Pathoma 11.3 Liver Flashcards

1
Q

The fibrosis found in cirrhosis is mediated by:

A

TGF-beta from stellate cells

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2
Q

Where are stellate cells found in the liver?

A

Beneath the endothelial cells that line the sinusoids

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3
Q

What are Mallory bodies and when are they seen?

A

Mallory bodies are damaged IFs within the hepatocytes and they are seen in alcoholic hepatitis

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4
Q

What lab values are commonly seen in alcoholic hepatitis?

A

AST > ALT

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5
Q

What lab values are commonly seen in nonalcoholic fatty liver disease?

A

ALT > AST

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6
Q

Dx: Excess body iron leads to deposition in the tissues and organ damage; Damage is mediated by generation of free radicals

A

Hemochomatosis May be primary or secondary Increased risk of hepatocellular carcinomina

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7
Q

What is the most common genetic mutation associated with Primary Hemochromatosis?

A

HFE gene - C282Y

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8
Q

Dx: Cirrhosis Secondary DM Bronze skin

A

Hemochromatosis

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9
Q

Dx: Cirrhosis Neurological manifestations Kayser-Fleisher rings on cornea; Increased risk of hepatocellular carcinoma

A

Wilson disease

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10
Q

What is the treatment for Wilson disease?

A

D-penicillamine

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11
Q

Dx: Autoimmune, granulomatous destruction of the intrahepatic bile ducts; Antimitochondrial antibody seen in labwork

A

Primary Biliary Cirrhosis

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12
Q

Decreased serum ceruloplasmin suggests what diagnosis?

A

Wilson disease

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13
Q

Dx: Inflammation and fibrosis of intrahepatic and extrahepatic bile ducts; Periductal fibrosis with an onion-skin appearance; Beaded appearance on imaging

A

Primary Sclerosing Cholangitis Patients present with obstructive jaundice

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14
Q

Primary Sclerosing Cholangitis is associated with what other autoimmune disorder?

A

Ulcerative colitis

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15
Q

What lab test is often seen in Primary Sclerosing Cholangitis?

A

Positive p-ANCA

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16
Q

Dx: Fulminant liver failure and encephalopathy; Children; Previous viral infection treated with aspirin

A

Reye Syndrome

17
Q

Primary Sclerosing Cholangitis carries increased risk for what cancer?

A

Cholangiocarcinoma (bile ducts)

18
Q

How do children with Reye syndrome present?

A

Hypoglycemia; Elevated liver enzymes; Nausea and vomiting

19
Q

Dx: Hepatic tumor of hepatocytes; Associated with oral contraceptive use - regresses when drug is stopped; Risk of rupture and intraperitoneal hemorrhage, especially during pregnancy

A

Hepatic adenoma

20
Q

Aflatoxins from Aspergillus raise the risk for:

A

Hepatocellular carcinoma Aflatoxins induce p53 mutations

21
Q

Dx: Liver infarction due to hepatic vein obstruction; Painful hepatomegaly and ascites

A

Budd-Chiari syndrome

22
Q

What is a common cause of Budd-Chiari syndrome?

A

Hepatocellular carcinoma

23
Q

What is the serum tumor marker for hepatocellular carcinoma?

A

Alpha fetoprotein