Liver Pathology Flashcards
what makes up the portal triad
hepatic a
portal v
bile ductule
how is a hepatic lobule perfused
center = centrolobular v edges = bundles of portal triads
what are the risks and benefits of Z1 (periportal) in a hepatic lobule
most O2 - least at risk of ischaemia
inc risk from viral hep
what are the risks and benefits of Z3 (periventricular) in a hepatic lobule
most mature/metab active - most liver enz, least O2
inc risk ischemia, inc damage from metab toxis (alco, paracetamol)
what causes acute hepatitis
Hep A/E, drugs
acute hep histology
spotty necrosis
histo of chronic hep
piecemeal necrosis/ - loss of border between portal triad and perenchyma -> bridging fibrosis from portal V to central V
histology of cirrhosius
distortion of vasc architecture, hepatocyte nec, fibrosis
changes to nodule size of regenerating hepatocytes in cirrhosis
alcoholic -> micro
viral/ alpha1/wilsons -> macro
what are some complications of cirrhosis
portal HTN
hepatic encephalopathy
hepatocellular carcinoma
what are the 3 different types of alcoholic liver disease and how do the exist
can all co-exist
- hepatic steatosis
- alco hep
- alco cirrhosis
what is hepatic steaosis
lrg, pale yellow liver - due to fat droplets in hepatocytes
fully reversible
presentation and histo of alco hep
large, fibrotic liber
hepatocye balooning, mallory denk bodies, Z3 damage
presentation and histo of alcoholic ciurrhosis
shrunken brown liver, micronodular cirrhosis
how will NAFLD present
similar to ALD
distiguish based on Hx - insulin res, inc BMI, diabetes
associations of pri sclerosis cholangitis (PSC)
M>F
UC
cholangiocarcinoma
what is the antibody in PSC
pANCA
what will an ultrasound show in PSC
bile duct dilation, onion skinning fibrosis, beading of bile ducts
what are the asso of pri biliary cirrhosis (PBC)
F>M
inflammatory
asso w/ other AI cond
what is the antibody in PBC
anti-mitochondrial Abs
what will a USS show in PBC
bile duct loss with granulomas
no dilation
who is most likely to get AI hep
young or post-menopausal F with other AI cond
what are the 2 types of AI hep
T1 - anti-nuclear ab, anti-smooth muscle ab
T2 - anti liver/kidney microsomal IG
what is the histo of haemachromatosis
inc gut Fe absorbtion -> Fe deposits in hepatocytes -> damage
