Patterns of liver injury Flashcards

1
Q

evolution of fatty liver disease

A

Hepatic steatosis, steatohepatitis, fibrosis/cirrhosis, CA (HCC)

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2
Q

what is metabolic syndrome

A

central (around waist) obesity, DM 2, HTN, dyslipidemia

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3
Q

What causes macrovesicular fatty liver

A

nurtritional (obesity, TPN), metabolic (DM, hyperlipidemia), drug-related (EtOH, corticosteroids)

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4
Q

what causes microvesicular fatty liver

A

pregnancy, Reye’s syndrome, tetracyclines

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5
Q

Lipogranulomas

A

cause lipoapoptosis. Exposure of non-adipose tissue (heliver) to excess long-chain FAs

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6
Q

PPARalpha

A

becomes defective/overloaded in fatty liver dz.

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7
Q

PPAR alpha vs gamma

A

alpha is signaled when fat comes into system and helps burn fat. Gamma stores fat

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8
Q

what pattern of drinking contributes more to liver damage: binge or steady

A

steady

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9
Q

ADH/ALDH2 pathway of alcohol metabolism

A

EtOH converted by Alcohol dehydrogenase (ADH) to acetaldehyde (toxic) in the cytosol which aldehyde dehydrogenase (ALDH2) then converts to acetate in the mitochondria.

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10
Q

Mutations in alcohol metabolism

A

most asians have mutant ADh that metabolizes EtOH faster resulting in acetaldehyde accumulation. ALDH2 mutation in some groups leads to inactivity and acetaldehyde buildup.

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11
Q

CYPs in EtOH metabolism

A

2E1. Generates ROS which damage hepatocytes and stimulate stellate cells to make collagen

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12
Q

three histo features of alcoholic hepatitis

A

necrosis, Mallory bodies, PMN infiltration

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13
Q

two major effects of acetaldehyde on liver

A

stellate cell activation leading to fibrosis. Steatohepatitis by altering metabolism and leading to hepatocyte death

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