

[alcoholic SH vs non-alcoholic SH]

PMN predominant, fibrosis prominent around central vein, mallory denk bodies are more

A

Alcoholic steatohepatitis

29
Q

alcoholic SH vs non-alcoholic SH]

mononuclear infiltrates, fibrosis prominent around portal vein, less mallory denk bodies

A

Non-alcoholic SH

30
Q

[diagnosis]

  1. micronodular cirrhosis
  2. Diabetes mellitus
  3. abnormal skin pigmentation
A

hemochromatosis

31
Q

[diagnosis]

ATPB mutation (Ch13)

A

wilson disease

32
Q

deposition of copper in the corneal limbus

A

keyser-fleisher ring

33
Q

most commonly diagnosed inherited hepatic disorder in infants and children

A

alpha 1 antitrypsin deficiency

34
Q

[diagnosis]

accumulation of misfolded proteins in hepatocytes, PAS positive, diastase-resistant hyaline globules

A

alpha 1 anti trypsin deficiency

35
Q

Inherited disorder that cause indirect hyperbilirubinemia

A

crigler-najjr I and II

Gilbert syndrome

36
Q

Inherited disorder that cause conjugated hyperbilirubinemia

A

Dubin-johnson

Rotor syndrome

37
Q

most common cause if large bile duct obstruction

A

gallstones in adult, biliary atresia in children

38
Q

[diagnosis]

  1. fever
  2. jaunduce
  3. RUQ pain
A

ascending cholangitis

39
Q

treatment of choice of extrahepatic biliary atresia

A

kasai procedure

40
Q

[diagnosis: autoimmune cholangitis]

female, 30-70 years old, progressive, AMA(+)

lymphoplasmacytic infiltration with or without granulomas (Florid duct lesion)

A

primary biliary cirrhosis

41
Q

[diagnosis: autoimmune cholangiopathies]

30 years old, usually males, associated with IBD, pancreatitis, retroperitoneal fibrosis

stricture and beading of large bile ducts

onion skin fibrosis, beading of contrast medium

A

primary sclerosing cholangitis

42
Q

[diagnosis]

  1. pain
  2. jaundice
  3. abdominal mask
A

choledocal cyst

43
Q

___ disease where there is dilatation of intrahepatic bile duct

A

caroli disease

44
Q

___ disease where there is dilatation of intrahepatic bile duct

A

caroli disease

45
Q

[diagnosis]

obstruction >/ 2 hepatic veins
liver enlargement, pain, ascites
hypercoaguable state
hemorrhagic centrilobular necrosis

A

budd chiari syndrome

46
Q

nutmeg liver is associated with what type of HF

A

left-sided HF

47
Q

most common benign tumor in the liver

A

cavernous hemangioma

48
Q

most common liver tumor of early childhood

A

hepatoblastoma

49
Q

most common tumor involving liver

A

metastasis

50
Q

most common primary malignant tumor of the liver

A

hepatocellular CA

51
Q

second most common primary malignant tumor of the liver

A

cholangiocarcinoma

52
Q

[diagnosis]

well-demarcated, poorly encapsulated with central scar that contains blood vessels, usually arterial

hypervascular with dense capillary blush on angiography

A

focal nodular hyperplasia

53
Q

[diagnosis: liver]

incidental mass, hypovascular on angiography, no uptake on liver scan, assciated with OCP use

A

hepatocellular adenoma

54
Q

tumor marker for hepatocellular CA

A

alpha fetoprotein

55
Q

most common metastatic site of HCCA

A

lung

56
Q

most common location of cholangiocarcinoma

A

perihilar (klatskin)

57
Q

most common congenital anomaly of gallbladder

A

folded fundus or phrygian cap

58
Q

most common biliary tract disease

A

cholelithiases

59
Q

[diagnosis: GB stone]

pale yellow, round to ovoid, finely granular, hard

radiolucent but can be radiopaque if with sufficient CaCO3

A

cholesterol stone

60
Q

[diagnosis: GB stone]

spiculated, molded surface

sterile, radiopaque

A

black pigment

61
Q

[diagnosis: GB stone]

spiculated, molded surface, with Ca salts of fatty acids

infected, radiolucent

A

brown pigment

62
Q

[diagnosis: chronic cholecystitis]

foamy macrophages

A

xanthogranulomatous cholecystitis

63
Q

[diagnosis: chronic cholecystitis]

extensive dystrophic calcification, increased risk for CA

A

porcelain GB

64
Q

[diagnosis: chronic cholecystitis]

atrophic, dilated with clear secretions

A

hydrops

65
Q

most important risk factor for GB CA

A

gallstone

66
Q

[diagnosis]

RUQ pain, anorexia, elevated ALP

A

GB CA