Pathology of the liver III Flashcards
where does the p450 cycle occur in the liver?
mitochondria
what zone is usually affected first in hepatic injury? what is the name of this zone? why is it injured first?
zone 3
centrilobular
lowest oxygen tension
what are the drug reactions / expectations for the intrinsic drugs?
predictable
dose dependent
short latency
specific lesions
what are the drug reactions / expectations for the idiosyncratic drugs?
unpredictable dose independent variable latency variable lesions hypersensitivity
what do tetracyclines cause in the liver?
microsteatosis
what does methotrexate cause in the liver?
macrosteatosis
what does acetaminophen cause in the liver?
necrosis
what do isoniazid and halothane cause in the liver?
hepatitis
what does amiodarone cause in the liver?
fibrosis
what do steroids and erythromycin cause in the liver?
cholestasis
what drug causes microsteatosis in the liver?
tetracyclines
what drug causes macrosteatosis in the liver?
methotrexate
what drug causes necrosis in the liver?
acetaminophen
what drugs cause hepatitis in the liver?
isoniazid and halothane
what drug causes fibrosis in the liver?
amiodarone
what drugs cause cholestasis in the liver?
erythromycin
how much alcohol is required to develop alcoholic liver disease?
male - over 80 g/day
what is the name for alcoholic hyaline, histologically?
mallory bodies
centrilobular and sinusoidal fibrosis occurs during what phase of alcoholic liver disease?
chronic alcoholic liver disease
mallory bodies are seen during what phase of alcoholic liver disease?
acute sclerosing hyaline necrosis
what is the AST:ALT ratio in alcoholic steatohepatitis?
greater than 2
in alcoholic steatohepatitis is AP increased or decreased?
increased
what are the proximate causes of death in alcoholic steatohepatitis?
hepatic coma
massive GI hemorrhage
infection
hepatorenal syndrome following a bout of alcoholic hepatitis
what are the features of nonalcoholic steatohepatitis (NASH)?
obesity
diabetes
hyperlipidemia
which conditions can lead to NASH?
insulin resistance / metabolic syndrome
drug hepatotoxicity
which drugs can lead to the development of NASH?
tamoxifen, nifedipine
ischemic hepatitis, shock liver, and hypoxic hepatitis are results of what conditions?
left sided heart failure
heart surgery
shock
what are the causes of intrahepatic portal vein thrombosis?
cirrhosis malignancy stasis pregnancy idiopathic PH
what are the causes of extrahepatic portal vein thrombosis?
abdominal infection and inflammation
hypercoagulability
surgery
what is an infarct of zahn?
intrahepatic portal vein thrombosis
no necrosis
what are the causes of hepatic passive congestion?
right sided heart failure
constrictive pericarditis
congenital heart disease
what is the gross appearance of centrilobular hemorrhagic necrosis?
nutmeg liver
what is budd-chiari syndrome?
clotting or obstruction of the hepatic vein and or IVC usually due to underlying condition that predisposes to blood clotting
what is the cause of obliterative hepatocavopathy?
IVC obstruction
what are the clinical features of obliterative hepatocavopathy?
abdominal wall edema
torturous abdominal venous pattern
leg edema
veno-occlusive disease follows what procedure / processes?
bone marrow transplantation
ingestion of certain alkaloids
