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GI > Liver Path > Flashcards

Liver Path Flashcards

1
Q

Describe drug induced liver disease

A

Very common, may cause any type of liver injury, may mimic any clinical liver disease, will recover when drug is stopped.

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2
Q

Characteristics of intrinsic drugs

A

predictable, dose dependent, short latency, specific lesions

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3
Q

Characteristics of idiosyncratic drugs

A

unpredictable, dose independent, variable latency, variable lesions, hypersensitivity

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4
Q

Harmful effects from tetracycline

A

microsteatosis

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5
Q

methotrexate

A

macrosteatosis

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6
Q

acetaminophen

A

necrosis

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7
Q

isoniazid, halothane

A

hepatitis

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8
Q

amiodarone

A

fibrosis

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9
Q

steroids, erythromycin

A

cholestasis

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10
Q

amt of alcohol for a man or woman to develop alcoholic liver disease

A

Men-over 80g/day

Women-over 40g/day

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11
Q

What is steatosis?

A

Fatty change of the liver. May revert back to normal.

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12
Q

What is hepatitis

A

Inflammation of the liver, can reverse back to normal

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13
Q

what is cirrhosis

A

fibrosis and hyperplastic nodules. Not reversible

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14
Q

Clinical presentation of pt with alcoholic steatohepatitis

A 
Elevated AST-ALT2
Increased AP
Jaundice
Leukocytosis
Fever
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15
Q

Causes of death in end stage alcoholism

A

hepatic coma, massive GI hemorrhage, infection, hepatorenal syndrome following bout of alcoholic hepatitis.

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16
Q

Portal vein thrombosis-Extrahepatic causes

A

abdominal infection and inflammation including appendicitis, diverticulitis, pancreatitis. Hypercoagulability, surgery

17
Q

Hepatic vein obstruction-cardiac related

A

venous passive congestion, centrilobular hemorrhagiv necrosis, cardiac sclerosis.

Budd chiari syndrome also causes obstruction

18
Q

What is budd chiari syndrome

A

clotting or obstruction of hepatic vein and/or IVC. Most pts have underlying condition that predisposes to blood clotting.

19
Q

What is veno occlusive disease

A

a complication following bone marrow transplantation or ingestion of certain plant alkaloids. Arises bc nonspecific vasculitis arising in response to inflammatory challenge, such as bone marrow transplant conditioning regimen.

20
Q

Symptoms of veno occlusive disease

A

tender hepatomegaly, weight gain, jaundice, portal hypertension/ascites, renal failure, liver failure, recovery/cirrhosis

21
Q

Hereditary hemochromatosis

A

Defective regulation of intestinal Fe absorption leading to increased absorption. Mutations of HFE gene encodes for membrane prtn regulating the interaction of transferrin receptors with transferrin. Mutant alleles C282Y and H63D.

22
Q

Complications of hereditary hemochromatosis

A

Diabetes, cardiomyopathy, hypogonadism, skin pigmentation , pseudo gout

23
Q

Function of copper

A

Pigment formation, neurotransmitter production ,peptide formation, connective tissue biosynthesis, and antioxidant defense

24
Q

what is wilson disease

A

hereditary disease that causes body to retain copper.

25
Q

Cause of wilson disease

A

Autosommal recessive. Mutation of ATP7B copper-transporter. Impaired copper biliary excretion. Copper accumulation.

26
Q

Clinical manifestations of Wilson disease in children

A

hepatitis, acute/chronic/fulminant

27
Q

Wilson in adults

A

neurologic/psych disease. Fatal if untreated

28
Q

Alpha1-antitrypsin deficiency

A

autosomal recessive. Primary liver metabolic disease, primary genetic liver disease in children, 2nd cause of liver transplatation in children

29
Q

Cause of alpha1 antitrypsin deficiency

A

Misfolding of PiZ

30
Q

focal nodular hyperplasia

A

solitary mass, central scar, fibrous septa, oral contraceptives, rare complications

31
Q

What is a hemangioma

A

most common benign hepatic tumor. Asymptomatic or abdominal pain. Risk of rupture/hemorrhage, so no biopsy. Dx thru angiogram/CT

32
Q

Liver cell adenoma

A

young women, oral contraceptives, glycogen storage disease, may rupture in pregnancy, may harbor hepatocellular carcinoma (rare)

33
Q

Risk factors for hepatocellular carcinoma

A

CIRRHOSIS, alcoholism, HBV, HCV, hereditary hemochromatosis, alpha1AT deficiency, aflatoxin, tyrosinemia

34
Q

Clinical presentation in hepatocellular carcinoma

A

painful hepatomegaly, abdominal mass, weight loss, portal/hepatic vein thrombosis, hemorrhagic ascites, hepatic failure, massive bleeding

35
Q

Hepatocellular carcinoma Dx

A

AFP>1000. Imaging too

36
Q

Common primary sites of malignant metastatic tumors

A

GI tract, breast, lung, pancreas, melanoma

GI (13 decks)

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