Pathology of the Liver 2

Question 1

Hep A

Answer 1

• faecal oral spread
• short incubation period
• no carrier state/chronic infection
• mild illness and a full recovery

Question 2

Hep B

Answer 2

• spread by blood, sexual intercourse and vertically (e.g mother to baby)
• long incubation period (2-6 months)
• carriers exist
• some carriers suffer from chronic hepatitis

Question 3

Hep C

Answer 3

• spread to blood, vertically and by sexual intercourse (rare)
• short incubation period
• asymptomatic
• often chronic, which leads to chronic hepatitis

Question 4

Hep D

Answer 4

occurs alongside hep B

Question 5

Hep E

Answer 5

• faecal oral spread
• short incubation
• mild illness
• no carriers exist

Question 6

What is primary biliary cirrhosis and who does it effect?

Answer 6

autoimmune disorder

mainly females

Question 7

What is present in the sufferers blood?

Answer 7

anti mitochondrial auto antibodies

increased serum amylase

Question 8

symptoms of PBC?

Answer 8

jaundice
xanthelasma
pruritus

Question 9

What is secondary biliary cirrhosis?

Answer 9

prolonged obstruction of extrahepatic bile ducts, while leads to inflam and then ultimately cirrhosis

Question 10

What causes secondary biliary cirrhosis?

Answer 10

gallstones
biliary atresia
strictures (e.g due to surgery)
carcinomas of the head of the pancreas

Question 11

what is primary sclerosing cholangitis?

Answer 11

chronic inflammation, affecting intra and extra hepatic bile ducts

Question 12

who gets PSC?

Answer 12

suffers of IBD, e.g UC

more common in males

Question 13

how do you diagnose PSC?

Answer 13

liver biopsy

ERCP

Question 14

what is haemochromatosis?

Answer 14

this is excess iron within the liver

Question 15

what are the two type of haemochromatosis and there causes?

Answer 15

primary
- genetic, increases absorption of iron
secondary
- iron overload due to diet, transfusions, iron therapy

Question 16

Primary haemochromatosis….

Answer 16

• autosomal recessive
• iron deposited in the liver, which can be asymptomatic
• can cause
  diabetes
  cardiac failure
  impotence
  arthritis
  liver failure
  hepatocellualr carcinoma

Question 17

Wilson’s disease

Answer 17

• autosomal recessive
• 5-15 year olds
• copper accumulates in liver and basal ganglia of the brain

Question 18

Symptoms of wilson’s disease

Answer 18

kayer fleischer rings at the corneal limbus

hepatic and neurological abnormalities

Question 19

how do you diagnose wilson’s disease?

Answer 19

liver biopsy
urine samples
caeruloplasmin decreased (copper binding protein)

Question 20

alpha 1 antitrypsin deficiency

Answer 20

• autosomal recessive

- cytoplasmic globules of unsecreted protein in the hepatocytes

Question 21

diagnosis of alpha 1 antitrypsin deficiency

Answer 21

liver biopsy

serum alpha 1 antitrypsin

Question 22

what can alpha 1 antitrypsin deficiency cause?

Answer 22

emphysema

cirrhosis

Question 23

Benign tumours of the liver

Answer 23

hepatocellular adenoma

Question 24

features of Benign tumours of the liver

Answer 24

occurs in females
can become large, may rupture or bleed
most remain asymptomatic

Question 25

malignant tumours of the liver

Answer 25

hepatocellular carcinoma

Question 26

causes of malignant tumours of the liver

Answer 26

hepatitis C and B
cirrhosis
haemochromatosis 
aflatoxin (fungus)
contraceptive pill use

Question 27

how do malignant tumours of the liver present?

Answer 27

a mass
RUQ pain
obstruction

Question 28

Where do secondary tumours of the liver come from?

Answer 28

Metastases from colon, pancreas, stomach, breast, lung (many more)