Liver CPC intro and 110821

Question 1

Why might you see mallory denk bodies and balloon cells

Answer 1

alcohol -> fat accumulation. This goes away if stop drinking, if damage -?mallory hyaline, if alcoholic hepatitis -> neutrophils

Question 2

Histological features of alcoholic hepatitis

Answer 2

 Liver cell damage (ballooning ± Mallory-Denk bodies) Fatty change
 Inflammation Megamitochondria
 Fibrosis

Question 3

Why might you see nutmeg liver

Answer 3

venous congestion (i.e. Budd-Chiari, congestive HF, etc.)

Question 4

treatment for alcoholic hepatitis

Answer 4

o Supportive Nutrition
o Stop alcohol Vitamins (esp. B1 and thiamine)
o Occasionally steroids (anti-inflammatory)

Question 5

features of chronic stable liver disease

Answer 5

o	Palmar erythema							Spider naevi (>5)
o	Gynaecomastia (failure of liver to break oestradiol down)		Dupuytren’s contracture

Question 6

Features of portal hypertension

Answer 6

o Visible veins
o Ascites
o Splenomegaly

Question 7

Liver failure defined by

Answer 7

o Failed synthetic function
o Failed clotting factor and albumin production
o Failed clearance of bilirubin
o Failed clearance of ammonia (leads to encephalopathy)
 Flapping tremor (asterixis) = manifestation of hepatic encephalopathy