Liver and Gallbladder Flashcards
reversible liver injury
steatosis and cholestasis
irreversible liver injury
necrosis and apoptosis
vitamin A storage cells in the liver
hepatic stellate cells
markers of hepatocyte integrity
AST, ALT, LDH
markers of hepatocyte synthetic function
albumin, PT, aPTT, ammonia
[diagnosis]
jaundice, cholestasis, hepatic encephalopathy, asterixis, occurring within 26 weeks post initial insult
acute liver injury
most common drug that cause acute liver failure
acetaminophen
Acute liver failure causes
ABCDEF
A hepatitis, acetaminophen B hepatitis C hepatitis, cryptogenic D hepatitis, drugs/toxins E hepatitis F atty liver
hepatitis virus that can cause chronic hep infection
HBV, HCV
[diagnosis]
jaundice with pruritus,
palmar erythema, spider angiomas, hypogonadism, gynecomastia, HPO axis abnormalities, portal HPN
chronic lover disease
[veins involved]
Portocaval anastomoses causing esophageal varices
esophageal branch of the left gastric vein and azygous vein
[veins involved]
Portocaval anastomoses causing hemorrhoids
superior, middle, and inferior rectal veins
[veins involved]
Portocaval anastomoses causing caput medusae
periumbilical veins and abdominal wall collaterals
hallmark of chronic viral hepatitis
portal inflammation
[diagnosis: hepatitis]
ground glass appearance of hepatocytes.
hepatitis b
[diagnosis: hepatitis]
lymphoid follicles, bile duct injury and steatosis (fatty change)
hepatitis c
[diagnosis: acute vs chronic]
ballooning degerenration, apoptosis, macrophages aggregates, scan mononuclear infiltrate
acute hepatitis
[diagnosis: acute vs chronic]
dense mononuclear necrosis, ground glass cells (Hep B) or fatty change (hep C), interface hepatitis, ductular reaction, bridging fibrosis
chronic hepatits
this refers to stem cell activation of hepatocyte during regeneration
ductular reaction
[diagnosis: autoimmune hepatitis]
female, middle aged, ANA, AntiSMA, anti-SLA/LP, AMA
more favorable prognosis
Type 1 Autoimmune Hepatitis
[diagnosis: autoimmune hepatitis
female, children to teenagers, anti LKM, CYP2D6 antibodies, anti ACL1
less favorable prognosis
Type 2 autoimmune hepatitis
anesthetic drug that causes dose-dependent hepatitis
halothane
this drug causes cholestasis leading to hepatitis
chlorpromazine
___ amount of alcohol that is associated with development of ALD
80g/day
[form of alcoholic liver disease]
lipid droplets in hepatocytes, fatty changes, perivenular fibrosis
hepatocellular steatosis
[form of alcoholic liver disease]
hepatocyte swelling, mallory denk bodies, neutrophilic infiltration
alcoholic steatosis
[form of alcoholic liver disease]
fibrosis at central vein, perisinusoidal, chicken-wire fence pattern
steatofibrosis
[alcoholic SH vs non-alcoholic SH]
PMN predominant, fibrosis prominent around central vein, mallory denk bodies are more
Alcoholic steatohepatitis
alcoholic SH vs non-alcoholic SH]
mononuclear infiltrates, fibrosis prominent around portal vein, less mallory denk bodies
Non-alcoholic SH
[diagnosis]
- micronodular cirrhosis
- Diabetes mellitus
- abnormal skin pigmentation
hemochromatosis
[diagnosis]
ATPB mutation (Ch13)
wilson disease
deposition of copper in the corneal limbus
keyser-fleisher ring
most commonly diagnosed inherited hepatic disorder in infants and children
alpha 1 antitrypsin deficiency
[diagnosis]
accumulation of misfolded proteins in hepatocytes, PAS positive, diastase-resistant hyaline globules
alpha 1 anti trypsin deficiency
Inherited disorder that cause indirect hyperbilirubinemia
crigler-najjr I and II
Gilbert syndrome
Inherited disorder that cause conjugated hyperbilirubinemia
Dubin-johnson
Rotor syndrome
most common cause if large bile duct obstruction
gallstones in adult, biliary atresia in children
[diagnosis]
- fever
- jaunduce
- RUQ pain
ascending cholangitis
treatment of choice of extrahepatic biliary atresia
kasai procedure
[diagnosis: autoimmune cholangitis]
female, 30-70 years old, progressive, AMA(+)
lymphoplasmacytic infiltration with or without granulomas (Florid duct lesion)
primary biliary cirrhosis
[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
primary sclerosing cholangitis
[diagnosis]
- pain
- jaundice
- abdominal mask
choledocal cyst
___ disease where there is dilatation of intrahepatic bile duct
caroli disease
___ disease where there is dilatation of intrahepatic bile duct
caroli disease
[diagnosis]
obstruction >/ 2 hepatic veins
liver enlargement, pain, ascites
hypercoaguable state
hemorrhagic centrilobular necrosis
budd chiari syndrome
nutmeg liver is associated with what type of HF
left-sided HF
most common benign tumor in the liver
cavernous hemangioma
most common liver tumor of early childhood
hepatoblastoma
most common tumor involving liver
metastasis
most common primary malignant tumor of the liver
hepatocellular CA
second most common primary malignant tumor of the liver
cholangiocarcinoma
[diagnosis]
well-demarcated, poorly encapsulated with central scar that contains blood vessels, usually arterial
hypervascular with dense capillary blush on angiography
focal nodular hyperplasia
[diagnosis: liver]
incidental mass, hypovascular on angiography, no uptake on liver scan, assciated with OCP use
hepatocellular adenoma
tumor marker for hepatocellular CA
alpha fetoprotein
most common metastatic site of HCCA
lung
most common location of cholangiocarcinoma
perihilar (klatskin)
most common congenital anomaly of gallbladder
folded fundus or phrygian cap
most common biliary tract disease
cholelithiases
[diagnosis: GB stone]
pale yellow, round to ovoid, finely granular, hard
radiolucent but can be radiopaque if with sufficient CaCO3
cholesterol stone
[diagnosis: GB stone]
spiculated, molded surface
sterile, radiopaque
black pigment
[diagnosis: GB stone]
spiculated, molded surface, with Ca salts of fatty acids
infected, radiolucent
brown pigment
[diagnosis: chronic cholecystitis]
foamy macrophages
xanthogranulomatous cholecystitis
[diagnosis: chronic cholecystitis]
extensive dystrophic calcification, increased risk for CA
porcelain GB
[diagnosis: chronic cholecystitis]
atrophic, dilated with clear secretions
hydrops
most important risk factor for GB CA
gallstone
[diagnosis]
RUQ pain, anorexia, elevated ALP
GB CA
