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Gastrointestinal > Liver Pathology III > Flashcards

Liver Pathology III Flashcards

1
Q

True or false: many of the drug induced liver diseases mimic other liver clinical diseases

A

True

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2
Q

What is phase I part of drug metabolism?

A

Oxidation
Reduction
Hydrolysis

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3
Q

What is phase II parts of liver metabolism?

A

Glucuronidation

and others

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4
Q

What zone of the liver is susceptible to toxic metabolites? WHy?

A

Zone 3

has lowest oxygen content

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5
Q

What type of drugs produce specific, predictable lesions of the liver?

A

Intrinsic

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6
Q

What type of drugs cause unpredictable lesions in the liver, and hypersensitivity reactions?

A

Idiosyncratic

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7
Q

Macrovesicular fatty change occurs with what type of liver insult? Microvesicular?

A 
Maco = EtOH
Micro = tetracyclines, salicylates,
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8
Q

What is the effect of acetaminophen on the liver?

A

Necrosis

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9
Q

What is the effect of tetracycline on the liver?

A

Microsteatosis

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10
Q

What is the effect of methotrexate on the liver?

A

Macrosteatosis

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11
Q

What is the effect of halothane on the liver?

A

Hepatitis

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12
Q

What is the effect of isoniazid on the liver?

A

Hepatitis

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13
Q

What is the effect of amiodarone on the liver?

A

Fibrosis

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14
Q

What is the effect of steroids on the liver?

A

Cholestasis

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15
Q

What is the effect of erythromycin on the liver?

A

Cholestasis

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16
Q

Porto-central bridging necrosis happens with what drug?

A

Halothane

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17
Q

Pathologic changes in the liver are seen with what level of daily EtOH consumption in men? Women?

A

Men >80g/day

Women >40g/day

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18
Q

What is the initial liver change with EtOH consumption? Is this reversible?

A

Steatosis

Reversible

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19
Q

What is the intermediate liver change with EtOH consumption? Is this reversible?

A

hepatitis

Reversible

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20
Q

What is the chronic liver change with EtOH consumption? Is this reversible?

A

Cirrhosis

Not reversible

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21
Q

What type of inflammation occurs with acute hepatitis? Chronic?

A 
Acute = PMN infiltration, mild fibrosis
Chronic = hyaline change + severe fibrosis
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22
Q

Where in the liver does most of the fat accumulate?

A

Pericentral (centrilobular) zone

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23
Q

Mallory bodies = ?

A

Hyaline change in the liver secondary to fatty liver EtOH

24
Q

What are the large eosinophilic bodies in hepatocytes secondary to EtOH consumption?

A

Megamitochondria

25
Q

Trichrome stain highlights what?

A

Fibrosis/collagen deposition

26
Q

What is the pattern of fibrosis in fatty liver?

A

Chicken-wire

27
Q

What forms the nodules in livers?

A

Bridging fibrosis

28
Q

What are the lab findings characteristics of alcoholic steatohepatitis? (CBC, LFTs x2)

A
  • Leukocytosis
  • AST:ALT >(2:1)
  • Alk Phos increased
29
Q

What is the cause of Wernicke-Korsakoff syndrome?

A

It is a manifestation of thiamine (vitamin B1) deficiency

30
Q

What are the four usual causes of death with chronic alcoholism?

A

Hepatic coma
Massive GI hemorrhage
Infx
Hepatorenal syndrome

31
Q

What are the two drugs that can cause steatohepatitis?

A

Tamoxifen

Nifedipine (DHP CCB)

32
Q

What are the two arterial supplies to the liver?

A

Hepatic artery

Portal vein

33
Q

What is Budd-Chiari syndrome?

A

Hepatic vein obstruction and/or IVC

34
Q

How does right heart failure cause liver failure? Left heart failure?

A

Right = Backup of blood causes congestion in the liver.

Left = Hypoxia secondary to loss of blood supply from the hepatic artery

35
Q

Why is liver infarction rare?

A

Liver has dual blood supply

36
Q

What is chemo-embolisation?

A

Giving chemo to the liver via the portal vein

37
Q

What is polyarteritis nodosa? What liver pathology can this cause?

A

Systemic vasculitis of unknown etiology, that often presents with nonspecific symptoms.

Infarction d/t fibrosis of arteries

38
Q

What are the intrahepatic causes of portal vein thrombosis? (4)

A

Cirrhosis
Malignancy
Stasis
Pregnancy

39
Q

What are the usual causes of extrahepatic portal vein thrombosis?

A

Appendicitis
Diverticulitis
Pancreatitis
Coagulopathies

40
Q

What are the ssx of poratal vein thrombosis?

A

Abdo pain
Portal HTN
Varices/ascites

41
Q

What is pylephlebitis?

A

An uncommon thrombophlebitis of the portal vein or any of its branches (ie a portal vein thrombosis) that is caused by infection

42
Q

What are infarcts of Zahn?

A

Infarcts in the hepatocytes causing atrophy without necrosis

43
Q

What can cause Budd-Chiari syndrome?

A

Clotting or obstruction of the hepatic vein and/or IVC

44
Q

Long term right heart failure can have what effect on the liver?

A

Cardiogenic sclerosis of the liver

45
Q

What are the heart diseases that can affect the liver?

A

Pericarditis
Right heart failure
Congenital heart disease

46
Q

What causes nutmeg liver?

A

centrilobular hemorrhage necrosis usually d/t right heart failure

47
Q

What is the cause of paroxysmal nocturnal hemoglobinuria? What effect does this have on the liver?

A

Acquired loss of Decay Accelerating Factor (DAF) on RBCs causes complement destruction

Causes hypercoagulable state, which can lead to Budd-Chiari syndrome

48
Q

What are the ssx of chronic Budd-Chiari syndrome?

A

Portal HTN
Cirrhosis
Obliterative hepatocavopathy

49
Q

What are the ssx of acute Budd-Chiari syndrome?

A

Abdo pain
Hepatomegaly
Ascites
Jaundice

50
Q

What is obliterative hepatocavopathy?

A

IVC obstruction due to membranous webs, leading to edema of the legs and abdominal wall

51
Q

What is veno-occlusive disease of the liver?

A

A condition in which some of the small veins in the liver are obstructed. It is a complication of high-dose chemotherapy given before a bone marrow transplant (BMT) and is marked by weight gain due to fluid retention, increased liver size, and raised levels of bilirubin in the blood.

52
Q

What are the chemicals that can cause veno-occlusive disease?

A

Bush tea alkaloids

53
Q

What are the ssx of veno-occlusive disease of the liver?

A 
Portal HTN
Tender hepatomegaly
Weight gain
Jaundice
Renal failure
54
Q

What does silver stain highlight?

A

Reticular fibers

55
Q

What does trichrome stain highlight?

Gastrointestinal (42 decks)

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