Liver Pathology

Question 1

What is the weight of the liver

Answer 1

1400-1600g

Question 2

How many blood supply does the liver have and can you mention them

Answer 2

It has dual blood supply and it is the portal vein and hepatic artery

Question 3

What percent does the portal vein supply

Answer 3

The portal vein supplies 60-70 percent of the hepatic blood flow

Question 4

What percent does the hepatic artery supply

Answer 4

The hepatic artery supplies 30 -40 percent of

Question 5

In liver cirrhosis what usually happens to the liver

Answer 5

The liver is always shrunken (micronodular)

Question 6

Another name for hilum of the liver

Answer 6

Porta hepatis

Question 7

What is hilum of the liver

Answer 7

Hilum of the liver or porta hepatis that is where the blood vessels go in and out from.

Question 8

Where is hilum of the liver located

Answer 8

It is located at the inferior aspect

Question 9

Where is the portal triad located

Answer 9

Periphery of the liver (zone1)

Question 10

What does zone 3 stand for

Answer 10

It stands for where the central vein is located also the zone that would suffer if there was an obstruction at zone 1 and zone 2 because it’s far

Question 11

Functions of the liver(5)

Answer 11

1)Manufacture and excretion of bile
2)manufacture of several major plasma proteins
3)detoxification of toxic substances such as alcohol and drugs
4)Storage of vitamins and irons
5)metabolism of carbohydrates,proteins and lipids

Question 12

The metabolite of paracetamol(acetaminophen)

Answer 12

N-acetyl-p-benzoquinone imine(NAPQI)

Question 13

Mention the hepatotrophic viruses

Answer 13

A,B,C,D and E

Question 14

The hepatotrophic viruses that is transmitted through faeco-oral transmission is?

Answer 14

A and E

Question 15

The hepatotrophic viruses that is transmitted through par enteral is ?

Answer 15

B,C ,D

Question 16

Mention 5 non hepatotrophic viruses

Answer 16

Epstein Barr viruses
Cytomegalovirus
Herpes simplex virus
Yellow fever virus
Adeno virus

Question 17

When there is liver damage what usually happens to enzymes and products

Answer 17

Enzymes leak out of the hepatocytes so they are increased while products are reduced because the hepatocytes are damaged there are no hepatocytes to produce them

Question 18

The hepatotrophic virus that cause chronic liver disease is

Answer 18

B and C but the D is also part because it causes a coinfection or Supra infection with B
Hepatitis D need hepatitis B to be activated

Question 19

What happens to the liver during hepatomegaly ,tumor and congestion

Answer 19

They all increase and hepatomegaly (>1600g)

Question 20

What is congestion

Answer 20

Congestion can be defined as a passive process due to the obstruction of venous blood flow leading to decreased blood flow which would cause cyanosis

Question 21

What is hyperemia

Answer 21

Hyperemia is an active process due to arterial dilation leading to increase blood flow and redness

Question 22

Difference betweeen congestion and hyperemia

Answer 22

Congestion
1.passive process
2.There is decreased blood flow
3.cyanosis
4.obstruction to venous blood flow
Hyperemia
1.active process
2.arterial dilation
3.increased blood flow
4.Redness

Question 23

How does non hepatotrophic viruses cause hepatitis

Answer 23

They cause hepatitis but it’s usually associated with systemic infection

Question 24

Commonest malignant tumor of the bile duct

Answer 24

Adenocarcinoma

Question 25

Commonest benign tumor of the liver

Answer 25

1.cavernous hemangioma 2.Hepatocellular Adenomas

Question 26

Tumors of the liver can be

Answer 26

Benign or malignant

Question 27

Malignant tumor of the liver is divide into two and which is the most commonest

Answer 27

Primary and secondary (metastatic ) Metastatic tumor is the most common malignant tumor or most common tumor seen in the liver

Question 28

Commonest tumor seen in the liver is?

