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Gastrointestinal System > Liver Pathology > Flashcards

Liver Pathology Flashcards

1
Q

What are the normal functions of the liver?

A

Storage

  • glycogen
  • vitamins
  • iron
  • copper

Synthesis

  • glucose
  • protein
  • lipids & cholesterol
  • bile
  • coagulation factors
  • albumin

Metabolism

  • bilirubin
  • ammonia
  • drugs
  • alcohol
  • carbohydrate/lipids
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2
Q

What is cirrhosis?

A

Irreversible scarring of the liver

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3
Q

What happens to the liver in cirrhosis?

A

Ongoing inflammation
Fibrosis
Hepatocyte necrosis

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4
Q

What is the end result of cirrhosis?

A

Impairment of liver function

Vascular changes - portal hypertension

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5
Q

What can cause cirrhosis?

A

Drugs

  • alcohol
  • iatrogenic

Infection

  • hep b
  • hep c

Deposition

  • fat
  • iron
  • copper

Autoimmune

  • hepatitis
  • primary biliary cirrhosis
  • primary sclerosing cholangitis

Other

  • α1 antitrypsin
  • glycogen storage disease
  • budd-chiari disease
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6
Q

What are 3 main mechanisms alcohol can affect the liver?

A

Fatty change
Alcoholic hepatitis
Cirrhosis

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7
Q

What are the signs of fatty liver?

A

Hepatomegaly

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8
Q

Is fatty liver reversible?

A

Yes

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9
Q

What are the signs of alcoholic hepatitis?

A

Rapid onset jaundice
Tender hepatomegaly
Nausea
Oedema

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10
Q

Is alcoholic hepatitis reversible?

A

Yes initially

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11
Q

Does hepatitis B have a vaccine?

A

Yes

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12
Q

Does hepatitis B have a cure?

A

No

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13
Q

Does hepatitis C have a vaccine?

A

No

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14
Q

Does hepatitis C have a cure?

A

Yes

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15
Q

What is non-alcoholic liver disease?

A

Accumulation of triglycerides in hepatocytes - causes similar pathogensis to ALD

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16
Q

What is hereditary haemochromatosis?

A

Abnormal iron metabolism

17
Q

What is the inheritance pattern of hereditary haemochromatosis?

A

Autosomal recessive

18
Q

What is the effect of hereditary haemochromatosis?

A

Increased absorption of iron
- excess deposition

Elevated serum iron
Abnormal LFTs

19
Q

How is hereditary haemochromatosis managed?

A

Venesection

20
Q

What is Wilson’s disease?

A

Abnormal copper metabolism

21
Q

What is the inheritance pattern of Wilson’s disease?

A

Autosomal recessive

22
Q

What is the effect of Wilson’s disease?

A

Reduced secretion of copper from biliary system

- accumulates in tissues

23
Q

What is a sign of Wilson’s disease?

A

Kayser-Fleischer ring around iris

24
Q

How is Wilson’s disease managed?

A

Chelating agents

Zinc

25
Q

What is primary sclerosing cholangitis?

A

Fibrosis of intra and extra hepatic bile ducts

26
Q

Who is more commonly affected by primary sclerosing cholangitis?

A

Men

27
Q

What are the symptoms of primary sclerosing cholangitis?

A

Asymptomatic

Pruritus
Cholangitis
Jaundice

28
Q

Which antibody is present in primary sclerosing cholangitis?

A

ANCA

29
Q

What is primary biliary cirrhosis?

A

Destruction of intrahepatic bile ducts

30
Q

Who is more commonly affected by primary biliary cirrhosis?

A

Women

31
Q

What are the symptoms of primary biliary cirrhosis?

A

Asymptomatic

Pruritus
+/- jaundice

32
Q

What antibody is present in primary biliary cirrhosis?

A

AMA

33
Q

What is portal hypertension?

A

Build up of blood in the portal venous system

34
Q

What cause portal hypertension?

A

Fibrotic liver

  • No very expandable
  • compresses veins entering liver
  • increased hydrostatic pressure in portal system
35
Q

What are the effects of portal hypertension?

A

Ascites - increased hydrostatic pressure

Varices - shunt from portal to systemic system

36
Q

What are the common sites of varices?

A

Oesophageal
Umbilical
Anorectal

37
Q

What are umbilical varices also known as?

A

Caput medusa

38
Q

What is hepatorenal syndrome?

A

Development of AKI in the presence of cirrhosis

39
Q

How does hepatorenal syndrome occur?

A

Portal hypertension

Arterial vasodilation - splanchnic artery

RAAS activated

Renal artery vasoconstriction

Gastrointestinal System (16 decks)

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