Pathology of the Liver Flashcards
What is the pathogenesis of liver disease?
Insult to hepatocytes (viral, drug, toxin, antibody etc.) → Degree of inflammation (grading) → Degree of fibrosis (staging) → Cirrhosis
What are some causes of acute liver failure?
Viruses
Alcohol
Drugs
Bile duct obstruction
What are the different classes of jaundice?
Pre-hepatic
Hepatic
Post-hepatic
What causes pre-hepatic jaundice?
Too much haem to break down
What causes hepatic jaundice?
Liver cells are injured/dead
What causes post-hepatic jaundice?
Bile cannot escape into bowel
What is cirrhosis?
Irreversible damage of the liver defined by bands of fibrosis separating regenerative nodules of hepatocytes
What are some complications of cirrhosis
Portal hypertension (oesophageal varices, caput medusae and haemorrhoids)
Ascites
Liver failure
What are some causes of cirrhosis and chronic liver failure?
Alcohol Oedema Ascites Hematemesis Coma Infection
How does drinking lead to alcoholic liver disease?
It causes increased peripheral release of fatty acids and increased synthesis of fatty acids and triglycerides within the liver cells
What is the correlation between different periods of drinking and the liver damage they cause?
Fatty liver - 2-3 days of drinking
Hepatitis - 4-6 weeks of drinking
Fibrosis - months-years of drinking
Cirrhosis - years of drinking
Describe the histopathology of different alcoholic liver diseases
Alcoholic fatty liver - fat vacuoles appear in hepatocytes
Alcoholic hepatitis - hepatocyte necrosis and neutrophils appear
Alcoholic fibrosis - collagen laid down around cells
Alcoholic cirrhosis - abundant white scarring
What can alcoholic liver disease cause?
Cirrhosis
Portal hypertension
Malnutrition
Hepatocellular carcinoma
What is NASH?
NASH (non-alcoholic steatohepatitis) is a liver disease pathologically identical to alcoholic liver disease that affects non-drinkers with diabetes, obesity and hyperlipideamia
