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Gastroenterology > Liver and Gallbladder Pathology > Flashcards

Liver and Gallbladder Pathology Flashcards

1
Q

what are the characteristics for hepatic inflammation

A

inflammatory infiltration
kupffer cell hyperplasia
binucleate cells
deglycogenation

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2
Q

classic acute hepatitis

A

lobular disarray and collapse

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3
Q

chronic hepatitis

A

interface

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4
Q

what is cirrhosis

A

a late stage of hepatic fibrosis

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5
Q

What is cirrhosis characterized by ?

A

distortion of the hepatic architecture/bridging fibrosis, alteration of portal blood flow, formation of regenerative nodules

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6
Q

micronodular cirrhosis is ususally caused by ______-

A

chemical agent (alcohol)

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7
Q

What are the stages of cirrhosis

A

1) incomplete septal- no noduels, some incomplete briding
2) ealry-thin bridging fibrosis with dissecting nodules
3) moderately advanced–thick bridging fibrosis with dissecting nodules
4) advanced–wide septa with regenerative hyperplastic nodules

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8
Q

inactive cirrhosis

A

no inflammation and intact limiting plates around septa which are fibrotic

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9
Q

slight cirrhosis

A

mild inflammation, segmental erosion of limiting plates

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10
Q

moderate cirrhosis

A

moderate inflammation and damage of limiting plates

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11
Q

severe cirrhosis

A

marked inflammation, extensive damage of limiting plates, piecemeal necrosis and parenchymal damage

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12
Q

HAV characteristics

A

single stranded RNA virus, with a protein capsin

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13
Q

HBV characteristics

A

partially double stranded and single stranded DNA genome

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14
Q

Dane particles

A

HBV infectious components

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15
Q

core antigen of HBV

A

seen in the liver but NOT in the blood

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16
Q

surface antigen of HBV

A

produced by the virus in large quantities and shed in the blood stream as spherules and rods

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17
Q

acute cholecystitis

A

syndrome of right upper quadrant pain, fever, and leukocytosis with gallbladder inflammation, usually related to gallstone disease

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18
Q

acute acalculous cholecystitis

A

identical to acute CCT but WITHOUT gallstones and usually occurs in critically ill pts

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19
Q

chronic cholecystitis

A

used by the pathologist to describe chronic inflammatory cell infiltration of the gallbladder; the result of acue attaacks of CCT leading to fibrosis and thickening of the gallbladder

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20
Q

acute cholecystitis is more common in

A

women

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21
Q

risk factors for gallstones

A

pregnancy, obesity, hemolytic anemia, medications, native americans, chileans, pima indians, ileal resection, diabetes, TPN, vagotomy, spinal cord injury

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22
Q

what is cholesterolosis

A

excess cholesterol in the bile; cholesterol deposits macrophages

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23
Q

yellow speckled mucosa surface

A

cholesterolosis

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24
Q

strawberry gallbladder

A

cholesterolosis

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25
Q

primary adenocarcinoma of extrahepatic ducts

A

epithelial malignancies showing glandular or ductal differentiation of the extrahepatic ducts down to ampulla of vater

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26
Q

Klatskin tumor

A

tumor arising from the common bile duct between right and left hepatic duct

27
Q

porclain gallbladder

A

gallbladder with dystrophic calcification from adenocarcinoma

28
Q

what is the characteristic feature of hepatocellular carcinoma

A

bile in neoplastic cells

29
Q

what is elevated in Hepatocellular carcinoma

A

alpha fetoprotein, increased ALP and GGT, production of ectopic hormones

30
Q

what should the workup be for HCC

A

alpha fetoprotein (AFP) and ultrasound, CT, and MRI

31
Q

gilberts syndrome

A

mild deficiency in glucuronyl transferase, more common in males

32
Q

crigler najjar syndrome type 1

A

severe deficiency of glucuronyl transferase, death in first year or two with kernicterus

