Liver , Pancreas & Biliary Tree pathology

Question 1

What are the direct causes of Hepatocyte Trauma?

Answer 1

• Toxins
• Ethanol, Paracetamol
• Infections - Hepatotropic viruses
• Storage diseases
• Hereditary haemochromatosis
• Wilson’s disease

Question 2

What are the Indirect causes of Hepatocyte Trauma?

Answer 2

• Cholestasis
• Primary Biliary Cholangitis (PBC)
• Primary sclerosing cholangitis (PSC)
• Haemostasis
• Congestive Cardiac Failure (CCF

Question 3

What is the reversible histologic response to Hepatocyte trauma?

Answer 3

Cholestasis & Steatosis

Question 4

What are the Irreversible histologic response t Hepatcyte trauma?

Answer 4

Necrosis & Apoptosis

Question 5

What is the histological feature described in Acute liver failure?

Answer 5

Massive hepatic necrosis

Question 6

What are the risk factors of Acute liver failure?

Answer 6

Drugs -
* Acetaminophen ( Paracetamol)
* Infections
- HBV, HAV
* Autoimmune
- AI Hepatitis

Question 7

What are the causes of Chronic liver failure?

Answer 7

• Chronic hepatitis B, * Chronic hepatitis C * Non-alcoholic fatty liver disease (NAFLD), * Alcoholic liver disease.

Question 8

What are the External specific features of Cirrhosis & Chronic liver failure?

Answer 8

Jaundice and icterus
Pruritus
Oedema
Gynaecomastia
Spider naevi
Palmar erythema
Testicular atrophy
Clubbing

Question 9

What are the causes of Posthepatic Portal Hypertension?

Answer 9

• Budd- Chiari syndrome
• Right sided heart failure
• Constrictive pericarditis

Question 10

What are the causes of Intrahepatic Portal hypertension ( most common)?

Answer 10

• Cirrhosis
• Tumour
• Regenerative Nodule
• Infiltrating disease infection

Question 11

True or False? Thrombosis an Massive splenomegaly is that causes of Prehepatic portal hypertension.

Answer 11

TRUE!!!

Question 12

What are the complications of Portal hypertension?

Answer 12

• Ascites
• spontaneous bacterial peritonitis
• Portosystemic venous shunts
• Oesophageal varices
• Caput medusa
• Haemorrhoids
• Congestive splenomegaly
• Hepatic encephalopathy

Question 13

What is the classic triad of Budd-Chiari syndrome?

Answer 13

Abdominal pain, ascites, and hepatomegaly

Question 14

What is the mode of transmission for Hepatitis A virus?

Answer 14

Ingestion of contaminated water and food

Question 15

What is the incubation period for Hepatitis A?

Answer 15

2-6 weeks

Question 16

What is the incubation period for Hepatitis E?

Answer 16

4 weeks

Question 17

What is the Incubation period for Hepatitis B?

Answer 17

8 weeks

Question 18

What are the modes of Transmission Hepatitis B ?

Answer 18

Parental / Sexual or Iv drug use

Question 19

What are the. most common modes of transmission for Hepatitis C?

Answer 19

• Intravenous drug abuse
• Multiple sex partners
• Having had surgery within the last 6 months
• Needle stick injury
• Multiple contacts with an HCV-infected individual
• Employment in the medical or dental field

Question 20

What is the most common benign liver tumour?

Answer 20

Haemangioma

Question 21

What are the major etiologic agents in Hepatocellular carcinoma?

Answer 21

• Hepatic Viruses - HBV, HCV
• Cirrhosis
• Aflatoxin

Question 22

What is Aflatoxin?

Answer 22

Aflatoxin is a mycotoxin produced by Aspergillus species that contaminates staple food crops in Africa and Asia.

Question 23

Where is Aspergillus flavus produced?

Answer 23

They grow on peanuts, soya other grains.

Question 24

What is the gene mutation for Hepatocellular carcinoma caused by Aflatoxin?

Answer 24

p53

Question 25

What gene is associated with Fibrolamellar variant of Hepatocellular carcinoma?

Answer 25

DNAJB1 - PRKACA fusion gene .

Question 26

What is the most frequent type of Hepatocellular carcinoma found in children?

Answer 26

Hepatoblastoma

Question 27

What are the Paraneoplastic effects of Hepatocellular carcinoma?

Answer 27

* Hypoglycaemia * Erythrocytosis * Hypercalcaemia * Oncofoetal antigens(foetal oncoprotein/hormones) * Alpha- fetoprotein * Beta-hCG

Question 28

What is Angiodysplasia?

Answer 28

This is Tortuous dilation of vessels .Vessels may bleed slowly, causing minimal or chronic blood loss, or may rupture causing acute or severe GI bleeding with hematochezia (bloody diarrhea).

Question 29

What is Diverticulosis?

Answer 29

This is a Pseudo-diverticular outpourings of mucosa and submucosa.

Question 30

What is the causative agent in Pseudomembranous colitis?

Answer 30

C. difficile

Question 31

Which infectious colitis is associated with a volcano lesion?

Answer 31

Pseudomembranous Colitis

Question 32

What is the gene mutation in Puetz-Jehgers syndrome?

Answer 32

STK11 loss-of-function mutation

Question 33

What is the gene mutation in Juvenile polyposis?

Answer 33

SMAD4 mutation

Question 34

Which gene mutation is involved Familial Adenomatous Polyposis (FAP)?

Answer 34

APC gene

Question 35

What are the clinical features seen in Acute pancreatitis?

Answer 35

 Abdominal pain  Nausea and vomiting  Systemic inflammatory response  ↑ serum amylase  ↑ serum lipase

Question 36

What is the most common location for a carcinoma of the Pancreas?

Answer 36

The head

Question 37

What are the pre-disposing factor for developing a pancreatic carcinoma?

Answer 37

 Cigarette smoking - ↑ risk X2-3.  ↑ Body mass index  Inherited genetic disorders -Peutz-Jeghers syndrome - Hereditary breast and ovarian cancer - Hereditary non-polyposis cancer syndrome (Lynch II)  Mutations: Eg. K-ras, p16, p53  Progresses from PanIN to invasive carcinoma

Question 38

Endocrine pancreatic tumours are more common in which areas?

Answer 38

The body and the tail