Path-Viral Hepatitis

Question 1

in general when we refer to hepatitis, we are talking about hepatitis caused by?

Answer 1

one of the hepatotropic viruses: Hep A,B,C,D, or E

Question 2

non-hepatotropic viruses are ____ and more commonly arise in ______ patients

Answer 2

rare; immunocompromised

Question 3

hepatitis is considered chronic when abnormalities persist for more than _________

Answer 3

6 months

Question 4

resolution of acute hepatitis is common for _____ (3 things)

Answer 4

hep A, EBV hepatitis, drug-induced hepatitis

Question 5

resolution of hepatitis is less common for (3 things) and may be clinically silent during the acute phase

Answer 5

hep B, hep C, steatohepatitis

Question 6

liver biopsies for acute hepatitis are useful when?

Answer 6

the diagnosis is uncertain or when it is important to assess extent of liver injury

Question 7

lobular ____ and _____ increase as severity of hepatitis advances

Answer 7

inflammation, necrosis

Question 8

acidophil bodies are?

Answer 8

singly necrotic hepatocytes

Question 9

later in the course of severity, necrosis becomes ____

Answer 9

confluent

Question 10

if you were to biopsy acute hepatitis, you would see?

Answer 10

scattered lymphocytes in the portal area, lymphocyte-mediated necrosis of hepatocytes (acidophil bodies)

Question 11

describe the histological structure of acidophil bodies

Answer 11

condensed cytoplasm is deeply eosinophilic, shrinks forming retraction halo, small dark nucleus (can be fragmented or disappear)

Question 12

in addition to the lobular inflammation and acidophil bodies seen in acute hepatitis, chronic hepatitis is characterized by?

Answer 12

expansion of portal areas by lymphocytes, which extends across the limiting plate + necrosis of periportal hepatocytes (interface hepatitis)

Question 13

longstanding persistent injury at limiting plate results in?

Answer 13

fibrous portal expansion, fibrotic bridging between adjacent portal areas, and regenerative nodules of cirrhosis

Question 14

what is the limiting plate?

Answer 14

space between portal area and hepatocyte plates

Question 15

interface hepatitis results in?

Answer 15

lymphocytes and acidophilic bodies surrounding the portal area

Question 16

the most striking feature of chronic hepatitis at low power is the presence of?

Answer 16

dense portal, periportal mononuclear infiltrate

Question 17

the presence of ________ points to chronic hep B

Answer 17

ground glass hepatocytes

Question 18

the presence of ________ points to chronic hep C

Answer 18

well-formed lymphoid nodules

Question 19

hepatocytes infected with hep B have a ground glass appearance due to?

Answer 19

hep B surface antigen accumulates in the cytoplasms as pale, hazy, granular material (and pushes nucleus to edge)

Question 20

the best way to tell that a cell is infected by hep B/has ground glass cytoplasm is that the cytoplasm lacks _____

Answer 20

course reticulations

Question 21

how do you detect hep B by immunohistochemistry?

Answer 21

stain for hep B surface antigen

Question 22

hep C typically has distinctly nodular _____ aggregates in ______ areas

Answer 22

lymphocytic, portal areas

Question 23

hepatocellular carcinoma stains (lighter/darker) than cirrhotic liver

Answer 23

darker

Question 24

herpes simplex hepatitis results _____ necrosis with what pattern?

Answer 24

hemorrhagic “geographic “necrosis

Question 25

in HSV hepatitis, residual intact hepatocytes have _____

Answer 25

herpetic viral cytopathic effect

Question 26

what are the 3 M’s of herpetic viral cytopathic effect?

Answer 26

Multinucleation, Molding of nuclei, and Margination of nuclear chromatin about central ground-glass nucleoplasm