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T's Histopathology Y5 > Liver Pathology > Flashcards

Liver Pathology Flashcards

1
Q

what makes up the portal triad

A

hepatic a
portal v
bile ductule

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2
Q

how is a hepatic lobule perfused

A 
center = centrolobular v
edges = bundles of portal triads
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3
Q

what are the risks and benefits of Z1 (periportal) in a hepatic lobule

A

most O2 - least at risk of ischaemia

inc risk from viral hep

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4
Q

what are the risks and benefits of Z3 (periventricular) in a hepatic lobule

A

most mature/metab active - most liver enz, least O2

inc risk ischemia, inc damage from metab toxis (alco, paracetamol)

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5
Q

what causes acute hepatitis

A

Hep A/E, drugs

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6
Q

acute hep histology

A

spotty necrosis

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7
Q

histo of chronic hep

A

piecemeal necrosis/ - loss of border between portal triad and perenchyma -> bridging fibrosis from portal V to central V

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8
Q

histology of cirrhosius

A

distortion of vasc architecture, hepatocyte nec, fibrosis

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9
Q

changes to nodule size of regenerating hepatocytes in cirrhosis

A

alcoholic -> micro

viral/ alpha1/wilsons -> macro

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10
Q

what are some complications of cirrhosis

A

portal HTN
hepatic encephalopathy
hepatocellular carcinoma

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11
Q

what are the 3 different types of alcoholic liver disease and how do the exist

A

can all co-exist

  • hepatic steatosis
  • alco hep
  • alco cirrhosis
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12
Q

what is hepatic steaosis

A

lrg, pale yellow liver - due to fat droplets in hepatocytes

fully reversible

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13
Q

presentation and histo of alco hep

A

large, fibrotic liber

hepatocye balooning, mallory denk bodies, Z3 damage

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14
Q

presentation and histo of alcoholic ciurrhosis

A

shrunken brown liver, micronodular cirrhosis

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15
Q

how will NAFLD present

A

similar to ALD

distiguish based on Hx - insulin res, inc BMI, diabetes

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16
Q

associations of pri sclerosis cholangitis (PSC)

A

M>F
UC
cholangiocarcinoma

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17
Q

what is the antibody in PSC

A

pANCA

18
Q

what will an ultrasound show in PSC

A

bile duct dilation, onion skinning fibrosis, beading of bile ducts

19
Q

what are the asso of pri biliary cirrhosis (PBC)

A

F>M
inflammatory
asso w/ other AI cond

20
Q

what is the antibody in PBC

A

anti-mitochondrial Abs

21
Q

what will a USS show in PBC

A

bile duct loss with granulomas

no dilation

22
Q

who is most likely to get AI hep

A

young or post-menopausal F with other AI cond

23
Q

what are the 2 types of AI hep

A

T1 - anti-nuclear ab, anti-smooth muscle ab

T2 - anti liver/kidney microsomal IG

24
Q

what is the histo of haemachromatosis

A

inc gut Fe absorbtion -> Fe deposits in hepatocytes -> damage

25
Q

what is the inheritance and age range of haemachromatosis

A

auto rec

likely in 40-50y olds

26
Q

how will haemachromatosis present

A

skin bronzing + diabetes + hepatomeg

27
Q

what is the diagnostic inv for haemachromatosis

A

prussian blue stain

28
Q

what is the Tx for haemachromatosis

A

venesection + desferroxamine

29
Q

what is the inheritance and age of presentation of wilsons

A

Auto rec

11-14y

30
Q

what is the histo of wilsons disease

A

failure of hepatocytes to sec copper into bile -> accum

31
Q

what is the presentation of wilsons d

A

liver D, neuro degen (parkisonism), kaiser flescher rings (iris)

32
Q

what is the diagnostic inv for wilsons d

A

rhodanin stain

33
Q

what is the Tx for wilsons D

A

lifelong peniclillamine

34
Q

what is the histo of alpha 1 antitrypsin def

A

failure to sec A1AT _> accum in hepato -> forms periorbital globules -> chronic hep

35
Q

how will A1At def present

A

FHx resp issues
kids - neonatal jaundice
adults - emphysema with CLD

36
Q

what are the risk factors for hepatic adenoma

A

oral contraceptive

37
Q

what is the most common benign liver malig

A

haemangioma

38
Q

what is the marker for hepatocellular carcinoma

A

AFP

39
Q

what is hepatocellular carcinoma associated with

A

viral hep, alco cirr, NAFLD, aflatoxin

40
Q

what is the histo of cholangiocarcinoma

A

capillary ingrowth

41
Q

what cancer is associated with PSC

A

cholangiocarcinoma

42
Q

where do liver cancers met

A

GIT, breast or bronchus

T's Histopathology Y5 (22 decks)

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