Liver Pathology and Patterns of Injury Flashcards
Chronic liver injuries lead to _____
fibrosis
How does a liver respond to acute injury?
death or regeneration
Key feature of cirrhosis
disruption of hepatocellular architecture by fibrosis w/ associated regions of regenerative hepatocytes
Stages of cirrhosis
normal –> expansion –> septae –> bridging of septae –> cirrhosis
Where does ALT live?
liver predominant (cytoplasm)
Where does GGT live?
bile canaliculus of hepatocyte –> indicator of biliary process
Where does AST live?
muscle, kidney, liver (cytoplasm and mitchondria)
Where does LDH live?
heart, kidney –> not a sign of liver involvement
Elevated serum enzymes result from ______ post cellular injury
cytoplasmic blebbing
In what cases is AST > ALT?
alcohol hepatitis and Wilson’s disease –> mitochondrial involvement
How does GGT increase after injury to the biliary tree?
increased synthesis (compensative) and secretion
What is different about the caudate lobe vs other lobes of liver?
has independent venous drainage into vena cava –> not dependent on hepatic vein –> safer during times of damage
Initial response to outflow blockage (e.g. right side heart failure).
hepatomegaly resulting in pain and leakage (ascites) –> congestion (zone 3) –> nutmeg liver
Chronic consequence of outflow blockage (e.g. right side heart failure).
cardiac type fibrosis (zone 3) in all lobes, atrophy of hepatocytes (low blood, pressure)
Consequence of outflow blockage (e.g. hepatic vein ala Budd-Chiari).
acute: caudate sparing, hepatomegaly, pain, ascites
chronic: caudate hepatomegaly, atrophy and fibrosis of rest of liver
