SFP: inflammatory disorders of the liver Flashcards
What is hepatitis?
Inflammation in the liver that destroys the hepatocytes; can be due to many things.
What is the time frame for acute hepatitis?
Several weeks.
What is the time frame for chronic hepatitis?
At least 6 months.
What is the time frame for fulminant hepatitis?
Less than 6 weeks with hepatic failure.
Which viral hepatitis has the shortest incubation period?
HVA.
Which types of hepatitis have fecal-oral transmission?
HVA and HVE.
Which types of hepatitis have transmission via needles?
HVB and HVC.
Which type of hepatitis may have sexual transmission?
HVB.
Which hepatitis is most likely to progress to chronic changes?
HVC.
What are the phases of acute viral hepatitis?
Incubation, symptomatic preicteric phase, symptomatic icteric phase, and convalescence.
What are the main histologic features of acute hepatitis?
Lobular disarray, liver cell injury, acidophilic councilman bodies, inflammatory infiltrate in lobules, Kupffer and sinusoidal hyperplasia, and evidence of regeneration.
Describe lobular disarray.
Cell swelling and regeneration causes compressed vascular sinusoids and loss of normal array of hepatocytes.
Describe the appearance of liver cell injury.
Ballooning or feathery degeneration.
Describe councilman bodies.
Dying hepatocytes that are eosinophilic.
What is seen on histology in fulminant hepatitis?
Massive necrosis of liver parenchyma along with signs of liver failure.
What is the gross pathology of fulminant hepatitis?
A shrunken liver that is wrinkled, pale, and mushy.
What is the histology of fulminant hepatitis?
Massive necrosis, lymphatic infiltrate, bile duct proliferation, and pan lobular necrosis.
What is the primary determinant of disease progression of hepatitis?
The etiology.
What are morphologic features of chronic hepatitis?
Fibrosis, portal tract inflammation, and piecemeal necrosis.
What is bridging fibrosis?
Fibrosis between 2 portal tracts or between a portal tract and central vein.
What is interface hepatitis?
Spillage of cells from the portal tract into the lobule due to increased number of cells in the tract.
What are histologic features of hepatitis C?
Lymphoid aggregates, mild steatosis.
What are histologic features of hepatitis B?
Ground glass cells from virus load in the cells.
Which type of hepatitis is often a carrier state?
HVB.
What is the common population of autoimmune hepatitis?
Young or perimenopausal women.
What are extrahepatic features of autoimmune hepatitis?
Arthritis, rash, other autoimmune diseases.
What markers may be useful in autoimmune hepatitis?
ANA, ASMA, anti-LKM.
What feature is seen in the blood in autoimmune hepatitis?
Hypergammaglobulinemia.
What is seen histologically in autoimmune hepatitis?
Prominent portal tract and lobular inflammation, increased plasma cells, and piecemeal necrosis.
What happens if autoimmune hepatitis is not treated?
Rapid progression to cirrhosis.
