Liver Pathology Flashcards
What is the weight of the liver
1400-1600g
How many blood supply does the liver have and can you mention them
It has dual blood supply and it is the portal vein and hepatic artery
What percent does the portal vein supply
The portal vein supplies 60-70 percent of the hepatic blood flow
What percent does the hepatic artery supply
The hepatic artery supplies 30 -40 percent of
In liver cirrhosis what usually happens to the liver
The liver is always shrunken (micronodular)
Another name for hilum of the liver
Porta hepatis
What is hilum of the liver
Hilum of the liver or porta hepatis that is where the blood vessels go in and out from.
Where is hilum of the liver located
It is located at the inferior aspect
Where is the portal triad located
Periphery of the liver (zone1)
What does zone 3 stand for
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
Functions of the liver(5)
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
The metabolite of paracetamol(acetaminophen)
N-acetyl-p-benzoquinone imine(NAPQI)
Mention the hepatotrophic viruses
A,B,C,D and E
The hepatotrophic viruses that is transmitted through faeco-oral transmission is?
A and E
The hepatotrophic viruses that is transmitted through par enteral is ?
B,C ,D
Mention 5 non hepatotrophic viruses
Epstein Barr viruses
Cytomegalovirus
Herpes simplex virus
Yellow fever virus
Adeno virus
When there is liver damage what usually happens to enzymes and products
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
The hepatotrophic virus that cause chronic liver disease is
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
What happens to the liver during hepatomegaly ,tumor and congestion
They all increase and hepatomegaly (>1600g)
What is congestion
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
What is hyperemia
Hyperemia is an active process due to arterial dilation leading to increase blood flow and redness
Difference betweeen congestion and hyperemia
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
How does non hepatotrophic viruses cause hepatitis
They cause hepatitis but it’s usually associated with systemic infection
Commonest malignant tumor of the bile duct
Adenocarcinoma
Commonest benign tumor of the liver
1.cavernous hemangioma
2.Hepatocellular Adenomas
Tumors of the liver can be
Benign or malignant
Malignant tumor of the liver is divide into two and which is the most commonest
Primary and secondary (metastatic )
Metastatic tumor is the most common malignant tumor or most common tumor seen in the liver
Commonest tumor seen in the liver is?
Metastatic tumor
Definition of liver cirrhosis
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
The four things you are meant to know about liver cirrhosis
- 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
Pathogenesis of liver cirrhosis
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
Mention 8 complications of liver cirrhosis
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
What viral hepatitis causes liver cirrhosis
Viral hepatitis B,C and D
Causes of liver cirrhosis
1.alcoholic liver disease
2.non alcoholic fatty liver disease
3.metabolic disease
4.untreated viral hepatitis
Liver cirrhosis is the most commonest cause of portal hypertension
Causes of metabolic liver disease can be
Acquired or inherited
Acquired metabolic liver disease
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
Inherited liver disease
Hemochromatosis
Wilson’s disease
Alpha1 antitrypsin deficiency (there is an imbalance between the antitrypsin and the trypsin itself)
The most commonest malignant tumor seen in children
Hepatoblastoma
How do you differentiate a primary tumor from a secondary tumor
Primary tumor usually have irregular large masses
Secondary tumor usually have small masses or nodules with a depression called CENTRAL UMBILICATION
What is the name of the depression at the middle of a secondary tumor
CENTRAL UMBILICATION
Choledococystitis
Inflammation of the bile duct
Cholelithiasis
It is the presence of gall stones in the gall bladder
Cholecystitis
Inflammation of the gall bladder
Another name for primary tumor and examples of primary tumor
Primary liver cell carcinoma/hepatocellular carcinoma/hepatoma
Examples
Hepatoblastoma
Secondary tumor is
Secondary tumor under malignant tumor it is different from hepatocellular carcinoma/primary and hepatoma
Examples of malignant tumor in the liver
Hepatocellular carcinoma
Intrahepatic cholangiocarcinoma
Angiosarcoma
Hepatoblastoma
Drug induced liver injury can be
Dose dependent (predictable)
Idiosyncratic (non predictable)
What are the 4 things that Epstein Barr virus cause
1.Mononucleosis
2.Hepatitis
3.burkitt lymphoma is a type of non Hodgkin’s lymphoma
4.nasopharyngeal carcinoma
