Path Cirr Mig Flashcards
Cirrhosis Definition
Abnormal architecture w/ fibrosis
What cell type is responsible for liver fibrosis? Where are they located in the liver?
Stellate cells in the Space of Disse
Histology of Alcoholic Liver Dx
- Globular red hyaline material known as “Mallory’s hyaline”
- Micronodular (Regenerative) Cirrhosis
Macronodular cirrhosis Common causes
- Viral
- Wilson’s
- a-1 antitrypotin
- Can be alcohol as well
Bilirubin Labs + Disease
High conjugated: Liver Dx
High unconjugated: Excess RBC breakdown causing blockage of Bile ducts
Hepatic encephalopathy Types
Type A: Acute liver injury a/s cerebral edema
Type B: a/s portosystemic shunt w/ intrinsic liver disease
Type C: a/s cirrhosis
Pathogenesis of hepatic encephalopathy
- INC Ammonia alters neurotransmission
- GABA is accentuated vvia benzodiazapine-like molecules
- Mercaptans f/ Sulfur compounds (smelled in breath - fetor hepaticus)
- Aromatic AAs: Lead to DEC synthesis of normal nts + INC synthesis of abnormal nts
Extrahepatic manifestations of Liver Dx
- Neural: encephalopathy
- Hemotologic: Hypoalbuminemia, TCP, Bleeding, DIC,
- Endocrine: Gynecomastia, testicular atrophy
- Renal: Azotemia, Oliguria
Presinusoidal Hypertension
Disease A/S
- PCV -> Splenomegaly
- CML
Pathology of intrahepatic Portal Hypertension
Endothelial Cell dysfunction -> Release of vasodilators
Postsinusoidal portal HTN
- Et
- A/S
- Et: Thrombosis of Portal Vein
- A/S: PCV; myeloproliferative Dx; Hypercoagulable states; OIC, Pregnancy, PNH
Budd-Chiari Syndrome
- Et
- Morph
- Et: Tea, antineoplastics, irradiation, GVH, SCD
- Morph: Liver enlargement + Ascites; Obstruction of Hepatic vein; Liver is swollen, Red-purple, + oozes blood
Most serious complication of Cirrhosis + Ascites
Spontaneous Bacterial Peritonitis
