Pathology : Liver disease Flashcards
which 3 structures make up the portal triad
a.portal vein, bile duct, hepatic artery
b.portal, artery, bile duct, hepatic vein
c.portal vein, bile caniliculi, hepatic artery
a.portal vein, bile duct, hepatic artery
hepatocytes divide at a …………. rate normally
a.slow
b.fast
a.slow
how much of hepatic function must be lost before clinical manifestations of liver failure become apparent
a.10-20%
b.30-40%
c.60-70%
d.80-90%
d.80-90%
a fatty change within the liver is known as
a.steatosis
b.steatohepatitis
c.cirrhosis
d.ascites
e.caput medusa
a.steatosis
true or false a steatosis is reversible cell injury
a.true
b.false
a.true
A 56 year old obese male with a history of hypercholesterolaemia, hypertension and diabetes mellitus presents with persistently mildly abnormal liver function tests with ALT>AST. There is no history of alcohol consumption. Clinical examination is unremarkable. Serological and other blood investigations are normal. MRCP shows no stones. Liver core biopsy is likely to show:
A: Amyloid
B: Cirrhosis
C: Fatty Change as part of NAFLD
D: Hepatocellular carcinoma
E: Hepatitis C
C: Fatty Change as part of NAFLD
what is an accumulation of fat with accompanying inflammatory changes known as
a.steatosis
b.steatohepatitis
c.caput medusae
d.cirrhosis
e.ascites
b.steatohepatitis
which of these conditions is more associated with alcohol use
a.steatosis
b.steatohepatitis
b.steatohepatitis
smouldring low grade chronic inflamation seen with NAFLD / repeated bouts of hepatitis (often seen in patients with alcohol abuse) leads to fibrosis in which liver condition
a.steatosis
b.steatohepatitis
c.cirrhosis
d.ascites
b.steatohepatitis
accumulation of collagen and ecm (fibrosis) in liver is characteristic of which condition
a.steatosis
b.steatohepatitis
c.cirrhosis
d.ascites
b.steatohepatitis
(mallory bodies seen) - hyaline inclusions of hepatocytes -purp;e nuclei in area of pale pink hyaline around and between cells
what method is used to measure stiffness of the liver as a surrogate marker of fibrosis / decree of fatty change expressed in A CAP score
a.mri
B.ULTRASOUND
C.X RAY
D. BLOOD TEST
e. serology
B.ULTRASOUND
what is measured by a fibro scan
a.size of liver
b.volume of liver
c.stiffness of liver
d.degree of function of liver
c.stiffness of liver
and degree of fatty change (steatosis)
severe esposure of a healthy liver leads to ..
a.hepatitis
b.steatosis
c.cirrhosis
a.hepatitis
which of these liver conditions associated with alcohol use cannot be reversed by abstinence from alcohol
a. hepatitis
b.steatosis
c.cirrhosis
c.cirrhosis
severe exposure of a steatoic liver to alcohol will lead to
a.hepatitis
b.cirrhosis
a.hepatitis
continued exposure of a steatoic liver to alcohol will lead to
a.hepatitis
b.cirrhosis
b.cirrhosis
cirrhosis long term effect
also caused by repeated hepatitis
repeated attacks of hepatitis leads to
a.steatosis
b. cirrhosis
c.return to normal liver
b. cirrhosis
which liver condition is characterised by liver cell necrosis, inflammation, mallory bodies and fatty change
a.hepatitis
b.steatosis
c.cirrhosis
d.ascites
a.hepatitis
which liver condition is characterised by fibrosis and hyperplastic nodules
a.hepatitis
b.steatosis
c.cirrhosis
d.ascites
c.cirrhosis
which liver condition is characterised by fatty change and perivenular fibrosis
a.hepatitis
b.steatosis
c.cirrhosis
d.ascites
b.steatosis
which of these factors is not a cause of liver cirrhosis
a.alcohol
b.iron defficiency
c.billiary disease, hep b , hep c
d.autoimmune liver disease
e.obesity
b.iron defficiency
iron OVERLOAD causes cirrhosis
which of these conditions of the liver can be caused by iron overload and is associated with obesity, alcohol and hep b and c
a.steatosis
b.hepatitis
c.cirrhosis
d.gall stones
c.cirrhosis
a diffuse processed defined by the prescence of fibrous septa that subdivide liver parenchyma (functional tissue) into structually abnormal nodules
a.cirrhosis
b.steatosis
c.steatohepatitis
d.hepatitis
a.cirrhosis
end stage of many progressive liver diseases
if hepatocytes are lost in the liver what is the most likely outcome?
