liver pathology Flashcards
What is liver cirrhosis
the developmetn of regenerative nodules surrounded by fibrous bands in response to chronic liver injury
Possible causes of liver cirrhosis
viral infection
Alcohol
MASL
Autoimmune disorders
Wilson’s disease
Alpha 1 anti-trypsin
Budd-Chiari
What are the four features of liver cirrhosis
Increased fibrillar collagen
Decreased exchange of metabolites and oxygen across the space of Disse
Increased angiongensis, sinus remodelling, and HSC
Increased sinusoidal resistance and portal hypertension
How can liver cirrhosis be diagnosed
Biopsy
Serum markers
Elastogrpahy
ELF
Fibroscan
What are examples of liver storage diseases (3)
haemochromatosis
Wilson’s disease
Alpha 1 anti-trypsin deficiency
What is meant by haemochromatosis (2)
when there is excess iron in the liver
Can be genetic or due tot iron overload from diet/blood transfusion/therapy
What is the clinical presentation of haemochromatosis (3)
cirrhosis
Cardiomyopathy
Pancreatic failure
What is Wilson’s disease(3)
(Autosomal recessive) disorder of copper metabolism
Results in copper deposits
Typically in liver and basal ganglia
What is used in the diagnosis of Wilson’s disease (3)
low serum caeruloplasin
Urinary copper
Kaiser Fleisher rings
What is alpha 1 anti-trypsin deficiency
an autosomal recessive disorder of production of an enzyme inhibitor
What is the clinical presentation of alpha 1 anti-trypsin deficiency (4)
lung emphysema
Deposits of mutant proteins in liver
Cell damage in liver
Liver cirrhosis
What is Budd-Chiari disorder
Thrombosis of hepatic veins
What is the clinical presentation of Budd-Chiari (3)
if acute - jaundice and tender hepatomegaly
If chronic - ascites
What are the types of primary liver tumour (2)
Hepatocellular adenoma
Hepatocellualr caracinoma/hepatoma
Which primary liver tumour is associated with cirrhosis
Hepatocellular carcinoma
Describe the pathogenesis of alcoholic liver disease (3)
increased production of fatty acids and triglycerides in the liver
Acetylaldehyde - Mallory’s hyaline
Increased collagen synthesis
Features of alcoholic fibrosis
Collagen surrounding swollen/degenerate hepatocytes
What is MASLD (3)
Metabolic associated steatotic liver disease
Non-alcoholic
Excess fat accumulate sin the liver
What is the spectrum of steatotic liver disease (3)
steatosis
Steatohepatitis (fat w inflammation)
Fibrosis/liver cirrhosis
what condition is associated with MASLD
Type 2 diabetes
What is the clinical presentation of MASLD (4)
Asymptomatic
Hepatomegaly
ALT greater than AST
Increased echogenicity on US
What is used to diagnose NASH
biopsy w biomarkers
What is used to diagnose liver fibrosis (3)
biopsy
Fibroscan
Biomarkers
How is steatotic liver disease managed
lifestyle changes
