Liver , Pancreas & Biliary Tree pathology Flashcards
What are the direct causes of Hepatocyte Trauma?
- Toxins
- Ethanol, Paracetamol
- Infections - Hepatotropic viruses
- Storage diseases
- Hereditary haemochromatosis
- Wilson’s disease
What are the Indirect causes of Hepatocyte Trauma?
- Cholestasis
- Primary Biliary Cholangitis (PBC)
- Primary sclerosing cholangitis (PSC)
- Haemostasis
- Congestive Cardiac Failure (CCF
What is the reversible histologic response to Hepatocyte trauma?
Cholestasis & Steatosis
What are the Irreversible histologic response t Hepatcyte trauma?
Necrosis & Apoptosis
What is the histological feature described in Acute liver failure?
Massive hepatic necrosis
What are the risk factors of Acute liver failure?
Drugs -
* Acetaminophen ( Paracetamol)
* Infections
- HBV, HAV
* Autoimmune
- AI Hepatitis
What are the causes of Chronic liver failure?
- Chronic hepatitis B, * Chronic hepatitis C * Non-alcoholic fatty liver disease (NAFLD), * Alcoholic liver disease.
What are the External specific features of Cirrhosis & Chronic liver failure?
Jaundice and icterus
Pruritus
Oedema
Gynaecomastia
Spider naevi
Palmar erythema
Testicular atrophy
Clubbing
What are the causes of Posthepatic Portal Hypertension?
- Budd- Chiari syndrome
- Right sided heart failure
- Constrictive pericarditis
What are the causes of Intrahepatic Portal hypertension ( most common)?
- Cirrhosis
- Tumour
- Regenerative Nodule
- Infiltrating disease infection
True or False? Thrombosis an Massive splenomegaly is that causes of Prehepatic portal hypertension.
TRUE!!!
What are the complications of Portal hypertension?
- Ascites
- spontaneous bacterial peritonitis
- Portosystemic venous shunts
- Oesophageal varices
- Caput medusa
- Haemorrhoids
- Congestive splenomegaly
- Hepatic encephalopathy
What is the classic triad of Budd-Chiari syndrome?
Abdominal pain, ascites, and hepatomegaly
What is the mode of transmission for Hepatitis A virus?
Ingestion of contaminated water and food
What is the incubation period for Hepatitis A?
2-6 weeks
What is the incubation period for Hepatitis E?
4 weeks
What is the Incubation period for Hepatitis B?
8 weeks
What are the modes of Transmission Hepatitis B ?
Parental / Sexual or Iv drug use
What are the. most common modes of transmission for Hepatitis C?
- 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
What is the most common benign liver tumour?
Haemangioma
What are the major etiologic agents in Hepatocellular carcinoma?
- Hepatic Viruses - HBV, HCV
- Cirrhosis
- Aflatoxin
What is Aflatoxin?
Aflatoxin is a mycotoxin produced by Aspergillus species that contaminates staple food crops in Africa and Asia.
Where is Aspergillus flavus produced?
They grow on peanuts, soya other grains.
What is the gene mutation for Hepatocellular carcinoma caused by Aflatoxin?
p53
What gene is associated with Fibrolamellar variant of Hepatocellular carcinoma?
DNAJB1 - PRKACA fusion gene .
What is the most frequent type of Hepatocellular carcinoma found in children?
Hepatoblastoma
What are the Paraneoplastic effects of Hepatocellular carcinoma?
- Hypoglycaemia
- Erythrocytosis
- Hypercalcaemia
- Oncofoetal antigens(foetal oncoprotein/hormones)
- Alpha- fetoprotein
- Beta-hCG
What is Angiodysplasia?
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).
What is Diverticulosis?
This is a Pseudo-diverticular outpourings of mucosa and submucosa.
What is the causative agent in Pseudomembranous colitis?
C. difficile
Which infectious colitis is associated with a volcano lesion?
Pseudomembranous Colitis
What is the gene mutation in Puetz-Jehgers syndrome?
STK11 loss-of-function mutation
What is the gene mutation in Juvenile polyposis?
SMAD4 mutation
Which gene mutation is involved Familial Adenomatous Polyposis (FAP)?
APC gene
What are the clinical features seen in Acute pancreatitis?
Abdominal pain
Nausea and vomiting
Systemic inflammatory response
↑ serum amylase
↑ serum lipase
What is the most common location for a carcinoma of the Pancreas?
The head
What are the pre-disposing factor for developing a pancreatic carcinoma?
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
Endocrine pancreatic tumours are more common in which areas?
The body and the tail
