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E 1.2: Histology, Anatomy, Pathology, and Infectious Diseases Lab > Week 4: Liver - Fibrosis/Cirrhosis, Liver Failure, and Hepatitis > Flashcards

Week 4: Liver - Fibrosis/Cirrhosis, Liver Failure, and Hepatitis Flashcards

1
Q

ID

A

Liver Steatosis

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2
Q

ID

A

Ballooned Hepatocytes

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3
Q

ID

A

Cholestasis

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4
Q

ID

A

Left - Normal Liver cells
Right - Hepatic Necrosis

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5
Q

ID

A

Hepatocyte Apoptosis - black arrows

apoptotic hepatocytes have an “acidophil body”

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6
Q

ID

A

Hepatic Necrosis (black arrow) and normal hepatic tissue (asterisk)

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7
Q

What are examples of reversible changes in liver tissue?

A

Steatosis, Cholestasis, and Ballooned Hepatocytes

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8
Q

What are examples of “Irreversible” changes in liver tissue?

A

Apoptosis, Necrosis, and Fibrosis

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9
Q

What is the main function of stellate cells?

A

lipid storage

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10
Q

ID the organ and staining

A

Normal Liver and Trichrome Stain

collagen stains blue so in normal liver only small amounts around the portal triad is blue.

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11
Q

ID the organ and staining

A

Stage 4 - Cirrhosis and Trichrome Stain

collagen stains blue so in liver cirrhosis there is islands of hepatocytes (pink) with lots collagen replacing hepatocytes and surrounding them

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12
Q

ID the Stage

A

Stage 3 - Bridging Fibrosis

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13
Q

ID the Stage

A

Stage 4 - Cirrhosis

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14
Q

ID the organ and staining

A

Stage 3 - Bridging Fibrosis and Trichrome Staining

delicate bridging

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15
Q

ID the organ and staining

A

Stage 3 - Bridging Fibrosis and Trichrome Staining

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16
Q

ID the organ and staining

A

Normal Liver and Trichrome Stain

collagen stains blue so in normal liver only small amounts around the portal triad is blue.

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17
Q

ID

A

Stage 1 - Fibrosis

fibrous tissue starts extending beyond the portal system

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18
Q

ID

A

Stage 2 - Fibrosis

Note the collagen blue is almost connecting two portal triads

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19
Q

ID

A

Stage 3 - Bridging Fibrosis

Note the collagen in blue is connecting between portal triads

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20
Q

ID

A

Stage 4 - Cirrhosis

collagen stains blue so in liver cirrhosis there is islands of hepatocytes (pink) with lots collagen replacing hepatocytes and surrounding them

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21
Q

ID

A

Cirrhotic Liver

22
Q

ID

A

Stage 4 - Cirrhosis

23
Q

In Acute Liver failure what enzymes are markedly elevated?

A

Liver transaminases (ALT, and AST)

24
Q

What Transaminase is a specific marker for the liver?

A

ALT

L for liver

25
Q

T/F:

A decline in transaminases following acute liver fialure (ALF) is always an indication of improvement in liver function?

A

False

Decline of serum transaminases is NOT an indication of improvement but rather a reflection that there are few viable remaining hepatocytes

26
Q

ID

A

Hepatic Necrosis

27
Q

What two things must occur for a classification of Acute Liver Failure (ALF)?

A
  • Hepatic Encephalopathy
  • Coagulopathy
28
Q

Spectrum of altered mental status ranging from subtle behavioral abnormalities to marked confusion/coma/death in ALF

A

Hepatic Encephalopathy

29
Q

The liver is responsible for production of Vit K dependent and independent clotting factors and for removing activated coagulation factors. Range from easy bruising to more severe (ex: intracranial bleeding)

A

Hepatic Coagulopathy

30
Q

Renal failure occurring in patients with liver failure. Decreased renal perfusion due to systemic vasodilation, activation of the renal sympathetic nervous system with vasoconstriction of the afferent renal arterioles. Patient has a drop in urine output and a rise in blood urea nitrogen and creatinine levels.

A

Hepatorenal Syndrome

31
Q

What are the three most common causes of cirrhosis in the United States?

A
  • MAFLD
  • Alcoholic Liver Disease
  • Chronic Hepatitis C
32
Q

What three typical findings in Chronic Liver Disease?

A

Palmar Erythema
Spider angiomas
Gynecomastia

33
Q

ID

A

Palmar Erythema

34
Q

ID

A

Telangiectasia (Spider Angiomas)

35
Q

Cirrhosis of the the liver indirectly occludes the sinusoids and raises the hydrostatic pressure of the hepatic portal system. What is this termed?

A

Portal Hypertension

36
Q

Portal Hypertension leads to what 4 things?

A
  • Ascites
  • Splenomegaly
  • Hepatic Encephalopathy
  • Portosystemic Venous Shunts
37
Q

What are the 3 main Portosystemic venous shunts?

A

Esophageal Varices
Hemorrhoids
Caput Medusae

Gut, But, and Caput

38
Q

ID

A

Caput Medusae

1/3 Portosystemic Shunts

39
Q

What molecule leads to Hepatic Encephalopathy

A

Ammonia

40
Q

ID

A

Portal inflammation with interface activity

characteristic – though not specific for – viral hepatitis

41
Q

ID

A

Large portal lymphoid aggregates/follicles

characteristic – though not specific for – Hepatitis C Virus (HCV)

42
Q

ID

A

Large portal lymphoid aggregates/follicles

characteristic – though not specific for – Hepatitis C Virus (HCV)

43
Q

ID

A

Clusters of Inflammatory cells

44
Q

ID

A

Apoptotic hepatocytes

45
Q

ID

A

Hepatitis B Virus (HBV)

Ground glass hepatocytes (black arrows) - abundant endoplasmic reticulum full of hepatitis B viral antigens. These have a distinct pale appearance on H/E staining

46
Q

ID

A

Hepatitis B Virus (HBV)

Ground glass hepatocytes - abundant endoplasmic reticulum full of hepatitis B viral antigens. These have a distinct pale appearance on H/E staining

47
Q

Which viruses never cause chronic hepatitis?

A

HAV and HEV

The vowels through the bowels; Hepatitis A and E never cause chronic hepatitis and are transmitted through fecal-oral route

48
Q

What are the three ways Hepatitis B is transmitted?

A
  • Blood
  • Birth
  • Banging

The 3 B’s of HepB

49
Q

Which requires HBV co-infection?

A

HDV

becaue it is D fective

50
Q

Which type of hepatitis is more often chronic and leads to cirrhosis?

A

HCV

“Hepatitis Chronic Virus” - HCV, 80% develop chronic hepatitis, 20% develop cirrhosis.

51
Q

What are the inflammatory cells seen in acute hepatitis? Chronic hepatitis?

A

the inflammatory cells in both acute and chronic viral hepatitis are mainly T-lymphocytes

It is the pattern of injury that changes with acute vs chronic hepatitis

E 1.2: Histology, Anatomy, Pathology, and Infectious Diseases Lab (16 decks)

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