Pathology of Liver Flashcards
What is Steatosis
2
Simple fatty liver: This means you have fat in your liver, but you may not have any inflammation in your liver or damage to your liver cells.
-only fat cells
What is Steatohepatitus
(2)
NASH + Alcohol related
Nonalcoholic steatohepatitis (NASH): This is much more serious than a simple fatty liver. NASH means you have inflammation in your liver. - Portal : Such as fibrosis and cirrhosis, which are types of liver scarring, and liver cancer.
- Alcohol related , you can see mallory bodies in histological specimens , fibrosis ,
- ->slow and chronic due to fat
- ->Acute bursts = alcohol and drug based
Describe the viral hepatitus
4
Viral hepatitis is an infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
HEP ABCDE
BCD= long term / chronic
AE=short term = A&E
what is primary scelrosing cholangitis
(4)
(scelrosing sounds like…)
-What is shown in MRI
Primary sclerosing cholangitis (PSC) is a rare disease that attacks the bile ducts.
The word sclerosing means scarring. In PSC, your bile ducts become scarred.
They slowly narrow until bile backs up into your liver and starts to damage it!
MRI = Beading shown (change in shape of the wall of bile duct)
what is primary biliary cirrhosis
(4)
1-common in —
2-What antibodies are more present
Primary biliary cholangitis (often referred to as primary biliary cirrhosis) is a type of liver disease that can get gradually worse over time. ( Bile ducts are slowly destroyed)
- Women aged 50 more susceptible
- Anti mitochondrial antibodies (AMA)/ ANCA = anti neutrophil bodies present
What is autoimmune hepatitus
(2)
- What antibodies are produced ?
- Men vs Women
Autoimmune hepatitis is liver inflammation that occurs when your body’s immune system turns against liver cells.
- IgG antibodies present in high level
- Anti smooth muscle markers present
- Higher in women
- NO TRACE OF VIRUS = AUTOIMMUNE
what is cirrhosis
2
Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure.
HEP A
- transmission
- vaccine ?
1-fecal -oral , generally food bourne
2-HAV vaccine
HEP B
HEP D
What are the tests ?
Transmission ?
DNA virus spread through sex, blood
-can lead to cancer and cirrhosis
TEST FOR 3 MAIN ANTIGENS: Surface E Antigens , core antigen , surface antigen = Also check for antibodies against them
- HEP B vaccine , screening = prevention is much preferred
-Transmission from mother to baby
hep d = NOT KNOWN ( often occurs with B ) = known as delta particle , its a defective virus ( requires coating of hep B)
HEP C
Needles and blood , drug , tattoos
- Chronic carriage of the virus = liver failure
- Hepatocelular carcinoma
- No vaccine
- Various Serotypes ( so they are all different , so you don’t get immunity if you have the infection once )
Hep E
1-water bourne = in ASIA
2-Carrier state possible
Treatment for Billiary tract infection
Bile = lots of bacteria Acute stress and obstruction = causes slowing of bile and hence infection 1-E.coli and Enterobacteriaceae Presenting complaints : 1.CHolecystitis and cholangitus 2. pain and tenderness , jaundice Management : 1-Soure controls 2-ERCP 3-Sample before antibiotics 4-Broad spec antibiotics ( beta -lactam inhibitors )
Pathogenesis of the liver abscess + management
Bacteria arrives from elsewhere in GI tract via the portal circulation (Entamoeba Histolytica , Echinococcus granulosus )
1- control the aetiology
2-Source control
3-broad spec ANTIbiotics
What is a zoonotic infection, examples that can cause jaundice
(4)
A zoonosis is an infectious disease that has jumped from a non-human animal to humans.
-carried by rats (urine )
1- leptospirosis = causes jaundice
Leptospirosis is a rare zoonotic infection which can result in conjugated hyperbilirubinemia and acute kidney injury
= open water swimming , triathletes and sewage workers are susceptible
What Is Portal Hypertension ? Bp above x Effect on liver + blood Causes ( 3 main types ) signs : ABCDE
(20)
1) Increased BP due to Hepatic fibrosis x>12mmhg
Portosystemic shunts = blood backs up into the systemic veins
= Less blood to liver, more ammonia in blood because it can’t be broken down
Causes of portal HT :
1) Pre hepatic = thrombus occluding portal vein
2) Intra hepatic = Cirrhosis , Schistosomiasis = flat worms in the liver
- Sarcoidosis = inflammatory cells form granulomas
3) Post hepatic = R heart failure, constrictive pericarditis ( around heart) , thrombus in venous flow which stops blood flowing to the liver
Signs: Ascites Bleeding Caput Medusa Diminished liver function Enlarged Spleen
