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GI II Exam 1 > Liver Path V > Flashcards

Liver Path V Flashcards

1
Q

autoimmune hepatitis

A

chronic hepatitis - immune abnormalities
-neg sero tests for virus

type 1 - female
type 2 - children

-elevated IgG

has titers

majority have other autoimmune

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2
Q

type 1 autoimmune hepatitis

A

female

ANA, ASMA
negative AMA

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3
Q

type 2 autoimmune hepatitis

A

children

ALKM1, ACL-1

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4
Q

predictable

A

intrinsic

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5
Q

unpredicatable

A

idiosyncratic

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6
Q

DDx for liver disease

A

always include exposure to toxin or drug

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7
Q

budd chiari

A

oral contraceptives

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8
Q

angiosarcoma

A

vinyl chloride

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9
Q

zone 3 necrosis

A

acetaminophen

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10
Q

zone 1 hepatotoxicity

A

Fe overload

allyl alcohol

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11
Q

zone 3 hepatotoxicity

A

acetaminophen
ethanol
CCl4

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12
Q

acetaminophen and ethanol

A

increased zone 3 necrosis

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13
Q

isoniazid

A

first line anti-TB drug

hepatic damage occurs

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14
Q

microvesicular fatty change

A

tetracycline

salicylates

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15
Q

cholestatic reactions

A

estrogens

antibiotics

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16
Q

NAPQI

A

problematic in path of acetaminophen toxicity

depletion of GSH

acetylcysteine - reduces NAPQ1 to APAP

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17
Q

drug metabolism

A

in zone 3 - centrilobular

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18
Q

reye syndrome

A

aspirin use

  • rare
  • chilren
  • mito dysfunction - liver and brain

extensive accumulation of fat droplets - microvesicular steatosis**

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19
Q

oil red O stain

A

for reye syndrome

stains lipids**

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20
Q

5th leading cause of death

A

alcoholic liver disease

21
Q

alcoholic liver disease path

A

ethanol > actaldeyde

  • alters lipid metabolism
  • decreased export lipoproteins
  • cell injury caused by ROS and cytokines**
22
Q

patterns of alcoholic liver disease

A

zone 3

-hepatic steatosis, alcoholic hepatitis, cirrhosis

23
Q

fatty liver

A

all drinkers with moderate intake

microvesicular to macrovesicular

completely reversible***

24
Q

alcoholic hepatitis

A

ballooning and necrosis of hepatocytes

25
Q

mallory bodies

A

alcoholic hepatitis

26
Q

AST:ALT >1 and AST <500, malaise, fever, jaundice, RUQ pain

A

alcoholic hepatitis

27
Q

alcoholic hepatitis

A

PMNs surrounding necrotic hepatocytes

28
Q

mallory bodies

A

tangles of keratin complexed with proteins like ubiquitin

in alcoholic hepatitis

29
Q

non-alcoholic fatty liver

A

fatty change in liver - no alcohol

25% of US adults

with metabolic syndrome

30
Q

diagnosis non-alcoholic fatty liver

A

biopsy gold standard

31
Q

NASH

A

non-alcoholis steatohepatitis

-ballooning degeneration, necrosis, lobular inflammation

32
Q

fatty liver

A

with fatty heart, HTN, diabetes

33
Q

elevated ALT/AST with no symptoms

A

think NASH

34
Q

iron overload

A

hemochromatosis

35
Q

copper overload

A

wilson disease

36
Q

hepcidin

A

inhibits Fe absorption in GI tract

acts as basolateral side of cells

37
Q

tx for hemochromatosis

A

bleeding

38
Q

anemia of chronic disease

A

IL-6 - increases hepcidin - inhibits iron absorption

39
Q

HFE

A

mutated in hereditary hemochromatosis - adults

no Fe recognition - and no hepcidin**

40
Q

childhood hemochromatosis

A

mutations - HAMP, HJV

41
Q

secondary hemochromatosis

A

thalassemia major

sideroblastic anemia

42
Q

inhibition of hepcidin

A

erythroblasts release - GDF-15 anf TWSG1

43
Q

acute phase reactant

A

hepcidin

-so is released with chronic inflammation**

44
Q

genetic hemochromatosis

A

auto recessive

increased iron in tissue - oxidative stress damage

genet defect HFE
-C282Y

finding of homozygous C282Y genotype confirms diagnosis of HH

45
Q

screening test for hemochromatosis

A

transferrin saturation

46
Q

specific test for hemochromatosis

A

iron biopsy
MRI of liver
HFE mutation - C282Y

47
Q

skin pigmentation, cirrhosis, diabetes

A

triad of hemochromatosis

also can see hepatocellular carcinoma

48
Q

prussian blue

A

Fe stain

49
Q

TIBC

A

indirect measure of transferrin

normal in hemochromatosis

GI II Exam 1 (29 decks)

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