Liver disorders AB Flashcards
A1AT - what is the mechanism of tissue damage in the lungs as opposed to the liver?
Lungs: elastin destruction by elastase
Liver: pathologic polymerization of AAT molecules > protein accumulation within hepatocytes
What are the histologic findings of NAFLD on liver biopsy?
Steatosis, generally greatest in zone 3 (peri-central vein)
Lobular inflammation in zone 3
Fibrosis
What are the histological findings of alcoholic hepatitis on liver biopsy?
Characteristic = Mallory hyaline
Acute alcoholic hepatitis = neutrophils, necrosis of hepatocytes, collagen deposition, fatty change
What is the genetic inheritance of A1AT?
Autosomal recessive / codominant
Ch 14
PIMM = normal
Homozygous PiSS = 50% normal A1AT
Homozygous PiZZ = 10% normal A1At
What processes take place in zone 1 in the liver?
Zone 1 = periportal = highest oxygenation
Important for oxidative liver function:
- Gluconeogenesis
- Beta oxidation of fatty acids
- Cholesterol synthesis
What processes take place in zone 3 in the liver?
Zone 3 = centrilobular = poorest oxygenation = most sensitive to ischaemic injury
Important for:
- Glycolysis
- Lipogenesis
- CYP 450
Which drugs may cause acute hepatitis?
Methyldopa
Isoniazid
Nitrofurantoin
Phenytoin
Which drugs may cause granulomatous formation in the liver?
Methyldopa Hydralazine Sulfonamides Quinidine Allopurinol
Which drugs may cause microvesicular fatty change?
EtOH
Salicylates
Tetracyclines
