Pathology of the liver II

Question 1

what are the DNAs of the hepatitis viruses? what is the exception?

Answer 1

ssRNA

exception - hepatitis B - dsDNA

Question 2

which hepatitis viruses will present asymptomatically with recovery and serological evidence only?

Answer 2

A, B, C, D co, E

Question 3

which hepatitis viruses will present symptomatically with recovery and serological evidence only?

Answer 3

A, B, C, D co, E

Question 4

which hepatitis viruses will present as chronic hepatitis with or without progression to cirrhosis?

Answer 4

B, C mostly, D superinfection

Question 5

which hepatitis viruses will present as fulminant hepatitis with massive to submassive hepatic necrosis?

Answer 5

D co and super, E pregnant

Question 6

what is the most common form of viral hepatitis?

Answer 6

A

Question 7

what is the transmission for hepatitis A?

Answer 7

fecal oral

Question 8

is there a carrier or chronic state for hepatitis A?

Answer 8

no

Question 9

which hepatitis virus is the most common cause of cirrhosis ad hepatocarcinoma worldwide?

Answer 9

hepatitis B

Question 10

what are the transmission routes for hepatitis B?

Answer 10

parenteral
sexual
vertical

Question 11

what is the immunopathogenesis of chronic hepatitis B?

Answer 11

CD4 T cells
CD8 T cells

CD8 cytotoxic cells kill hepatocytes

Question 12

what are the extrahepatic mainfestations of HBV?

Answer 12

glumerulonephritis - children

polyarteritis nodosa - adults

Question 13

what is required for HDV to replicate?

Answer 13

HBsAg

Question 14

what is superinfection?

Answer 14

surface carrier for hepatitis B

IgG forms to B, then IgM forms to D

Question 15

what is the most common chronic liver disease?

Answer 15

hepatitis C

Question 16

what are the transmission routes for hepatitis C?

Answer 16

parenteral
sexual
vertical

Question 17

what are the extrahepatic manifestations of hepatitis C?

Answer 17

cryoglobulinemia
thyroiditis
glomerulonephritis
thrombocytopenia

Question 18

when does ALT peak for hepatitis E infection?

Answer 18

5-7 weeks

Question 19

when are symptoms seen in hepatitis E infection? with what serum markers do they correlate?

Answer 19

5-8 weeks

ALT, IgM anti HEV, IgG anti HEV

Question 20

hepatitis E is usually a benign condition unless you are in which demographic?

Answer 20

pregnant

Question 21

what test is used to evaluate for viral hepatitis?

Answer 21

liver biopsy

Question 22

what is a councilman body?

Answer 22

apoptotic hepatocytes (acidophilic)

Question 23

in which condition are councilman bodies seen?

Answer 23

acute viral hepatitis

Question 24

piecemeal necrosis is seen in what type of hepatitis?

Answer 24

chronic

Question 25

ground glass hepatocytes are seen in what type of hepatitis? why?

Answer 25

B loaded with viral particles and surface antigens

Question 26

lymphoid aggregates are seen in what type of hepatitis?

Answer 26

C

Question 27

viral hepatitis cirrhosis is what type of cirrhosis?

Answer 27

macronodular

Question 28

what are the immunologic diseases affecting the liver?

Answer 28

primary biliary cirrhosis primary sclerosing cholangitis autoimmune hepatitis

Question 29

primary biliary cirrhosis is characterized by what features?

Answer 29

granulomas affecting smaller bile ducts in portal tract

Question 30

primary biliary cirrhosis is positive for what liver antibody?

Answer 30

antimitochondrial

Question 31

presence of antimitochondrial antibodies indicates infection of what disorder?

Answer 31

primary biliary cirrhosis

Question 32

what is the presentation for primary biliary cirrhosis?

Answer 32

``` female fatigue itching jaundice steatorrhea osteomalacia xanthomas ```

Question 33

what are the lab values for primary biliary cirrhosis?

Answer 33

increased ``` AMA anti-M2 IgM 5-NT / GGT cholesterol ```

Question 34

what will be seen histologically in primary biliary cirrhosis?

Answer 34

macrophages and granulomas (multinucleated giant cells)

Question 35

what characterizes phase 2 of primary biliary cirrhosis?

Answer 35

cholestasis

Question 36

primary sclerosing cholangitis is associated with what IBD?

Answer 36

ulcerative colitis

Question 37

what is the presentation for primary sclerosing cholangitis?

Answer 37

male itching weight loss abdominal pain

Question 38

what are the lab values seen in primary sclerosing cholangitis?

Answer 38

increased ``` AP GGT 5-NT ALT/AST ANA, anti-SMAb pANCA ```

Question 39

what test is used to evaluate for primary sclerosing cholangitis?

Answer 39

endoscopic retrograde cholangiography (ERCP)

Question 40

primary sclerosing cholangitis patients are more at risk for development of what type of cancer?

Answer 40

cholangiocarcinoma

Question 41

what is autoimmune hepatitis?

Answer 41

patient's own immune systems attacks liver causing inflammation and liver cell death

Question 42

which antibodies are seen in autoimmune hepatitis?

Answer 42

anti-LKM1, IgG