Liver Pathophysiology Flashcards

1
Q

What is gradually occuring in this photo?

A
  • Loss of structure from R->L in Hepatocytes
  • Zone 1 Necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Identify green and red

A

Green - endothelial cell
Red - sinusoid containing RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens to Zone 1 if it is exposed to too much oxygen?

A
  • Zone 1 becomes more prone to oxidative stress due to the overproduction of ROS.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name 2-3 things that can cause ballooning?

A
  • NAFLD: excessive fat in liver -> cellular stress
    -> cellular injury and swelling
  • Oxidative Stress: overproduction of ROS -> swelling -> death
  • Toxins/Drug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of metabolism does Zone 3 rely on?

A
  • **Zone 3 **relies more on anaerobic glycolysis due to the lower oxygen levels compared to Zone 1.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why is Zone 3 more prone to hypoxic injury?

A
  • Zone 3 has the lowest oxygen levels because it is furthest from the blood supply, making it more susceptible to hypoxia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is Zone 3 more vulnerable to damage from reactive metabolites?

A
  • Low oxygen levels in Zone 3 make it harder for the cells to neutralize reactive metabolites, leading to **oxidative stress **and cell damage.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the role of the liver?

A
  • Regulates most chemical levels in the blood
  • Excretes bile, helps break down fat
  • Produces cholesterol, converts glucose into glycogen
  • Converts ammonia (toxic by product) to urea (excreted through urine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is conjugated bilirubin?

A
  • Water-soluble
  • Processed by the liver and excreted into bile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is Zone 1 the first to encounter toxins and oxygen in the liver?

A
  • Zone 1 is closest to the** portal triad**, where blood from the hepatic artery and portal vein enters the liver.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the main cause of oxidative stress in Zone 1?

A
  • High oxygen levels leading to the overproduction of reactive oxygen species (ROS), which need to be neutralized by antioxidants like glutathione.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the role of the bile duct in the portal triad?

A
  • The bile duct transports bile produced by hepatocytes out of the liver to the gallbladder or small intestine for digestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the role of glutathione in Zone 1?

A
  • Glutathione is an antioxidant that neutralizes ROS, protecting liver cells from oxidative stress.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the two blood sources that flow into the liver lobule, and where do they come from?

A
  • Blood from the hepatic artery (oxygenated) and portal vein (deoxygenated, nutrient-rich) flows into the lobule via the sinusoids -> to the central vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is unconjugated bilirubin?

A
  • Fat-soluble
  • Not processed by the liver and cannot be excereted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the primary function of Zone 3 in the liver?

A
  • Detoxification via the cytochrome P450 enzyme system
17
Q

What are the key features of acute hepatitis

A

Acute Hepatitis
* short term inflammation
* ballooning, necrosis, and inflammation around the PT
* reversible

18
Q

Fibrosis vs Cirrhosis

A

Fibrosis: first tissue injury, turns into scar tissue, its reversible

Cirrhosis: follows fibrosis, severe, irreversible, scar tissue affects liver function

19
Q

Identify both reds

A

Left to right: CV -> PT

20
Q

What could high levels of conjugated bilirubin in the blood indicate?

A
  • Liver or bile ducts dysfunction
21
Q

What are the key features of apoptosis

A
  • Organized, needs ATP, does not cause inflammation
22
Q

What are sinusoids, and what is their role in the liver lobule?

A
  • Specialized capillaries where blood from the hepatic artery and portal vein mixes and is filtered by hepatocytes before flowing into the central vein
23
Q

What is the portal triad made up of?

A
  • Hepatic Artery
  • Portal Vein
  • Bile Duct
24
Q

What is an acinus, and what are its zones?

A
  • The acinus is the functional unit of the liver with three zones:

Zone 1: Closest to the portal triad (most oxygenated)

Zone 2: Intermediate zone

Zone 3: Closest to the central vein (least oxygenated)

25
Q

What are the key features of chronic hepatitis

A

Chronic Hepatitis
* long term inflammation
* necrosis, apoptosis, fibrosis
* irreversible

26
Q

What are the arrows pointing at?

A

Bile duct

27
Q

What are the key features of necrosis

A
  • Unorganized, no ATP, and causes inflammation
28
Q

What are features of healthy hepatocytes?

A
  • granular cytoplasm
  • round and prominent centrally placed nuclei
  • sometimes can be binucleated
29
Q

How does cytochrome P450 in Zone 3 contribute to liver damage during an overdose?

A
  • Cytochrome P450 produces reactive metabolites when detoxifying substances, and in excess, these metabolites can cause** cell damage **if not neutralized.
30
Q

Identify black and red

A

Red - Sinusoids
Black - Central Vein

31
Q

This is not the control. What is this H& E stain showing us?

A
  • Liver Fibrosis & Cirrhosis
  • Fibrosis is reversible
  • Cirrhosis is not reversible