Pathology of the liver III

Question 1

where does the p450 cycle occur in the liver?

Answer 1

mitochondria

Question 2

what zone is usually affected first in hepatic injury? what is the name of this zone? why is it injured first?

Answer 2

zone 3

centrilobular

lowest oxygen tension

Question 3

what are the drug reactions / expectations for the intrinsic drugs?

Answer 3

predictable
dose dependent
short latency
specific lesions

Question 4

what are the drug reactions / expectations for the idiosyncratic drugs?

Answer 4

unpredictable 
dose independent 
variable latency 
variable lesions 
hypersensitivity

Question 5

what do tetracyclines cause in the liver?

Answer 5

microsteatosis

Question 6

what does methotrexate cause in the liver?

Answer 6

macrosteatosis

Question 7

what does acetaminophen cause in the liver?

Answer 7

necrosis

Question 8

what do isoniazid and halothane cause in the liver?

Answer 8

hepatitis

Question 9

what does amiodarone cause in the liver?

Answer 9

fibrosis

Question 10

what do steroids and erythromycin cause in the liver?

Answer 10

cholestasis

Question 11

what drug causes microsteatosis in the liver?

Answer 11

tetracyclines

Question 12

what drug causes macrosteatosis in the liver?

Answer 12

methotrexate

Question 13

what drug causes necrosis in the liver?

Answer 13

acetaminophen

Question 14

what drugs cause hepatitis in the liver?

Answer 14

isoniazid and halothane

Question 15

what drug causes fibrosis in the liver?

Answer 15

amiodarone

Question 16

what drugs cause cholestasis in the liver?

Answer 16

erythromycin

Question 17

how much alcohol is required to develop alcoholic liver disease?

Answer 17

male - over 80 g/day

Question 18

what is the name for alcoholic hyaline, histologically?

Answer 18

mallory bodies

Question 19

centrilobular and sinusoidal fibrosis occurs during what phase of alcoholic liver disease?

Answer 19

chronic alcoholic liver disease

Question 20

mallory bodies are seen during what phase of alcoholic liver disease?

Answer 20

acute sclerosing hyaline necrosis

Question 21

what is the AST:ALT ratio in alcoholic steatohepatitis?

Answer 21

greater than 2

Question 22

in alcoholic steatohepatitis is AP increased or decreased?

Answer 22

increased

Question 23

what are the proximate causes of death in alcoholic steatohepatitis?

Answer 23

hepatic coma
massive GI hemorrhage
infection
hepatorenal syndrome following a bout of alcoholic hepatitis

Question 24

what are the features of nonalcoholic steatohepatitis (NASH)?

Answer 24

obesity
diabetes
hyperlipidemia

Question 25

which conditions can lead to NASH?

Answer 25

insulin resistance / metabolic syndrome | drug hepatotoxicity

Question 26

which drugs can lead to the development of NASH?

Answer 26

tamoxifen, nifedipine

Question 27

ischemic hepatitis, shock liver, and hypoxic hepatitis are results of what conditions?

Answer 27

left sided heart failure heart surgery shock

Question 28

what are the causes of intrahepatic portal vein thrombosis?

Answer 28

``` cirrhosis malignancy stasis pregnancy idiopathic PH ```

Question 29

what are the causes of extrahepatic portal vein thrombosis?

Answer 29

abdominal infection and inflammation hypercoagulability surgery

Question 30

what is an infarct of zahn?

Answer 30

intrahepatic portal vein thrombosis no necrosis

Question 31

what are the causes of hepatic passive congestion?

Answer 31

right sided heart failure constrictive pericarditis congenital heart disease

Question 32

what is the gross appearance of centrilobular hemorrhagic necrosis?

Answer 32

nutmeg liver

Question 33

what is budd-chiari syndrome?

Answer 33

clotting or obstruction of the hepatic vein and or IVC usually due to underlying condition that predisposes to blood clotting

Question 34

what is the cause of obliterative hepatocavopathy?

Answer 34

IVC obstruction

Question 35

what are the clinical features of obliterative hepatocavopathy?

Answer 35

abdominal wall edema torturous abdominal venous pattern leg edema

Question 36

veno-occlusive disease follows what procedure / processes?

Answer 36

bone marrow transplantation | ingestion of certain alkaloids