Pathology of the liver 2 Flashcards

1
Q

Describe Viral hepatitis

A
  • infection of the liver
  • May cause acute injury or chronic liver injury
  • Causes can be common or rare
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2
Q

What are the common types of hepatitis virus

A
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis E
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3
Q

What are rare causes of hepatitis

A

Ebstein-Barr virus, Yellow fever virus, Herpes simplex cirus and cytomegalovirus

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4
Q

Describe hepatitis A

A
  • Transmission: Faecal-oral spread - contaminated food or water
  • Short incubation time
  • Can be sporadic or endemic (isolated or common)
  • Acute - mild ilness with full recovery usuaully
  • Directly cytopathis - direct change to host cell
  • no carrier state
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5
Q

What are the serological markers in HAV

A
  • IgM = active infection
  • IgG = recovery antibody - tells us that there has been recovery from HAV
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6
Q

What are the histological features of HAV

A
  • Periportal inflammation, necrosis and apoptosis
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7
Q

Describe hepatits B virus

A
  • Transmission: blood, blood products, sexually and in utero
  • long intubation time
  • Liver damage is by antiviral immune response
  • Carriers exist
  • only 20% become chronic but depends on age - the younger the patient the more likely to become chronic
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8
Q

Describe hepatitis C virus

A
  • Transmission: blood, blood products and sexually
  • Short intubation time
  • often asymptomatic
  • Tends to become chronic
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9
Q

describe the histological features of HCV

A
  • Dense portal chronic inflammation - lymphocytosis
  • Interface hepatitis - piecemeal necrosis
  • Lobular inflammation
  • Council man bodies - intracytoplasmic eosinophillic collection of globulate inside the cell of dying hepatocytes
  • Fibrosis and cirrhosis
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10
Q

What is piecemeal necrosis

A

Piecemeal necrosis is defined as the appearance of destroyed hepatocytes and lymphocytic infiltration at the interface between the limiting plate of periportal hepatocyte, parenchymal cells and portal tracts

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11
Q

What does lobular inflammation look like

A
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12
Q

Describe the outcome of hepatitis B virus

A
  • Fulminant acute infection - death
  • Chronic hepatitis
  • Cirrhosis
  • Hepatocellular carcinoma
  • Asymptomatic - Carrier
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13
Q

What is the outcome of hepatitis C

A
  • Chronic hepatits
  • Cirrhosis
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14
Q

What are other causes of chronic hepatits

A
  • Hepatitis B, C
  • pirmary biliary cirrhosis
  • Autoimmune hepatits
  • Drug induced hepatitis
  • Primary Sclerosing cholangitis
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15
Q

Describe primary biliary cirrhosis

A
  • Rare autoimmune disease - unknown cause
  • Associated with autoantibodies to mitochondria
  • Females - 90%
  • Biopsy - to stage doisease
  • Presence of granulomas and bile duct loss
  • Outcome: unpredictable
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16
Q

Descirbe the histological features of primary biliary cirrhosis

A
  • Dese lymphocytic infiltrate in porta tracts
  • Inflammation of bile duct
  • Granuloma around duct
17
Q

What does inflammed bile duct look like

A
18
Q

What does the duct granuloma look like

A
19
Q

What is the complication of primary BC

A
  • Cholestasis
  • Liver injury
  • inflammation
  • fribrosis and cirrhosis
20
Q

What is autoimmune hepatitis

A

Chronic self perpetuating inflammatory liver disease of unknown cause mainly occurring in females of all ages and ethnic groups

  • Associated with other AI diseases
  • Pattern is similar to chronic hepatitis
  • Numerous plasma cells
  • Autoantibodies to - SM, nuclear, LKM and raised IgG
  • Trigger : drugs
21
Q

Describe chronic drug induced hepatitis

A
  • Similar features to all other types of chornic hepatitis
  • May lead to autoimmune hepatits
  • loads to causes
22
Q
A