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Digestive System > systemic pathology > Flashcards

systemic pathology Flashcards

1
Q

The ___ lobule is composed of:
portal triads
hepatic sinuses,
terminal hepatic venule (central vein) and associated plates of hepatocytes

A

classic

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2
Q

the terminal hepatic vein (CV) is at the center of a “lobule,” while the portal tracts (PV) are at the periphery

A

Lobular Model

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3
Q

Pathologists refer to the regions of the parenchyma as “__ and ___.”

A

periportal

centrilobular

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4
Q

Relies on the basis of blood flow, three zones can be defined, zone 1 being the closest to the blood supply and zone 3 being the farthest

A

Acinar Model

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5
Q

The two models of the liver

A

hepatic lobular model and acinar model

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6
Q

Functionally, the liver can be divided into three zones, based upon oxygen supply:

A

zone 1
zone 2
zone 3

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7
Q

this zone encircles the portal tracts where the oxygenated blood from hepatic arteries enters

A

zone 1

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8
Q

this zone is located around central veins, where oxygenation is poor

A

Zone 3

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9
Q

these cells:
Line the sinusoids
Fenestrated, w/o tight junctions, w/o basement membrane

A

Endothelial Cells

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10
Q

these cells are Bone marrow derived phagocytes

Immune and cytokine release functions.

A

Kupfer Cells

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11
Q

these cells are Beneath endothelial cells In the space of Disse
Specialized storage capacities
Secrete ECM components

A

Stellate Cells

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12
Q

Hepatocytes have three specialized surfaces

A

Sinusoidal
Lateral
Canalicular

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13
Q

functions of the liver: (5)

A 
metabolic
synthetic
storage
catabolic
Excretory
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14
Q

this function of the liver maintaining glucose homostasis; Free Fatty acid oxidation and conversion to triglycerides and secretion as lipoproteins

A

Metabolic

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15
Q

the liver synthesizes ___ proteins

A

serum

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16
Q

the liver is storage point for :

A 
glycogen
triglycerides
iron
copper
lipid-soluble vitamin
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17
Q

in the liver, Endogenous substances are catabolized to maintain balance; detoxification of ___.

A

xenobiotics

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18
Q

the liver excretes ___

A

bile

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19
Q

the end stage of chronic liver disease

A

Cirrhosis

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20
Q

The central pathogenic processes in cirrhosis are:

A

Injury/death of hepatocytes
Extracellular Matrix deposition
Vascular reorganization

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21
Q

Cirrhosis is defined by three main morphologic characteristics:

A

Bridging fibrous septa
Parenchymal nodules.
Disruption of the architecture of the entire liver

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22
Q

Major Causes of Cirrhosis: (6)

A 
Alcoholic Liver Disease
Chronic Hepatitis
Biliary Disease
Nonalcoholic Fatty Liver Disease  (NAFLD)
Metaboloic Disease
Cryptogenic
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23
Q

types of chronic hepatitis: (3)

A

Chronic Viral Hepatitis

Autoimmune Hepatitis

Drugs

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24
Q

types of Biliary Disease

3

A

Extrahepatic Biliary Obstruction

 Primary Biliary Cirrhosis

 Sclerosing Cholangitis
25
Q

examples of metabolic diseases are (8)

A

Hemochromatosis
Wilson Disease Hereditary Fructose Intolerance
Glycogen Storage Disease
Tyrosinemia Glactosemia
α1-Antitrypsin Deficiency
Hereditary Storage Diseases

26
Q

contains small, regenerative nodules of parenchyma and fatty change.

A

Micronodular Cirrhosis

27
Q

in this situation the liver is misshapen, and the cut surface reveals irregular nodules and connective tissue septa of varying width.

A

Macronodular Cirrhosis

28
Q

The major clinical consequences in the setting of cirrhosis, shown for the male is

A

portal hypertension

29
Q

In women, oligomenorrhea, amenorrhea, and sterility are frequent, as a result of ___.

