liver disease cps Flashcards
what is the space of disse? role?
The perisinusoidal space (or space of Disse) is a location in the liver between a hepatocyte and a sinusoid. It contains the blood plasma.
Microvilli of hepatocytes extend into this space, allowing proteins and other plasma components from the sinusoids to be absorbed by the hepatocytes.
what is the use of the van den Bergh reaction?
• Measuring Fractions of Bilirubin
direct reaction: conjugated bilirubin
indirect: unconjugated
______ - unconjugated bilirubin = conjugated bilirubin?
total bilirubin
tell me all about paediatric jaundice?
usually NORMAL
caused by liver immaturity
UNCONJUGATED hyperbilirubinaemia
suspect other causes if does NOT resolve
how can paediatric jaundice be treated?
○ Phototherapy
§ Converts bilirubin into lumirubin + photobilirubin
what is the pathophysiology of Gilberts syndrome?
autosomal recessive
REDUCED UDP glucuronyl transferase activity
what is urinary urobilinogen level in biliary obstruction?
ZERO!
present in urine if enterohepatic circulation is intact
what is the most representative marker of liver function ?
prothrombin time
normal PT is about 12-14 seconds
name some causes of hepatic jaundice?
○ Pre-Hepatic
§ Gilbert’s syndrome
§ Haemolysis
○ Hepatic
§ Viral hepatitis
§ Alcoholic hepatitis
§ Cirrhosis
○ Post-Hepatic
§ Gallstones
Pancreatic cancer
what do you see on alcohol hepatitis histology?
balloon cells containing Mallory hyaline
this blocks the flow of bile through the liver
what are the Differential Diagnosis for Fatty Liver Disease?
○ Alcoholic hepatitis
○ Malnourishment (Kwashiorkor)
○ Non-alcoholic steatohepatitis (NASH)
§ looks exactly like alcoholic hepatitis
§ most common cause
micronodular cirrhosis is seen in?
Alcoholic livers
what is Courvoisier’s Law?
if the gallbladder is palpable in a jaundiced patient, the cause is unlikely to be gallstones (i.e. it is more likely to be pancreatic cancer)
