Liver Pathology Lecture 12 Flashcards
Where is unconjugated bilirubin conjugated
The hepatocytes of the liver
What substance is conjugated bilirubin secreted into?
Bile
What gives faeces its brown colour?
Sterocobulin
What does the gut bacteria convert conjugated bilirubin into?
Urobilinogen
Which part of haemoglobin is converted into bilirubin?
Haem
Which form of bilirubin is excreted into the kidneys
Urobilinogen
What causes the faeces to become pale?
Less conjugated bilirubin
Or a lack of bile ie due to obstruction
What is choleocystitis
Inflammation of the gall bladder
What is cholangitis?
Inflammation of the bile ducts
What type of change in the liver is steatosis
Fatty change in the liver
Which, steatosis or steatohepatitis is most commonly associated with alcoholics
Steatohepatitis
What is the difference between steatohepatitis and steatosis
Both are fatty liver
Steatohepatitis is associated with inflammation also
Repeated bouts of inflammation of the hepatocytes with fatty changes is associated with what?
Alcoholism
What does repeated bouts of hepatitis due to addiction lead to in the liver?
Fatty changes
Inflammation
Liver cell death
What is the progression of fatty liver disease? 1-4
- Steatosis
- Steatohepatitis
- Fibrosis
- Cirrhosis (change in the liver function and structure)
What is steatohepatitis
Inflammation and fat accumulation in the liver
What is cirrhosis of the liver?
It is the laying down of fibrous tissue, leading to the structural change of the liver parenchyma. Structurally abnormal lobes= ↓ liver function
What structures in the liver don’t have the same association in cirrhosis, leading to ↓ function
Portal triad and central vein
Why does cirrhosis cause jaundice?
Accumulation of unconjugated bilirubin due to ↓ in hepatocyte function
Function of hepatocytes
Conjugate bilirubin
Protein production (clotting factors and albumin)
Toxin detoxification
How does cirrhosis cause coagulopathies
Hepatocytes ↓ function
Hepatocytes form clotting factors
Why does cirrhosis cause ascites (accumulation of fluid in peritoneal cavity)
↓ albumin production from hepatocytes
Portal hypertension caused by changes to triads and vessels
Fluid out
How does cirrhosis cause portal hypertension?
Cirrhosis causes change to the liver parenchyma
This leads to slowing of blood coming from the portal vein
↑ blood pressure as a result
What does portal hypertension lead to?
Splenomegaly
Ascites (in combination with albumin production ↓)
Which hepatitis is fecal oral spread?
Hepatitis A
Which hepatitis shows pale hepatocytes?
Hepatitis B
Which hepatitis virus’ cause chronic disease?
Vowels
B C D
What can chronic hepatitis lead to?
Cirrhosis
Hepatoceullular carcinoma (malignant cancer)
How is hep c spread?
Through blood ie tattoos, blood products in haemophiliacs and IV drug users
What does cholicyst- refer to?
Gall bladder
Types of hepatitis
Loads
Alcoholic hepatitis and disease (bile ducts and gall bladder)
Autoimmune hepatitis
Hepatitis virus
Which type of hepatitis presents with autoantibodies against smooth muscle
Autoimmune hepatitis
Which autoimmune disease leads to destruction of epithelium of the bile ducts within the liver.
Primary biliary cirrhosis/cholangiopathy
Which autoimmune hepatitis is..
- presented with chronic pancreatitis and inflammatory bowel disease
- mostly in males
- shown to cause inflammation of the intra and extra hepatic bile ducts
Primary sclerosinng cholangitis
Types of autoimmune liver disease
Autoimmune hepatitis
Primary biliary cirrhosis
Primary sclerosing cholangitis
Diseases causing impaired hepatic excretion (autoimmune and obstruction)
Primary biliary cirrhosis
Primary sclerosing cholangitis
Gall stones
Causes of hepatic cellular dysfunction
Hepatitis virus
Autoimmune hepatitis
CMV
Alcohol