A

hypogonadism

30
Q

A daily intake of more than __ gm of alcohol in men and __ gm in women significantly increases the risk of cirrhosis

A

60

20

31
Q

Alcoholic liver disease spans three major morphologic and clinical entities:

A 
Fatty liver  (Hepatic Steatosis)
Alcoholic Hepatitis (Alcoholic Steatohepatitis)
Cirrhosis
32
Q

___ is the accumulation of intrahepatocyte fat and it is directly dependent on the intake of alcohol, since it is fully and rapidly reversible on discontinuation of alcohol ingestion. Virtually all chronic alcoholics have this

A

Steatosis

33
Q

Signs and Symptoms of Alcoholic Fatty Liver (Hepatic Steatosis)

A

few symptoms of liver disease, and does not by itself progress to more severe disease

34
Q

Treatment/Prognosis of Alcoholic Fatty Liver (Hepatic Steatosis)

A

The fatty change is completely reversible if there is abstention from further consumption of alcohol

35
Q

acute necrotizing lesion

A

Alcoholic Hepatitis

36
Q

Alcoholic Hepatitis is characterized by: (4)

A

Necrosis of hepatocytes
Mallory bodies
Neutrophilic inflammatory response
Perivenular fibrosis.

37
Q

Signs & Symptoms

A

Presents with:
malaise, anorexia, fever, right upper quadrant abdominal pain, and jaundice
mild leukocytosis

38
Q

Serum aminotransferase activities are ___ elevated and Serum Alkaline Phosphatase activity is usually ___ in alcoholic hepatitis

A

moderately

increased

39
Q

treatment for alcohol hepatitis

A

no specific treatment

40
Q

__% of alcoholics develop cirrhosis

A

15

41
Q

continued exposure to alcohol can result in steatosis and eventually ____

A

cirrhosis

42
Q

____ and ___ can result in abstinence. in other words they are reversible

A

steatosis

hepatitis

43
Q

repeated attacks of hepatitis can lead to ___

A

cirrhosis

44
Q

severe exposure when having steatosis can lead to _____

A

hepatitis

45
Q

close resemblance to Alcoholic Liver Disease.

the risk factors which appear to be the apparent triggers for the initiation of the liver disease (e.g., obesity, Type 2 Diabetes, and hyperlipidemia).

A

Nonalcoholic Fatty Liver Disease (NAFLD)

46
Q

The observed pathology of Alcoholic Liver Disease and ___ Liver Disease are mirrow images
The treatment and the prognosis are different because they are driven by the different risk factors

A

Non-Alcoholic

47
Q

In ____ disease, signs and symptoms are asymptomatic with only moderate increases in serum liver enzymes

A

Nonalcoholic Fatty Liver Disease (NAFLD)

48
Q

About one-half of the people with both severe __ and ___ have Nonacoholic Steatohepatitis (NASH)

A

obesity

diabetes

49
Q

Two major categories to describe the patterns by which drugs cause injury:

A

Predictable pattern

Unpredictable pattern

50
Q

Drugs that cause injury in a dose-dependent manner refers to:

A

Predictable pattern

51
Q

Drugs that cause injury with low frequency, irrespective of dose and without obvious predisposition (idiosyncratic reaction)

A

Unpredictable pattern

52
Q

The main treatment for DILI is withdrawal of the offending ___
However, some types of liver injury can be associated with a progressive course, possibly leading to fibrosis or cirrhosis, despite discontinuation of the ___

A

drug

drug

53
Q

____ for treatment of tuberculosis, after 3 weeks, elevated the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in a patient.

A

isoniazid

54
Q

in alcoholic cirrhosis, the greenish tint of some nodules is due to __ ___

A

bile stasis

55
Q

In severe cases of __ the venules and perivenule sinusoids are obliterated and surrounded by dense fibrous tissue

A

Central Hyaline Sclerosis

56
Q

The sudden onset of alcoholic hepatitis suggests an ___ or physiologic co-factor, but none have been identified to date

A

environmental

57
Q

daily intake of more than 60 gm of alcohol in men significantly increases the risk of cirrhosis. this corresponds to __ oz. (180 ml) of 86 (__%) proof alcohol, three 8 oz. glasses of wine, or four-and-one-half 12 oz. bottles of bear.

A

6

43

58
Q

A daily intake of 20 gm of alcohol in women significantly increases the risk of cirrhosis. This corresponds to:
2 oz. (60 ml) of 86 (43%) proof alcohol, __ 8 oz. glasses of wine, or one-and-one-half __ oz. bottles of bear

A

one

12

59
Q

In general, more than __ years of alcoholism is required to produce cirrhosis. Only __% of alcoholics develop cirrhosis

A

10

15

Digestive System (8 decks)

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