Liver Pathology 1

Question 1

Icterus

Answer 1

yellow sclera discoloration

Question 2

Bili mechanism

Answer 2

reticuloendothelial cells –> bili
bili transported to liver complexed to albumin (unconjugated)
conjugated w/ glucuronic acid in hepatocytes
conjugated bili excreted in bile –> brown stools
some in urine –> yellow

Question 3

Bili solubilities

Answer 3

unconjugated (majority): bound to albumin

conjugated: water soluble in serum

Question 4

Which bili is toxic to tissues?

Answer 4

unconjugated
acute bili encephalopathy
kernicterus

Question 5

Complications of hyperbilirubinemia in infant

Answer 5

acute biliruben encephalopathy

kernicterus

Question 6

Gilbert’s syndrome

Answer 6

decreased glucuronyl transferase activity
benign disorder
mild increase in unconjugated bilirubin

Question 7

Hepatocellular cholestasis

morphology

Answer 7

brown pigment/bile in hepatocytes

Question 8

Canalicular cholestasis

morphology

Answer 8

bile in canaliculi

Question 9

Which hepatitis viruses become chronic infections?

Answer 9

B, B+D, C

Question 10

Damage in hepatitis is done by what process

Answer 10

inflammation in response to infection

Question 11

Hep A
transmission
Sx
Vaccine/Tx

Answer 11

transmission: transient bacteremia in infection
Sx: generally asymptomatic
vaccine: available

Question 12

Hep B
transmission
Sx
Vaccine/Tx

Answer 12

transmission: viremia
Sx: 5% chronic, 90% acquire immunity, 70% asymptomatic
vaccine: available

Question 13

Hep C
transmission
Sx
Vaccine/Tx

Answer 13

transmission: viremia
Sx: 80% chronic
vaccine: none

Question 14

Delta Hep Virus
transmission
Sx
Vaccine/Tx

Answer 14

transmission: only when already infected with B, common in IV drug users
Sx: worse hepatitis than B alone
vaccine: vaccinate w/ hep B vaccine to prevent (requires B to be infected)

Question 15

Hep E

Answer 15

no chronic hepatitis

Question 16

Hep B–infancy tolerance?

Answer 16

exposure during infancy
acquire tolerance to virus
no inflammatory response –> no hepatitis
but still carrier!

Question 17

Chronic hepatitis definition

Answer 17

> 6 mo course of infection

Question 18

Most common cause of hepatic failure

Answer 18

acetaminophen overdose

Question 19

Transfused blood is screened for which hepatitis viruses?

Answer 19

B and C

Question 20

Type 1 autoimmune hepatitis

Answer 20

ANA +, anti-sm muscle actin

Question 21

Increase of this cell type in autoimmune hepatitis

Answer 21

plasma cells

Question 22

Tx of autoimmune hepatitis

Answer 22

immunosuppression

*reason it’s very different to distinguish from viral hepatitis

Question 23

Cirrhosis

Answer 23

diffuse interconnected fibrous scars

from Stellate cells

Question 24

Healing cirrhosis

Answer 24

regression possible
breakdown/remodeling of fibrous scars
occurs when pathology is resolved

Question 25

Reye syndrome

pathology

Answer 25

widspread mitochondrial damage

Question 26

Ascites and portal vein thrombosis

Answer 26

ascites does not occur in setting of portal vein thrombosis