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liver pathology Flashcards

Discuss the common non-infectious entities resulting in liver injury and their clinicopathological characteristics Compare and contrast the clinicopathological characteristics of primary biliary cirrhosis and primary sclerosing cholangitis Describe the clinicopathologic features of fulminant hepatic failure Describe the causes and clinical presentations associated with cirrhosis

1
Q

massive liver necrosis inficates

A

acute liver failure

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2
Q

casues acute liver failure

A

drugs or viral hepatitis

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3
Q

signs of chronic liver failure

A

palmer erythema
apider angioma
hypogonadism/gynomastia in men

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4
Q

signs of acute liver failure

A

jaundice and encephalopathy, coaguopathy

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5
Q

retention of bile causes

A

jaundice

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6
Q

retention of bilirubin, bile salts and cholesterol

A

cholestasis

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7
Q

most common causes of jaundice

A

hepetitis, bile obstruction, hemolytic anemia

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8
Q

mild, fluctuating unconjugated hyperbilirubinmea - inborn

A

Gilbert

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9
Q

charecteristic of hepatic encephalopathy

A

flapping tremor

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10
Q

pathenogensis of hepatic encephalopathy

A

severe loss of hepatocellular function

shunting of blood from portal to systemic circulation around chronically diseased liver

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11
Q

causes hepatic encephalopathy in actute/chronic setting

A

ammonia/deranged NT production (especially GABA)

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12
Q

fibrosis and concersion of normal liver architecture into structuraly abnormal nodules

A

cirrhosis

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13
Q

fibrous septa and parachymal nodules

A

cirrhosis

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14
Q

pathogenesis process of cirrhosis

A

death of hepatocytes
extracellular matrix deposition
vascular reorg

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15
Q

anoerxia, weight loss, weakness may indicate

A

cirrohsis

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16
Q

fatal outcomes of liver cirrhosis

A

progressive liver failure
portal hypertension complications
hepatocellular carcinoma

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17
Q

signs of portal hypertension

A 
ascites
esophogeal varices
splenomegaly
caput medusae
hemorroids
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18
Q

can cause massive and fatal bleeding in portal hypertension

A

esophogeal varices

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19
Q

most important agent that produces toxic liver injury

A

EtOH

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20
Q

clues of heppatopulmonary syndrome

A

eaiser breathing lying down, fall of arterial blood oxygen with upright posture

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21
Q

most common toxin leading to acute liver failure needed transplant

A

acetomenophen

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22
Q

type of hepititis with less inflammation and more hepatocyte death

A

acute

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23
Q

female, elevated IgG, high titwers of autoantiboodies and liver damage signs

A

autoimmune hepatitis

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24
Q

“chicken-wire fence” histology

A

non-alchoholic fatty liver disease

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25
Q

manifestations of alchoholic liver disease

A

hepatic steatosis, alchoholic hepatitis, cirrohsis

26
Q

years it takes most people to progress to alchoholic cirrhosis

A

10-15 years

27
Q

risk factors of NAFLD

A

DM type 2
obesity
syslipidemia
hypertension

28
Q

pathogensis of NAFLD

A

impaired oxidation of fatty acids
increasd synthesis and uptake of fatty acids
decreasd hepatic secretion of VLDL cholesterol

29
Q

what you see in EtOH fatty liver disease, but not NAFLD

A

heptocyte balloning
denk bodies
neutophillic infiltration

30
Q

casues EtOH fatty liver disease

A

changes in lipid metabolism
ROS
cytokines

31
Q

time period of neonatal cholestasis

A

birth to 14days

32
Q

collapse of liver parenchyma leaving only shriveled organ with wrinkled capsule

A

fulminant hepatic failure

33
Q

most common cause of fulminant hepatic failure

A

viral hepatitis

34
Q

most common cause of cirrhosis

A

EtOH

35
Q

compression of sinusoids and central veins, reduction in number of functional sinusoids

A

cirrhosis

36
Q

metabolism functions affected in liver failure

A

nitrogen metabolism
circulating protein production
biliary excretory function
steroid hormone metabolism

37
Q

most common type of autoimmune hepatitis

A

type 1

38
Q

HLA-DR3/4 associated with

A

autoimmune hepatitis

39
Q

lab findings in autoimmune hepatitis

A

positive antinuclear antibody test and anti-smooth muscle antbodies

40
Q

anti-smooth muscle antibodies

A

autoimmune hepatitis

41
Q

multinucleated cells

A

neonateal hepititis

42
Q

most common causes of neonate hepatitits

A

CMV or inborn errors of metabolism

43
Q

causes of microvesicular fatty liver

A

reye’s syndrome
fatty liver of pregnancy
tetracycline tox

44
Q

get from taking asprin with acute viral infections

A

reye’s

45
Q

encephalopathy, fatty liver changes, transaminase elevation in kid home-treated with an acute viral infection; think -

A

reye’s

46
Q

groosly enlarged, pale, waxy liver

A

fatty liver

47
Q

treatment for EtOH liver

A

stop drinking. Can be reversed

48
Q

causes EtOH hepatitis

A

acetaldehyde damage to hepatocytes

49
Q

hepatocyte swelling and necrosis
intracytoplasmic depositis of cytokeratin
neutophilic infiltrate

A

alchoholic hepatits

50
Q

point of no return of alcholic hepatists

A

fibrosis

51
Q

chronic progressive cholestatic liver disease with destruction of intrahepatic ducts

A

Primary biliary cirrohosis

52
Q

woman with pruitis, fatige. elevated Alkaline phostphatase and cholersterol

A

Primary biliary cirrohosis

53
Q

anti-mitochondiral antibodies

A

Primary biliary cirrohosis

54
Q

franulomatous destruction of intrahepatic bile ducts

A

Primary biliary cirrohosis

55
Q

inflamation, obiliterative fibrosis, segmental involvement of intra and extra heptic bile ducts

A

primary schlerosiing cholangitis

56
Q

associated with inflammatory bowel disease

A

primary schlerosiing cholangitis

57
Q

male, 30-60 with fatige, itching and jaundice

A

primary schlerosiing cholangitis

58
Q

primary schlerosiing cholangitis has increased risk, long term, of

A

cholangiocarcinoma

59
Q

onion skin lesion

A

cholangiocarcinoma

60
Q

diagnosing test of primary schlerosiing cholangitis

A

ERCP (“beading” of bile ducts)

61
Q

leads to obiliteration od bile duct, leading to cholestatis and cirrhoss

A

primary schlerosiing cholangitis

62
Q

primary liver disease with p-ANCA

A

primary schlerosiing cholangitis

GI (22 decks)

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