Liver non-neoplastic Flashcards
Vitamin A is stored in what cell of the liver?
Hepatic stellate cell
Percentage of functional capacity lost before hepatic failure ensues?
80 - 90%
What is the incubation period of Hep A, B, C, D and E?
Hepa A - 2 to 6 weeks B - 2 to 26 weeks C - 4 to 26 weeks D - same as B E - 4 to 5 weeks
What can be detected in the window period of Hepatitis B infection?
IgM- HbcAg
What is the best predictor of chronicity in hepatitis B infection?
Age at the time of infection
Remarks: the younger the age, the higher probability of chronicity.
What is the second most common cause of hepatitis C?
Multiple sex partners
Remarks: Intravenous drug abuse - number one cause
Unknown cause - number three cause
This hepatitis is known as quasispecies?
Hepatitis C
Remarks: it has low fidelity and closely related genetic variants exists within any given individual (quasispecies).
How many percent does hepatitis C transform into chronic disease? and to cirrhosis?
Chronic disease occurs in 80 to 90% of hepatitis C and 20% will become cirrhotic.
In symptomatic individuals of chronic hepatitis, what is the most common clinical finding?
Fatigue
Hepatitis that has a high mortality rate in pregnant women.
Hepatitis E
Hepatitis that may be especially rich in plasma cell infiltrates?
Hepatitis A.
Hepatitis that is associated with metabolic syndrome?
Hepatitis C
Remarks: particularly the genotype 3
Which type of autoimmune hepatitis is more common in children?
Type 2 - autoantibodies include Anti-LKM (liver-kidney), anti-ACL1
Remarks: Type 1 is more common in adults - Autoantibodies are ANA, ASMA, LKM, SLA/LP (liver-pancreas)
Mallory-Denk bodies are seen in alcoholic hepatitis, these structures are made up of what?
Intermediate filaments such as keratins 8 and 18 and ubiquitin
Remarks: also seen in Wilson disease and chronic biliary tract disease.
What is the threshold (mg/day) for the development of alcohol liver disease?
80 mg/day of alcohol
True or false. Nonalcoholic fatty liver disease show central fibrosis and neutrophilic infiltrates?
False
Remarks: NAFLD - portal fibrosis and mononuclear cell infiltrates vs Alcoholic liver disease - central fibrosis with neutrophilic cell infiltrates.
What is the most common mutation in hemochromatosis?
HFE mutation is most common in adults
Remarks: HFE on chr. 6 at 6p21.3, a cysteine-to-tyrosine substitution at amino acid 282 (C282Y)
What is the mutation in Wilson disease?
ATP7B gene mutation on chr. 13
Mnemonics: Wilson ate 7 Bananas = Energy (ATP)
What is the most specific screening test for Wilson disease?
Most specific screening test: Increased urinary excretion of copper.
Most sensitive and accurate test: Decrease in serum ceruloplasmin and increase hepatic copper content.
Most common mutation in Alpha-1 antitrypsin deficiency?
Piz mutation
Remarks: Alpha-1 antitrypsin def. is the most commonly diagnosed inherited hepatic disorder in infants and children.
True or false. Primary biliary cirrhosis is more common in males and is associated with inflammatory bowel disease?
False.
Remarks: Primary Biliary Cirrhosis: associated with Sjogren syndrome and is more common in females. Primary Sclerosing Cholangitis: associated with ulcerative colitis and is more common in males.
What part of the bile duct is involved in Primary Sclerosing Cholangitis?
PSC: inflammation and obliterative fibrosis of LARGE INTRAHEPATIC and EXTRAHEPATIC bile ducts.
Remarks: PBC: nonsuppurative, inflammatory destruction of SMALL and MEDIUM INTRAHEPATIC bile ducts.
What syndrome constitutes the obstruction of two or more major hepatic veins producing liver enlargement, pain, and ascites?
Budd-Chiari syndrome
Sinusoidal obstruction syndrome is originally described in Jamaican drinkers of what beverage?
Bush tea containing pyrrolizidine alkaloid
Remarks: Causing toxic injury to the sinusoidal endothelium.
