Viral and Non-viral Liver Disease Flashcards
what are the signs of liver failure
Jaundice Icterous Acities: Hypoalbuminemia Estrogen problem Spyder angiometa Pulmar Arrythema Gynocomastia Coagulopathy
what is cirrhosis
Scarred liver
End point to many chronic liver diseases
what is compensated vs decompensated liver cirrhosis
Compensated = Functional Decompensated = Failing functions
what are the gross characteristic of liver cirrhosis
Characterized by diffuse fibrous septation that divides the liver parenchyma into nodules
Result of chronic recurring death of hepatocytes, deposition of extracellular matrix, and architectural and vascular reorganization
what is portal hypertension?
A consequence of cirrhosis
Increase blood pressure in portal system
Result of vascular reorganization in liver
Increase in sinusoidal pressure
what is the most common cause of Chronic Liver Disease in U.S. Adults
HCV
Inflammation in Hepatitis types characteristic but not pathognomonic Lymphocytes – many \_\_\_\_\_\_ Neutrophils – common in \_\_\_\_\_\_\_ Eosinophils – common in \_\_\_\_\_\_\_\_ Plasma cells – common in \_\_\_\_\_\_
hepatitides; common in viral,
steatohepatitis,
drug injury,
autoimmune hepatitis
list the microscopic findings in acute hepatitis
lobular disarray, marked inflammation throughout, widespread hepatocyte injury, no fibrosis
cytoplasmic accumulation of: Fat = \_\_\_\_\_ Bile = \_\_\_\_ Iron = \_\_\_\_\_ Copper =\_\_\_\_\_\_\_ Viral particles = \_\_\_\_\_\_\_
Steatosis, Cholestasis, Hemosiderosis/ genetic hemochromatosis, Wilson Disease / chronic cholestasis, Viral hepatitis
Serial liver biopsies track liver disease progress
“Grade” = amount of _______
“Stage” = amount of _______
inflammation and injury,
fibrous tissue deposition
Major cause of chronic liver disease worldwide
is ______
Hep B
which hepatitides never become chronic liver disease
A & E
which hepatitides have fecal - oral route of transmission
A&E
the hep D virus is Replication incompetent, completely dependent on _______
HBV coinfection
what is the Clinical Presentation of Primary Biliary Cirrhosis
Insidious onset with pruritus often appearing before jaundice.
Middle aged women most commonly affected.
Cholestatic liver function testing (elevated ALP, GGT, bilirubin)
what is common serology finding (90%) for Primary Biliary Cirrhosis
Anti-mitochondrial antibody
Clinical Presentation of primary sclerosing cholangitis
Men > women; 70% of patients have _______
Asymptomatic with persistent ________ elevation.
Progressive fatigue, pruritus, and jaundice
ulcerative colitis,
alkaline phosphatase
what is seen on cholangiography in primary sclerosing cholangitis
alternating biliary strictures and dilation
pts with Primary Sclerosing Cholangitis have an incresaed risk of ______
cholangiocarcinoma
Periductal “onion-skin” fibrosis on histology probably means ______
Primary Sclerosing Cholangitis
which drug is a Major cause of acute liver failure that leads to liver transplant in United States?
Acetaminophen
Acetaminophen is an Intrinsic hepatotoxin that can cause ________
Centrilobular necrosis (zone 3)
what is steatosis?
Accumulation of fat in hepatocytes due to Metabolic derangement of hepatocytes
what is the pathogenesis of Alcohol Steatosis/Steatohepatitis
alcohol blocks beta oxidation within the hepatocyte
which usually converts lipids to CO2 and ketones
name a histiologic finding associated with Alcohol Steatosis/Steatohepatitis
Mallory bodies
what is a Fatty liver disease associated with:
Obesity, diabetes type II, hypertriglyceridemia
Non-alcoholic steatosis/steatohepatitis
what is Alpha-1-Antitrypsin Deficiency
Genetic decreased production of alpha-1-antitrypsin (protease inhibitor)
PASD stain in Alpha-1-Antitrypsin Deficiency histology will reveal _______
pink globules
what is the Most common 1° malignant liver tumor
Hepatocellular Carcinoma
hepatocellular adenoma is a Benign neoplasm of hepatocytes. Occurs mostly in ______
Associated with _______ use
Usually no underlying ________
women of child-bearing age,
oral contraceptive,
chronic liver disease