a.recovery
b.cirrhosis
a.recovery
if the architecture of the hepatocytes in the liver is disrupted what is the most likely outcome?
a.recovery
b.cirrhosis
b.cirrhosis
fibrous septa subdivide liver to abnormal nodules
impaired breakdown and an accumulation of bilirubin that is a common complication of untreated liver disease
a.jaundice
b.coagulopathy
c.encephalopathy
d.ascites
e.splenomegaly
a.jaundice
impaired synthesis of clotting factors caused by end stage liver disease is known as
a.jaundice
b.coagulopathy
c.encephalopathy
d.ascites
e.splenomegaly
b.coagulopathy
hyperammonaemia caused by untreated liver disease is known as
a.jaundice
b.coagulopathy
c.encephalopathy
d.ascites
e.splenomegaly
c.encephalopathy
impaired albumin sysnthesis and portal hypertension as a result of untreated liver disease is known as
a.jaundice
b.coagulopathy
c.encephalopathy
d.ascites
e.splenomegaly
d.ascites
which best describes the features of ascites caused by untreated liver disease
a.increased albumin synthesis and portal hypotension
b.impaired albumin synthesis and portal hypertension
c.increased albumin synthesis and portal hypertension
d.impaires albumin synthesis and portal hypotension
b.impaired albumin synthesis and portal hypertension
caput medusa , splenomegaly, ascites, leukonychia and flapping tremor of hands are all characteristic of what condition
a.hepatitis
b.chronic liver disease
c. acute liver disease
d.steatosis
b.chronic liver disease
leukonychia (characteristic of chronic liver disease ) is best described as..
a.yellow fingernails
b.pitting on fingernails
c.white fingernails
d. peeling fingernails
e.clubbed nails
c.white fingernails
what colour is the faeces and urine in hepatitis
a.dark urine, light faeces
b.light urine, dark faeces
c.dark urine , dark faeces
d.light urine, light faeces
a.dark urine, light faeces
pale faeces in hepatitis is caused by blockage of what structure
a.cystic duct
b. pancreatic duct
c, bile duct
c, bile duct
lack of bile pigments in faeces males it pale
oedema is present in hepatitis due to reduced plasma oncotic pressure what causes the pressure drop
a.reduced albumin
b.increased albumin
c.lack of bile salts
a.reduced albumin
impaired hepatic clotting factor synthesis in hepatitis causes which symptom
a.oedema
b.pale urine
c.easy bruising
d.leukonychia
d.leukonychia
A 45 year old male with a history of liver disease and haematemesis is
noted to have marked splenomegaly on cross sectional imaging. This
is most likely due to:
A: Chronic myeloid leukaemia
B: Hypoalbumenaemia
C: Infiltration by follicular lymphoma
D: Portal hypertension
E: Autoimmune thrombocytopaenia
D: Portal hypertension
causes congestion in spleen
most viral hepatitis presents as ……….. hepatitis with ………. inflammation and impaired liver function due to liver cell death
b.acute
c.chronic
a.acute
which hep virus is spread via fecal oral contact
a.A, E
b.B,C
c.D
a.A, E
eg remeber by :need to go a and a for faecal oral
which hep virus is spread via parenteral contact only contact
a.A, E
b.B
c.D, C
c.D, C
infectious agent entering not via GI tract
which hep virus is spread via parenteral and sexual contact
a.A, E
b.B
c.D, C
b.B
nasal cocaine use is a risk factor for which type of hepatitis virus
a.A
b.B
c.C
d.D
e.E
c.C
which hepatitis is most likely to lead to chronic liver disease
a.A
b.B
c.C
d.D
e.E
c.C
which hepatitis will never lead to chronic liver disease
a.A , E
b.B
c.C
d.D,C
e.E
a.A , E
both the fecal oral types
how is hep A diagnosed
a.serum igM antibodies
b. HBs antigen
c.PCR assay for HCV, ELISA
d. IgM and IgG antibodies, HDV , HD antigen in liver
e.PCR assay for HEV, serum IgM and IgG
a.serum igM antibodies
serum igm Antibodies
how is hep B diagnosed
a.serum igM antibodies
b. HBs antigen
c.PCR assay for HCV, ELISA
d. IgM and IgG antibodies, HDV , HD antigen in liver
e.PCR assay for HEV, serum IgM and IgG
b. HBs antigen
hBs
how is hep C diagnosed
a.serum igM antibodies
b. HBs antigen
c.PCR assay for HCV, ELISA
d. IgM and IgG antibodies, HDV , HD antigen in liver
e.PCR assay for HEV, serum IgM and IgG
c.PCR assay for HCV, ELISA
pCr hCv
how is hep D diagnosed
a.serum igM antibodies
b. HBs antigen
c.PCR assay for HCV, ELISA
d. IgM and IgG antibodies, HDV , HD antigen in liver
e.PCR assay for HEV, serum IgM and IgG
d. IgM and IgG antibodies, HDV , HD antigen in liver
igm and igg antiboDies , hDv , hD antigen in liver
how is hep E diagnosed
a.serum igM antibodies
b. HBs antigen
c.PCR assay for HCV, ELISA
d. IgM and IgG antibodies, HDV , HD antigen in liver
e.PCR assay for HEV, serum IgM and IgG
e.PCR assay for HEV, serum IgM and IgG
sErum igg igm , pcr assay for hEv
which of these infections is self limiting?
