Liver Pathology

Question 1

Diffuse bridging fibrosis and nodular regeneration via stellate cells disrupts normal architecture of liver

Answer 1

Cirrhosis

Question 2

Cirrhosis top 2 etiology?

Answer 2

Alcohol and Viral

Question 3

Acute pancreatitis markers?

Answer 3

amylase and Lipase

Question 4

More specific for Acute pancreatitis?

Answer 4

Lipase (amylase is everywhere)

Question 5

Alkaline phosphatase (ALP) in cirrhoris?

Answer 5

Cholestasis, HCC, Bone

Question 6

Alcoholic AST vs ALT

Answer 6

Alcoholic hepatitis (AST > ALT)

Question 7

Ceruloplasmin is decreased in?

Answer 7

Wilson disease

Question 8

γ-glutamyl transpeptidase (GGT) is elevated similar to ALP except one thing is not elevated, what is this?

Answer 8

In bone

Question 9

Reye’s Syndrome MOA?

Answer 9

aspirin metabolites􏰂=>decrease β-oxidation* by reversible inhibition of mitochondrial enzymes

Question 10

When is only time to give aspirin to a child?

Answer 10

Kawasaki’s disease

Question 11

Is Hepatic steatosis reversible?

Answer 11

Yes

Question 12

Where will you see Mallory Bodies?

Answer 12

Alcoholic hepatitis

Question 13

What are Mallory Bodies?

Answer 13

intracytoplasmic eosinophilic inclusions of damaged keratin filaments OR damaged IF

Question 14

Alcoholic cirrhosis is reversible?

Answer 14

No

Question 15

Alcoholic cirrhosis has what kind of appearance?

Answer 15

Hobnail

Question 16

Esp. what site is affected by Alcoholic cirrhosis

Answer 16

Zone 3

Question 17

Alcoholic cirrhosis without drinking alcohol

Answer 17

Non-alcoholic fatty liver disease

Question 18

Non-alcoholic fatty liver disease MOA? Associated with?

Answer 18

insulin resistance=> 􏰁fatty infiltration of hepatocytes=>􏰁cellular “ballooning” and eventual necrosis Obesity

Question 19

With Hepatic Encepathopathy, dietary protein, GI bleed, constipation, infection would increase production or decrease removal of NH3?

Answer 19

NH3 production

Question 20

With Hepatic Encepathopathy 􏰂(due to renal failure, diuretics, bypassed hepatic blood flow post-TIPS) would increase production or decrease removal of NH3?

Answer 20

NH3 removal

Question 21

Tx for Hepatic Encepathopathy?

Answer 21

Lactulose

Question 22

jaundice, tender hepatomegaly, ascites, polycythemia, anorexia?

Answer 22

HCC

Question 23

With HCC what specific carcinogen should you think of?

Answer 23

aflatoxin from Aspergillus

Question 24

How does HCC spread?

Answer 24

Hematogenously

Question 25

HCC Dx?

Answer 25

Increased AFP

Question 26

Rare, benign liver tumor that is found with OCP use?

Answer 26

Hepatic adenoma

Question 27

Budd Chiari Syndrome is?

Answer 27

Thrombosis or compression of hepatic veins with centrilobular congestion and necrosis=>congestive liver disease

Question 28

What is one key feature of Budd?

Answer 28

No JVD

Question 29

MCC of Budd?

Answer 29

Polycythemia

Question 30

cirrhosis with PAS ⊕ globules A in liver?

Answer 30

AAT1 def

Question 31

AAT 1 def is due to?

Answer 31

Misfolded gene product protein aggregates in hepatocellular ER

Question 32

AAT 1 is what kind of genetic form?

Answer 32

Codominant

Question 33

Answer 33

AAT 1 def

Question 34

Which allele is responsible for the misfolded protein in AAT 1 def?

Answer 34

PiZ allele

Question 35

PiZ allele leads to accumulation of misfolded protein in?

Answer 35

ER hepatocyte accumulation

Pizza goes to Liver=>GO to ER!

Question 36

PiMZ heterozygous, you have increased risk of?

Answer 36

emphysema w/smoking

Question 37

PIZZ homozgous=>increased risk of panacinar emphysema and cirrhoris