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Gastrointestinal - Pathology > Liver II > Flashcards

Liver II Flashcards

1
Q

What serological markers are found in autoimmune hepatitis?

A

Anti-nuclear antibodies and anti-smooth muscle actin and elevated IgG

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2
Q

What is seen on biopsy of autoimmune hepatitis?

A

Plasma cells and inflammation

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3
Q

How do you treat AIH?

A

Corticosteroids

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4
Q

What causes most cases of cirrhosis?

A

Alcoholic liver disease

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5
Q

What are the three main causes of death associated with cirrhosis?

A

Progressive liver failure
Complications of portal hypertension
Hepatocellular carcinoma

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6
Q

What is the most common cause of acute liver failure?

A

Acetaminophen overdose

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7
Q

What is the most common cause of chronic liver failure?

A

Cirrhosis

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8
Q

What is the clinical manifestation of liver failure?

A 
Jaundice
Hypoalbumin
Coagulopathy
Hyperammonemia
Fetor hepaticus
AST/ALT
Hypoglycemia
Endocrine changes
Decreased drug metabolism
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9
Q

What is the most common cause of portal hypertension?

A

Cirrhosis

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10
Q

What are the main complications of portal hypertension?

A

Splenomegaly
Hepatic Encephelopathy
Esophageal Varices
Ascites

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11
Q

What cells are often seen on liver biopsy for alcoholic hepatitis?

A

Swelling liver cells
Mallory bodies
Neutrophils

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12
Q

What can steatofibrosis oftentimes lead to?

A

cirrhosis

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13
Q

What are the major causes of death for alcoholic cirrhosis?

A 
Encephalopathy, coma
Esophageal varices
Infection
Hepatorenal syndrome
Hepatocellular carcinoma
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14
Q

What is the gross appearance of alcoholic cirrhosis?

A

Early: Enlarged, fatty, micronodular
Late: Shrunken, nonfatty, nodules varying in size, cholestasis

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15
Q

What oftentimes leads to non-alcoholic liver disease?

A

Insulin resistance

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16
Q

What is defined as an autoimmune cholangiopathy characterized by porgressive inflammatory destruction of small and medium sized intrahepatic bile ducts?

A

Primary biliary cirrhosis

17
Q

How does primary biliary cirrhosis present?

A

Anicteric pruritis
Xanthomas
Bile stuff

18
Q

What serological marker is common in primary biliary cirrhosis?

A

Antimitochondrial antibodies

19
Q

What are the four stages for PBC?

A

1: Lymphocytic/granulomatous cholangitis in portal tracts
2: Periportal hepatitis with periportal fibrosis
3: Bridging necrosis with bridging fibrosis
4: Cirrhosis

20
Q

What causes secondary biliary cirrhosis?

A

Anything causing prolonged bile duct obstruction

21
Q

What is defined as an autoimmune cholangiopathy with progressive, random, uneven fibroinflammatory destruction of extrahepatic and intrahepatic bile ducts?

A

Primary sclerosing cholangitis

22
Q

Who usually gets PSC?

A

People with IBD
Male
40 years

23
Q

What gene is oftentimes mutated in hereditary hemochromatosis? What is the change?

A

HFE, regulates hepcidin synthesis

C282Y

24
Q

What is the clinical triad of Hereditary hemochromatosis?

A

Cirrhosis, diabetes, skin pigmentation

25
Q

What is the best screening test for Hereditary Hemochromatosis?

A

Fasting transferrin saturation

26
Q

What is different on liver biopsy for primary and secondary hemochromatosis?

A

In secondary, iron initially accumulates in the Kupffer cells, not hepatocytes

27
Q

What is the inheritance pattern of Wilson’s disease and what is mutated?

A

Autosomal recessive

ATP7B is mutated

28
Q

What serum levels are low in Wilson’s disease?

A

Ceruloplasmin

29
Q

What causes liver disease with A1AT deficiency?

A

Accumulation of A1AT in hepatocytes

30
Q

What is direct hepatotoxicity in terms of drug induced liver damage?

A

Toxic in a predictable, dose dependent manner.

31
Q

What is unpredictable hepatotoxicity (with drugs)?

A

Idiosyncratic liver injury from drugs. Not all exposed will develop injury

32
Q

What causes Reye’s syndrome?

A

Aspirin after acute viral illness

33
Q

What are the symptoms for Reye’s syndrome?

A

Liver injury and encephalopathy

34
Q

What is seen on liver biopsy for Reye’s syndrome?

A

Small lipid vacuoles in hepatocytes

Microvesicular steatosis

35
Q

What is neonatal cholestasis?

A

Diseases caused by Prolonged conjugated hyperbilirubinemia in theanemia

36
Q

What is defined as a complete or partial obstruction of the biliary tree in the first three months of life?

A

Biliary atresia

37
Q

What are the most common causes of neonatal hepatitis?

A

Biliary atresia
Metabolic disorders (A1AT deficiency, CF)
Infections
Idopathic

38
Q

What causes granulomatous hepatitis?

A

Idiopathic (50%)
Sarcoidosis (22%)
Drug related (6%)
Tuberculosis (3%)

Gastrointestinal - Pathology (10 decks)

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