a.hep A
b hep B
c. hep c
d.hep d
a.hep A
what is the incubation period of hep a
a.2-6 weeks
b.1 week
c.3days
a.2-6 weeks
how does hep a cause liver damage
a.toxins
b.antigens
c.immune response to virus
d.immune response to bacteria
c.immune response to virus
RNA virus
which hep is not associated with chronic hepatitis, cirrhosis or a carrier state
a.hep A
b hep B
c. hep c
d.hep d
a.hep A
which hepatitis virus may present as acute hepatitis with recovery or sudden hepatitis with massive necrosis
a.hep A
b hep B
c. hep c
d.hep d
b hep B
which of these hepatitis viruses is associated with a asymptomatic carrier state
a.hep A
b hep B
c. hep c
d.hep d
b hep B
which type of hep may lead to cirrhosis, chronic hepatitis, fulminant hepititis and hepatocellular carcinoma
a.hep A
b hep B
c. hep c
d.hep d
b hep B
which hep is associated with tattoos, iv drugs and haemophilliacs as a result of bood product contamination as it is spread via blood
a.hep A
b hep B
c. hep c
d.hep d
c. hep c
which of these autoimmune liver diseases involves only intrahepatic bile ducts being targetted
a.primary billoary cirrhosis
b.sclerosing cholangitis
a.primary billoary cirrhosis
which of these autoimmune liver diseases involves both extrahepatic and intrahepatic bile ducts being targetted
a.primary billoary cirrhosis
b.sclerosing cholangitis
b.sclerosing cholangitis
autoimmune hepatitis is most common in..
a.females
b.males
a.females
what antibody is elevated in autoimmune hepatiotis
a.igA
b.IgG
c.IgM
b.IgG
what type of hepatitis is associated with forms of autoimmune disease eg rheumatoid arthiritis, sjogrens syndrome , ulcerative colitis
a.A
b.C
c.B
d.autoimmune
d.autoimmune
what group is primary billiary cirrhosis most prevalent in
a.women
b. men
a.women
+ve anti mitochondrial autoantibodies and chronic autoimmune destruction of intrahepatic bile ducts are charcaterisitic of which disease
a.cirrhosis
b.primary billary cirrhosis
c.hep b
d.sclerosing cholangitis
b.primary billary cirrhosis
sjogrens syndrome, sclerodoma and thyroid disease are associated with which condition?
a.cirrhosis
b.primary billary cirrhosis
c.hep b
d.sclerosing cholangitis
e.autoimmune hepatitis
b.primary billary cirrhosis
granulomas are seen histologically in which condition
a. steatosis
b.steatohepatitis
c.cirrhosis
d.primary billiary cirrhosis
d.primary billiary cirrhosis
chronic inflam destruction of extrahepatic and larger intrahepatic bile ducts with beading of ducts visible on mri or ercp is characteristic of
a.primary billiary cirrhosis
b.autoimmune hepatitis
c.primary sclerosing cholangitis
c.primary sclerosing cholangitis
which of these can be seen by radiology ( mri/ercp)
a.primary sclerosing cholangitis
b.primary billiary cirrhosis
c.hepatitis c
d.steatosis
a.primary sclerosing cholangitis
what group is primary sclerosing cholangitis most common in?
a. male
b.female
b.female
which liver condition is associated with chronic inflammatory bowel disease, and autoimmune pancreatitis
a.autoimmune hepatitis
b.primary billiary cirrhosis
c.primary sclerosing cholangitis
c.primary sclerosing cholangitis
which type of diabetes us caused by autosomal recessive gene mutations in the HFE gene with an adult onset
a.type 1
b.type 2
c.bronzed
c.bronzed
symptoms = skin pigmentation, cardiomyopathy, iron overload, liver damage
