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Y1 GI > Pathology of the liver 2 > Flashcards

Pathology of the liver 2 Flashcards

1
Q

Common causes of viral hepatitis

A

Hep A
Hep B
Hep C
Hep E

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2
Q

Rare causes of viral hepatitis

A 
Delta agent 
Ebstein-Barr virus 
Yellow fever virus 
Herpes simplex virus 
Cytomegalovirus
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3
Q

Summary of Hep A

A 
faecal oral spread 
short incubation period 
sporadic or endemic 
directly cytopathic 
no carrier state 
mild illness, usually full recovery
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4
Q

How is Hep B spread

A 
Blood, sexually, vertically 
Long incubation period 
carriers exist 
outcome is variable 
increases risk of carcinoma
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5
Q

Outcomes of Hep B infection

A

Acute hepatitis with resolution
Acute hepatitis with liver failure
Chronic hepatitis
Asymptomatic carrier

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6
Q

Types of chronic hep

A

Non-progressive-stays the same but doesn’t go away

Progressive - gets worse until cirrhosis develops

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7
Q

How is Hep C spread

A

blood, sexually, virtically

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8
Q

What doesn’t Hep C have a vaccine

A

Does not have a constant antigen and can exist in many forms

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9
Q

Hep C has a long incubation period true/false

A

False

Short

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10
Q

Hep C tends to become chronic true/false

A

true

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11
Q

What does acute hep look like

A

ballooning degeneration -slightly clear cytoplasms
Chronic Inflammatory cells - mainly lymphocytes
Inflam cells infiltrate the portal triad
globular inflammation

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12
Q

What does cirrhosis look like

A

Scarring between the portal triads splitting up the hepatocytes and isolating them from each other and vasculature

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13
Q

What are the two types of cirrhosis

A

macro >3mm

micro <3 mm

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14
Q

Outcomes of hep c

A

chronic hep

cirrhosis

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15
Q

Other causes of chronic hepatitis (not viral)

A

Primary biliary cirrhosis
Autoimmune hepatitis
Drug induced hepatitis
Primary Sclerosing cholangitis

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16
Q

What is primary biliary cirrhosis

A

Rare autoimmune disease- unknown aetiology
mainly females affected
associated with auto antibodies to mitochondria

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17
Q

What does PBC look like histologically

A

Granulomas
Bile duct loss
Granuloma around bile duct while lymphocytes attack bile duct

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18
Q

What is the outcome of PBC

A

unpredictable

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19
Q

What is the definition of a granuloma

A

A collection of histocytes surrounded by lymphocytes

20
Q

If untreated what does PBC lead to

A 
Cholestatis (reduction of bile flow) 
liver injury 
inflammation 
fibrosis 
cirrhosis
21
Q

What is autoimmune hepatitis

A 
Autoimmune disease 
common in females 
Associated with other AI diseases 
Autoantibodies to smooth muscle
raised IgG
May have triggers including drugs
22
Q

What is drug induced hepatitis

A

similar features to all other types of chronic hep
may trigger autoimmune hep
chronic adverse process
too many causes to list

23
Q

Is drug induce hep always dose related

A

No

sometimes idiosyncratic

24
Q

What is primary sclerosis cholangitis

A

chronic inflammation affecting intra and extra hepatic bile ducts
Leads to duct destruction, jaundice and fibrosis

25
Q

Primary sclerosis cholangitis is more common in males true/false

A

True

26
Q

What other GI condition is primary sclerosisng cholangitis associated with

A

Ulcerative colitis

27
Q

PSC increases/decreases risk of malignancy in liver/bile ducts

A

Increases

Bile ducts

28
Q

What are the main storage diseases

A

Haemochromatosis
Wilson’s disease
Alpha-1-antitripsin deficiency

29
Q

What is haemochromatosis

A

Excess iron in the liver

30
Q

What is the difference between primary and secondary haemochromatosis

A

Primary - genetic condition, increases absorption of iron

Secondary- iron overload from diet, transfusions, iron therapy

31
Q

Describe primary haemochromatosis

A

Inherited autosomal recessive condition
Gene defect
Excess iron absorption from intestine
Worse in homozygotes, men

32
Q

Primary haemochromatosis gives a variety of symptoms

A

False, asymptomatic for years

33
Q

Where is iron eventually deposited in primary haemochromatosis

A

Portal connective tissue

this stimulated fibrosis

34
Q

What happens if primary haemochromatosis is not treated

A

Cirrhosis
Predisposed to carcinoma
Causes diabetes, cardiac failure, and impotence

35
Q

How is iron confirmed to have accumulated in hepatocytes

A

Perls stain

36
Q

What is Wilsons disease

A

Inherited autosomal recessive disorder of copper metabolism

Copper accumulates in liver and brain

37
Q

What does Wilson’s disease cause

A

chronic hep

neurological deterioration

38
Q

Sign of Wilsons disease

A

Kayser-Fleischer rings at corneal limbus

39
Q

What is alpha 1- antitrypsin deficiency

A

inherited autosomal recessive disorder of production of an enzyme inhibitor

40
Q

What does alpha 1- antitrypsin deficiency cause

A

emphysema

cirrhosis

41
Q

What are the primary (rare) liver tumours

A

Hepatocellular adenoma

Hepatocellular carcinoma

42
Q

What are the secondary (common) liver tumours

A

Multiple

metastases from colon, pancreas, stomach, breast, lung, others

43
Q

What is a hepatocellular adenoma

A 
Benign 
Females get it 
May become large- can rupture or bleed 
Most remain assymptomatic 
Poor prognosis
44
Q

What is a hepatocellular carcinoma

A

Rare in Europe

Associated with HBV, HVC, and cirrhosis

45
Q

How does hepatocellular carcinoma present

A

Mass
Pain
obstruction
usually advanced unless discovered incidentally

Y1 GI (41 decks)

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