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Patología Aparatos y Sistemas > Liver, gallbladder & pancreas > Flashcards

Liver, gallbladder & pancreas Flashcards

1
Q

La cirrosis hepática tiene posibilidad de evolucionar a:

A

Hepatocarcinoma

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2
Q

Estadío de daño hepático que NO es reversible

A

Fibrosis

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3
Q

Gente con mayor probabilidad de daño hepático

A

Mujeres y asiáticos

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4
Q

Neoplasm with no central scar and no portal tracts

A

Hepatocellular adenoma

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5
Q

Prominent ballooning of liver cells may form..

A

Mallory hyaline

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6
Q

Ballooning hepatocites are a hallmark of

A

Steatohepatitis

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7
Q

Principal cell type that produces scar in a damaged liver

A

Hepatic stellate cell

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8
Q

Failure of fusion of fetal duct systems of the pancreas

A

Pancres divisum

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9
Q

Gene that causes pancreas agenesia

A

PDX1

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10
Q

Place where trypsin activates before activating pancreatic enzymes

A

Duodenum

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11
Q

Trypsin inhibitors secreted by acinar and ductall cells

A

Protease inhibitor Kazal type 1

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12
Q

Most common cause of acute pancreatitis

A

Biliary tract disease and alcoholism

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13
Q

Factor necessary for trypsin activated, increased in pancreatitis

A

Calcium

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14
Q

Genes associated with hereditary pancreatitis

A

PRSS1, SPINK1 and CFTR

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15
Q

Trypsinogen gene with a gain-of-function mutation that avoids trypsin self-inactivation

A

PRSS1

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16
Q

Trypsin inhibitor gene altered in pancretisis

A

SPINK1

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17
Q

5 basic alterations of acute pancreatitis

A

Microvascular leak and edema
Fat necrosis
Acute inflammation
Damage (autodigestion)
Blood vessel destruction with interstitial hemorrage

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18
Q

Result of pancreatic fat necrosis in which fatty acids combine with calcium and surviving fat cells look blue in microscope

A

Saponification

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19
Q

Pancreatic parenchymal necrosis also has intraparenchymal hemorrage.

A

Hemorragic pancreatitis

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20
Q

Cardinal manifestation of acute pancreatitis

A

Abdominal pain (constant, intense and referred to the upper or mid back and left shoulder)
+ anorexia, naurea and vomiting

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21
Q

Blood indicators for acute pancreatitis

A

Lipase and amylase (lipase more specific and sensitive)

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22
Q

Ominous complications of acute pancreatitis

A

Respiratory distress syndrome and acute renal failure

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23
Q

Advere pronostic indicators of acute pancreatitis

A

Systemic organ failure and pancreatic necrosis

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24
Q

It starts with destruction of pancreatic exocrine parenchyma, future fibrosis and destruction of endocrine.

A

Chronic pancreatitis

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25
Q

Most common cause of chronic pancreatitis

A

Long-term alcohol use

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26
Q

Immunoglobulin associated with autoimmune autoimmune pancreatitis type 1

A

IgG4

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27
Q

Clinical manifestation of chronic pancreatitis

A

Acute symptoms repeatedly, attacks precipitated by a alcohol and medications that increase sphincter of oddi

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28
Q

Mediators shown in chronic pancreatitis as a result of repeated episodes acinar cell injury

A

Profibrogenic cytokines (TGFB) and PDGF

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29
Q

Macroscopic aspect of pancreas in cronic pancreatitis

A

Hard gland with visibly dilated ducts

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30
Q

Phlebitis and lymphoplasmatic inflammation is characteristic of this type of pancreatitis

A

Autoinmune pancreatitis type 1

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31
Q

Granylocyte epithelial lesions and neutrophilic infiltrates of medium-sized pancreatic ducts is characteristic of

A

Autoimmune pancreatitis type 2

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32
Q

Lining of pseudocysts

A

Fibrous tissue and granulation tissue, lack epithelial lining

33
Q

65 y/o women presents non-specific symptoms (abdominal pain). Imaging shows a mass in the tail of pancreas with small cavities. Probable diagnosis and gene associated to the condition.

A

Serous cystic neoplasm, VHL tumor suppresor gene inactivated.

34
Q

Women presents a mass in the tail of the pancreas. Analysis of the piece shows large cystic cavities filled with mucin. Most common diagnosis and receptors the piece will express. Mutation in KRAS and RNF43

A

Mucinous cystic neoplasm. Estrogen, progesterone receptors and inhibin.

35
Q

Men presents mass in the head of the pancreas with absence of ovarian stroma and pancreatic duct. Diagnosis and mutation

A

Intraductal papillary mucinous neoplasms. KRAS, RNF43 and Gsa mutation.

36
Q

Pancreatic mass with CTNNB1 B-catenini mutation that presents in young women with abdominal discomfort.

A

Solid-pseudopapillary neoplasm

37
Q

Pancreatic cancer precursor lesions that develop in small ducts

A

Pancreatic intraepithelial neoplasia (PanIN)

38
Q

Genes most commonly associated with cancer pancreas.

A
  1. KRAS
  2. TP53
    3.SMAD4
  3. CDKN2A
39
Q

Strongest environmental influence for pancreatic cancer (x2)

A

Cigarette smoking

40
Q

Male, 60, presents Courvoisier sign (jaundice + enlarged bladder), weightloss, anorexia and Trousseau sign (migratory thrombophlebitis), is a common smoker. Clinical suspicion and damage locatin and probable mutation.

