Liver Pathology Lecture 12

Question 1

Where is unconjugated bilirubin conjugated

Answer 1

The hepatocytes of the liver

Question 2

What substance is conjugated bilirubin secreted into?

Answer 2

Bile

Question 3

What gives faeces its brown colour?

Answer 3

Sterocobulin

Question 4

What does the gut bacteria convert conjugated bilirubin into?

Answer 4

Urobilinogen

Question 5

Which part of haemoglobin is converted into bilirubin?

Answer 5

Haem

Question 6

Which form of bilirubin is excreted into the kidneys

Answer 6

Urobilinogen

Question 7

What causes the faeces to become pale?

Answer 7

Less conjugated bilirubin

Or a lack of bile ie due to obstruction

Question 8

What is choleocystitis

Answer 8

Inflammation of the gall bladder

Question 9

What is cholangitis?

Answer 9

Inflammation of the bile ducts

Question 10

What type of change in the liver is steatosis

Answer 10

Fatty change in the liver

Question 11

Which, steatosis or steatohepatitis is most commonly associated with alcoholics

Answer 11

Steatohepatitis

Question 12

What is the difference between steatohepatitis and steatosis

Answer 12

Both are fatty liver

Steatohepatitis is associated with inflammation also

Question 13

Repeated bouts of inflammation of the hepatocytes with fatty changes is associated with what?

Answer 13

Alcoholism

Question 14

What does repeated bouts of hepatitis due to addiction lead to in the liver?

Answer 14

Fatty changes

Inflammation

Liver cell death

Question 15

What is the progression of fatty liver disease? 1-4

Answer 15

1. Steatosis
2. Steatohepatitis
3. Fibrosis
4. Cirrhosis (change in the liver function and structure)

Question 16

What is steatohepatitis

Answer 16

Inflammation and fat accumulation in the liver

Question 17

What is cirrhosis of the liver?

Answer 17

It is the laying down of fibrous tissue, leading to the structural change of the liver parenchyma. Structurally abnormal lobes= ↓ liver function

Question 18

What structures in the liver don’t have the same association in cirrhosis, leading to ↓ function

Answer 18

Portal triad and central vein

Question 19

Why does cirrhosis cause jaundice?

Answer 19

Accumulation of unconjugated bilirubin due to ↓ in hepatocyte function

Question 20

Function of hepatocytes

Answer 20

Conjugate bilirubin

Protein production (clotting factors and albumin)

Toxin detoxification

Question 21

How does cirrhosis cause coagulopathies

Answer 21

Hepatocytes ↓ function

Hepatocytes form clotting factors

Question 22

Why does cirrhosis cause ascites (accumulation of fluid in peritoneal cavity)

Answer 22

↓ albumin production from hepatocytes

Portal hypertension caused by changes to triads and vessels

Fluid out

Question 23

How does cirrhosis cause portal hypertension?

Answer 23

Cirrhosis causes change to the liver parenchyma

This leads to slowing of blood coming from the portal vein

↑ blood pressure as a result

Question 24

What does portal hypertension lead to?

Answer 24

Splenomegaly

Ascites (in combination with albumin production ↓)

Question 25

Which hepatitis is fecal oral spread?

Answer 25

Hepatitis A

Question 26

Which hepatitis shows pale hepatocytes?

Answer 26

Hepatitis B

Question 27

Which hepatitis virus’ cause chronic disease?

Answer 27

Vowels B C D

Question 28

What can chronic hepatitis lead to?

Answer 28

Cirrhosis Hepatoceullular carcinoma (malignant cancer)

Question 29

How is hep c spread?

Answer 29

Through blood ie tattoos, blood products in haemophiliacs and IV drug users

Question 30

What does cholicyst- refer to?

Answer 30

Gall bladder

Question 31

Types of hepatitis

Answer 31

Loads Alcoholic hepatitis and disease (bile ducts and gall bladder) Autoimmune hepatitis Hepatitis virus

Question 32

Which type of hepatitis presents with autoantibodies against smooth muscle

Answer 32

Autoimmune hepatitis

Question 33

Which autoimmune disease leads to destruction of epithelium of the bile ducts within the liver.

Answer 33

Primary biliary cirrhosis/cholangiopathy

Question 34

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

Answer 34

Primary sclerosinng cholangitis

Question 35

Types of autoimmune liver disease

Answer 35

Autoimmune hepatitis Primary biliary cirrhosis Primary sclerosing cholangitis

Question 36

Diseases causing impaired hepatic excretion (autoimmune and obstruction)

Answer 36

Primary biliary cirrhosis Primary sclerosing cholangitis Gall stones

Question 37

Causes of hepatic cellular dysfunction

Answer 37

Hepatitis virus Autoimmune hepatitis CMV Alcohol