Path-ALD,NALD,DILD Flashcards
what is the most common chronic hepatic disorder in the West?
NAFLD
radiographic imaging, such as ___ can identify steatosis but it cannot distinguish it from NASH/ASH
CT, US, MRI
fatty liver may be (smaller/larger) than a normal liver, and it is (hypo/hyper)dense compared to the spleen
larger, hypodense
mild to moderate steatosis shows fat deposition primarily in the ______ region
centrilobular/surrounding central vein (not periportal)
early fibrosis in NAFLD shows what pattern?
perisinusoidal (projects from central vein)
most severe form of NAFLD
cirrhosis
alcoholics absorb more endotoxin from the gut, which activates ______, resulting in _______
Kupffer cells; cytokines TNF-alpha and hepatocyte death
why is the centrilobular zone more sensitive to fat deposition?
metabolism of fat requires high O2 and these cells are farthest from the blood supply
alcohol metabolites like _____ bind to and alter hepatocyte ___, which stimulates injury
acetaldehyde; proteins
what are Mallory bodies (AKA Mallory’s hyalin)?
acetaldehyde-induced condensations of cytokeratin filaments within cyto of damaged hepatocytes
what is hepatocellular ballooning?
swelling and rounding; accumulation of small-droplet fat in cytoplasm; and dilation of ER
how does adipose tissue become inflamed?
proinflammatory factors, cytokines, oxidative stress
the risk for progression to cirrhosis and development of HCC are significantly greater when a patient has both fatty liver disease AND _______
hepatitis C
major differences between AFLD and NAFLD
history, AST:ALT ratio >2, Mallory bodies all seen in AFLD but not NAFLD
the only histological feature relevant to DILI is a predominance of ______ (inflammatory cells)
eosinophils