Answer 28

Metastatic tumor

Question 29

Definition of liver cirrhosis

Answer 29

Liver cirrhosis can be defined as a severe chronic liver disease that is marked by remodeling of the liver into parenchyma nodules which are often regenerative and are often surrounded by fibrous bands

Question 30

The four things you are meant to know about liver cirrhosis

Answer 30

1. It is a chronic liver disease 2.There is distortion of the architecture of the liver 3.There is formation of parechymal regenerative nodules 4.There is fibrosis

Question 31

Pathogenesis of liver cirrhosis

Answer 31

Between the hepatocytes there are spaces called sinusoids and the sinusoids are lined by fenestrated endothelial cells .between the sinusoids and the hepatocytes there is a space called the space of DISSE ,in this space there are special cells called hepatic lipocytes,hepatic Stella the cells and ITO cells they are also known as fat cells or vitamin A storing cells So the macrophages in the liver known as kupffer cells produces PDGF(platelet derived growth factor ) and TNF (tumor necrosis factor )which activates the ITO cells and this cells are contracted by endothelin 1. The kupffer cells produces transforming growth factor B which makes the contracted ito cell to deposit fibrous tissue which makes them fibroblastic

Question 32

Mention 8 complications of liver cirrhosis

Answer 32

1.Hepatic encephalopathy 2.Bleeding from oseophageal varices secondary to portal hypertension 3.Bacteria infections 4.Hepatorenal syndrome 5.liver failure 6,hepatocellular carcinoma 7.death 8.coagulopathies

Question 33

What viral hepatitis causes liver cirrhosis

Answer 33

Viral hepatitis B,C and D

Question 34

Causes of liver cirrhosis

Answer 34

1.alcoholic liver disease 2.non alcoholic fatty liver disease 3.metabolic disease 4.untreated viral hepatitis

Question 35

Liver cirrhosis is the most commonest cause of portal hypertension

Question 36

Causes of metabolic liver disease can be

Answer 36

Acquired or inherited

Question 37

Acquired metabolic liver disease

Answer 37

Non alcoholic fatty liver disease(NAFLD) it can be defined as the accumulation of fat into the liver usually not caused by a significant amount of alcohol .it can be seen in obesity and diabetes

Question 38

Inherited liver disease

Answer 38

Hemochromatosis Wilson’s disease Alpha1 antitrypsin deficiency (there is an imbalance between the antitrypsin and the trypsin itself)

Question 39

The most commonest malignant tumor seen in children

Answer 39

Hepatoblastoma

Question 40

How do you differentiate a primary tumor from a secondary tumor

Answer 40

Primary tumor usually have irregular large masses Secondary tumor usually have small masses or nodules with a depression called CENTRAL UMBILICATION

Question 41

What is the name of the depression at the middle of a secondary tumor

Answer 41

CENTRAL UMBILICATION

Question 42

Choledococystitis

Answer 42

Inflammation of the bile duct

Question 43

Cholelithiasis

Answer 43

It is the presence of gall stones in the gall bladder

Question 44

Cholecystitis

Answer 44

Inflammation of the gall bladder

Question 45

Another name for primary tumor and examples of primary tumor

Answer 45

Primary liver cell carcinoma/hepatocellular carcinoma/hepatoma Examples Hepatoblastoma

Question 46

Secondary tumor is

Answer 46

Secondary tumor under malignant tumor it is different from hepatocellular carcinoma/primary and hepatoma

Question 47

Examples of malignant tumor in the liver

Answer 47

Hepatocellular carcinoma Intrahepatic cholangiocarcinoma Angiosarcoma Hepatoblastoma

Question 48

Drug induced liver injury can be

Answer 48

Dose dependent (predictable) Idiosyncratic (non predictable)

Question 49

What are the 4 things that Epstein Barr virus cause

Answer 49

1.Mononucleosis 2.Hepatitis 3.burkitt lymphoma is a type of non Hodgkin’s lymphoma 4.nasopharyngeal carcinoma