A

Pancreatic carcinoma, head pancreas ,BRCA2 mutation

41
Q

Image of pancreas with prominant cell architecture with minimal stroma. Lacks fibrous component.

A

Acinar cell carcinoma

42
Q

Principal cell involved in scare deposition in liver, it normally stores lipid and vitamin A

A

Stellate cell

43
Q

Place where liver scarring commence

A

Space of Disse with loss of sinusoidal fenestration (sinusoidal capillaritazion)

44
Q

Sinusoidal capillarization in liver suggests

A

Nonalcoholic steatohepatitis

45
Q

Predominant fiture in cirrotic noduls due to hepatocytes replication to survive

A

Regenerative nodules

46
Q

Appearance of liver in rehabilitation through metalloproteinases

A

Incomplete septal cirrhosis

47
Q

Liver illness assoc. with encelopathy and coagulopathy within 26 weeks (8w) after initial liver injury without previous existing disease.

A

Acute liver failure

48
Q

Time in which liver failure occures after acetaminophen toxicity

A

1 week

49
Q

Patient manifests nausea, vomiting and jaundice, followed by encephalopathy and coagulation deffects.

A

Actue liver failure

50
Q

Hepatitis virus that is self-limited and does not lead to chronic hepatitis.

A

Hepatitis A

51
Q

Hepatitis virus most often associated with chronic disease

A

Hepatitis C

52
Q

Cirrhosis that arises without any clear cause

A

Cryptogenic cirrhosis

53
Q

Clinical features of chronic liver failure

A

Cholestasis, modification in estrogens, hypogonadism

54
Q

Main circulation altered in hyperdynamic cirucilation due to portal hypertension.

A

Splachnic circulation

55
Q

Consequences of portal hypertension

A

Hepatic encelopathy
Ascites
Portosystemic venous shunts
Congestive splenomegaly

56
Q

Lack of blood oxygenation due to portal hypertension and dilated lung capilaries

A

Hepatopulmonary syndrome

57
Q

Dyspnea and clubbing on the fingers are a manifestation of this portal hypertension condition

A

Portopulmonary hypertension

58
Q

Diseases with Mallory hyeline bodies

A

NASH
Alcoholic hepatitis
Wilson’s disease

59
Q

Alcohol amount necessary to produce mild, reversible, hepatic steatosis

A

80 g of alcohol (6 beers u 8 oz of 80-proof liquor)

60
Q

Amount of alcohool assoc. with severe lever injury

A

160 g / day for 10-20 years

61
Q

Enzyme that has 50% of activity in asians and makes them intolerant to alcohol.

A

ALDH*2

62
Q

Lobular zone in which alcoholic liver disease changer occur

A

Lobular zone 3

63
Q

Hepatic enzyme ratio in liver disease

A

AST>ALT 2:1

64
Q

NAFLD injury with similar histologic features to those of alcoholic hepatitis

A

NASH

65
Q

Its metabolism is impaired by alcohol, decreasing glutathione and making the liver more susceptible to oxidative injury.

A

Methionine

66
Q

Pattern of steatohepatitis fibrosis

A

Pericellular or perinusoidal, “chicken wire”

67
Q

Phases of fibrosis in alcoholic liver disease

A
  1. Chicken wire
  2. Periportal fibrosis
  3. Bridging fibrosis
68
Q

Micronodular fibrosis of the liver in alcoholic liver disease

A

Laennec fibrosis

69
Q

Women presents a mass in the liver with a capsule and central stellate scar. Biopsy IHC for glutamine synthase shows a maplike pattern.

A

Focal nodular hyperplasia

70
Q

A surgeon finds small subcapsular lesions in the liver and thought of metastasis. The lesion was obstructing the bile ducts.

A

Bile duct adenoma or biliary hamartoma

71
Q

Most common benign liver tumor, looks red-blue, with a subcapsular location, dilated thin-walled vascular channels

A

Cavernous hemangiomas

72
Q

Young woman taking contraceptives presents liver mass. Most common diagnosis

A

Hepatocellular adenoma

73
Q

Subtypes of hepatocellular adenoma

A
  1. HNF1a-inactivated
  2. Inflammatory
  3. B-catenin
74
Q

Subtype of hepatic adenoma with mutation in gp130, associated with obesity and metabolic syndrome.

A

Inflammatory hepatocellular adenoma

75
Q

A patient who used to present a liver mass now presents massive abdominal bleeding. Which is the name of the mass?

A

Hepatocellular adenoma

76
Q

Child aged 2 presents jaundice and abdominal distention, CT shows a liver mass and metastasis to the lungs. What’s the mass, it resembles to embryonal and fetal hepatocytes.

A

Hepatoblastoma

77
Q

Asian male of 30 years with acquired infection of HBV presents abdominal pain, fatigue, weightloss and hepatomegaly. US shows a green-yellowish liver mass. Most common diagnosis

A

Hepatocellular carcinoma

78
Q

Tumors in the intrahepatic biliary tree

A

Intrahepatic cholangiocarcinoma

79
Q

Tumors in the extrahepatic biliary tree

A

Biliary adenocarcinoma

Patología Aparatos y Sistemas (5 decks)

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