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Alimentry > Liver Pathology > Flashcards

Liver Pathology Flashcards

1
Q

What is the function of the liver

A

Fat and carb metabolism via production of bile
Protein synthesis
Removal of toxins

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2
Q

What are causes of acute live injury

A

Hepatitis from viruses alcohol and drugs

Bile duct obstruction

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3
Q

List the different hepatitis viruses

A

A,B,C,E

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4
Q

How do the different hepatitis viruses differ from one another

A

Structurally and mode of transmission

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5
Q

What is the pathology of viral hepatitis

A

Causes cell death and damage to individual cells

Leads to inflammation

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6
Q

What percentage of cells need to die for viral hepatitis to cause liver failure

A

Around 70%

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7
Q

What viral hepatitis may resolve acute inflammation

A

A and E

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8
Q

What viral hepatitis may lead to sever damage to liver

A

A,B and E

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9
Q

What viral hepatitis may lead to chronic hepatitis and cirrhosis

A

A and B

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10
Q

What is the pathology of alcoholic liver hepatitis

A 
Acute inflammation 
Liver cell death
Liver failure 
Same as viral 
Can lead to cirrhosis
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11
Q

What are the 3 phases for bilirubin metabolism

A

Pre hepatic
Hepatic
Post hepatic

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12
Q

Describe the pre-hepatic stage of bilirubin metabolism

A

Separation of haemaglobin to haem And globin

Haem is then converted to bilirubin which is released into circulation

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13
Q

What is the hepatic stage to bilirubin metabolism

A

Bilirubin is conjugated in the hepatocytes and released into bilary system

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14
Q

Describe post-hepatic bilirubin metabolism

A

Conjugated bilirubin is more water soluble allowing it to be transported to the small intestine and break it down

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15
Q

What is the enterprise-hepatic circulation of bilirubin

A

Re-absorption of bilirubin back to the liver

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16
Q

How can jaundice be classified

A

By the stage of bilirubin metabolism effected

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17
Q

Describe pr-hepatic jaundice

A

Lysis of red blood cells

Though this is usually small amount of bilirubin

18
Q

What are hepatic causes of jaundice

A

Cholestatsis

Intra-hepatic bile duct obstruction

19
Q

In relation to hepatic jaundice, what is cholestasis

A

Accumulation of bile within hepatocytes or bile canaliculi

20
Q

In relation to hepatic jaundice, what are the causes of cholestsasis

A

Viral hepatitis
Alcoholic hepatitis
Liver failure any cause
Drugs

21
Q

In drug induced cholestasis, are therapeutic drugs most likely to cause predictable or non-predictable reactions

A

Non-predictable

22
Q

What does it mean if a drug is predictable vs un predictable reaction

A

Predictable is dose related

Unpredictable is non dose related

23
Q

What are causes of intros-hepatic bile obstruction

A

Primary bilary cholangitis
Primary sclerosing cholangitis
Tumours of the liver

24
Q

What is primary biliary cholangitis

A

Organ specific autoimmune disease

25
Q

In someone with primary bilary cholangitis what clinical things should you consider

A

Female
Anti-mitochondrial auto antibodies
Raised serum alkaline phosphotase

26
Q

What is the pathology of primary biliary cholangitis

A

Granulomatous inflammations involving bile ducts
Loss of intra-hepatic bile ducts
Progression to cirrhosis

27
Q

What is primary sclerosing cholangitis

A

Chronic inflammation and fibrous obliteration of bile ducts

Loss of intra-hepatic bile ducts

28
Q

Someone presents with inflammatory bile disease, what else may you want to check for

A

Primary sclerosing cholangitis

29
Q

What is th pathology of primary sclerosising cholangitis

A

Profession to cirrhosis

30
Q

What specifically causes increased risk of cholangiocarcinoma

A

Primary sclerosing cholangitis

31
Q

Define hepatic cirrhosis

A

End stage chronic liver disease effecting whole of liv r

32
Q

What are the causes to cirrhosis

A 
Alcohol 
Hep B and C
Immune mediated 
Metabolic disorders: excess iron (primar haemochromatosis), excess copper (Wilson’s)
Obesity, diabetes mellitus
33
Q

What are the associated complications with liver cirrhosis

A

Altered liver function > liver failure
Abnormal blood flow > portal hypertension
Increased risk of hepstocellulaf carcinoma

34
Q

What are the different liver tumours

A 
Hepatocellular carinoma (associate with cirrhosis 
Cholangiocarcinoma (assoicated with primary biliary cholangitis 
Metastatic (other alimentary tumours)
35
Q

What are post hepatic jaundice causes

A

Cholelithiasis (gall(
Disease of gall
Extra-hepatic duct obstruction

36
Q

What are the risk factors for gallstones

A

Obesity

Diabetes

37
Q

What is the pathology of gall stones

A

Acute cholecystitis

Chronic cholecystitis

38
Q

What are the outcomes of acute cholecystitis

A

1) empyema
2) perforation leading to bilary peritonitis
3) progression to chronic

39
Q

What are th symptoms of chronic cholecystitis

A

Pain when eating

Especially fatty foods

40
Q

What is ascending cholangitis

A

Inflammation of bile duct due to California organism

41
Q

How is ascending cholangitis formed

A

Usually secondary to obstruction , gall stones for example

Alimentry (9 decks)

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