Systems pathology- liver

Question 1

Name some functions of the liver

Answer 1

Carb and fat metabolism. protein and bile synthesis. storage of ions etc. detoxification

Question 2

Describe how the supply of blood differs to different hepatocytes

Answer 2

Centrilobar = LOW 02 low oxidase high esterase
Peripheral = HIGH 02 high oxidase low esterase

Question 3

What are the responses of the liver to injury

Answer 3

Fatty change, Cholestasis, Inflammation, Fibrosis, Regeneration, Hepatocyte necrosis, Neoplasia

Question 4

What two things are elevated during cholestasis?

Answer 4

Bilirubin. alkaline phosphatase

Question 5

Describe the three ways liver failure can occur

Answer 5

1. Acute liver damage (virus or toxin) –> liver cell necrosis
2. Systemic shock –> liver cell necrosis
3. Chronic disease –> acute decline

Question 6

Name 4 features of acute liver failure and how they are caused

Answer 6

1. Jaundice - cant metabolise biliruben
2. Encephalopathy - failure to clear N products
3. renal failure - decreased GFR
4. bleeding - cant produce clotting factors

Question 7

Define Cirrhosis and Chronic Hepatitis

Answer 7

Cirrhosis - nodules of regeneration separated by fibrosis. distorted architecture.
Chronic hepatitis - inflammation of the liver lasting >6 months

Question 8

Describe some causes of Hepatitis

Answer 8

Hep B,C,D
Drugs
Autoimmune
Metabolic disease e.g. wilsons

Question 9

Define how the Grade and Stage of liver damage is assessed

Answer 9

GRADE = severity of necrosis and inflammaion 
STAGE = fibrosis

Question 10

Consequences of cirrhosis

Answer 10

Reduced hepatocyte function

Portal hypertension

Question 11

Name three things portal hypertension can cause

Answer 11

Ascites, Splenomegaly, anastomosis (oesophageal varicies)