33
Q

crigler najjar syndrome type II

A

moderate deficiency of glucuronyl transferase, responds to enzyme treatment, can sufer from billirubin encephalopathy

34
Q

physiologic jaundice of the newborn

A

transient insufficiency of glucuronly transferase first few days of life

35
Q

examples of things that cause reduced hepatic uptake (interference with bilirubin albumin bindiing sites)

A

sulphonamides, breast milk jaundice, salicylates and contrast media

36
Q

black liver

A

dubin johnson syndrome

37
Q

No pruritus or elevation of serum alkaline phosphatase or evidence of cholestasis

A

dubin johnson syndrome

38
Q

where does the pigment predominante in Dubin Johnson syndrome

A

centrolobular zone

39
Q

brownish coarse pigments stored in hepatocytes

A

dubin johnson syndrome

40
Q

rotor syndrome is similar except

A

no pigment in the liver itssue

41
Q

occurs in the third trimester of pregnancy when estrogen levels are the highest and disappears postpartum

A

familial recurrent intrahepatic cholestasis of pregnancy

42
Q

canicular cholestasis

A

most common, mostly pericentral without hepatocellular damage

43
Q

ductal cholestasis

A

big bile in bile ductules and canals of herng at the periphery of portal fields

44
Q

cysts of the gallbladder

A

cuboidal or columnar epithelium resembling bile duct epithelium

45
Q

bile ducts embedded in fibrous stroma

A

von meyenburg complex

46
Q

most common choledochal cyst

A

type 1–cystic dialtion of the common bile duct

47
Q

least common choledochal cyst

A

type 2–true diverticulum of the extrahepatic bile duct located proximal to the duodenum

48
Q

what is caroli’s disease

A

congenital disorder characterized by multifocal, segmental dilatation of large intrahepatic bile ducts without aggressive fibrosis leading to biliary sludge and intraductal lithiasis

49
Q

beyler’s syndrome

A

paucity of intrahepatic ducts since birth with progressive jaundice and death in 1-2 years

50
Q

aagenase syndrome

A

cholestatsis with lymphedema

51
Q

alagille syndrome

A

hepatic ductular hypoplasia, retarded physical, mental and sexual development

52
Q

what is the vulnerable area in autoimmune hepatitis

A

periportal region with marked chronic inflammation with lymphocyte and macrophages spilling through the limiting plates encricling the hepatocytes…rosetting …piecemeal necrosis

53
Q

genes associated with hereditary hemochromatosis

A

HFE gene (C282Y, H63D)

54
Q

excessive iron deposition in the tissues

A

hereditary hemochromatosis

55
Q

what is AAT

A

inhibitor of proteolytic enzyme elastase

56
Q

liver manifestation of alpha 1 antitrypsin def.

A

caused by intrahepatocyte accumulation of AAT molecules rather than proteolytic mechanism

57
Q

inclusions within hepatocytes that stain positively with periodic acid-Schiff (PAS) reagent but resist digestion by diastase

A

alpha 1 antitrypsin deficiency

58
Q

treatment of wilson’s disease

A

D penicilamine or trientine

59
Q

vascular amyloidosis

A

sulfated alcian blue stain- greenish material accumulated in the wall of portal arteriole

60
Q

nutmeg liver, centrolobular veins congestion

A

acute right heart failure

61
Q

Sinusoidal dilatations forming large blood cysts scattered throughout the liver, grossly visible, measuring up to more than 1 cm in diameter

A

peliosis hepatica

62
Q

what causes peliosis hepatica

A

Drugs, anabolic steroids contraceptives, antineoplastic, metals (copper, arsenic), debilitating infections (tuberculosis, endocarditis AIDS), solid tumors, myeloproliferative disorders (myelofibrosis, polycythemia vera), lymphomas, myeloma, renal transplantation

63
Q

occlusion of MAIN hepatic veins

A

budd chiari syndrome

Gastroenterology (8 decks)

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