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Gastrointestinal > wk 6 5 pathology of liver 1/2 > Flashcards

wk 6 5 pathology of liver 1/2 Flashcards

1
Q

microanatomy can be divided into 3 structures

A

1 - periportal
2- mid acinar
3 - pericental
(used to describe the patterns of liver injury)

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2
Q

‘grading’ is a degree of……

‘staging’ is a degree of….

A

.. inflammation

…fibrosis

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3
Q

acute causes of jaundice 4

A

virus
alcohol
drugs
bile duct obstruction

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4
Q

acetoaminophen toxicity is seen in suicide of paracetamol consumption, what happens to liver

A

confluent necrossis

acute liver failure

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5
Q

how can jaundice be classified

A

pre-hepatic (uncomplicated)
hepatic
post-hepatic (complicated)

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6
Q

3 ways pre-hepatic jaundice can occur (too much haem)

A

haemolysis (incr in RBC breakdown = incr in bilirubin production)
haemolytic anaemias
unconjugated bilirubin ]

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7
Q

5 ways hepatic jaundice can occur

death of liver cells

A 
acute liver failure
alcoholic hepatitis
cirrhossi 
bile duct loss
pregnancy
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8
Q

4 ways post-hepatic jaundice (bile cannot escape into bowel)

A

conginetal biliary atresia
gallstonesblock
stricutres of CB Duct
Tumours (head of pancrea)

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9
Q

t/f cirrhosis iss reversible

A

true

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10
Q

define cirrhosis

A

bands of fibrosis separated by regenerative nodules of hepatocytes

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11
Q

if cirrhosis is said to be ‘micronodular’ this indicates

A

alcoholism

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12
Q

6 common causes of cirrhosis

A 
alcohol 
viral disease
iron overload
autoimmune
obstructive liver disease
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13
Q

histologically cirrhosis is

A

nodules of hepatocytes separatyed by fibrotic bands

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14
Q

main complication of cirrhosis

A

portal hypertension - porto-caval anastimoses

lead to oesophageal varices, caput medusa, haemorrhoids

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15
Q

sites of porto-caval anastimoses

A

around rectum, paraumbilical and oesophagus

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16
Q

clinical features of chronic liver disease

A 
oedema
ascites
haematemesis 
spider naevi 
gnaecomastia
purpura and bleeding
infection
coma
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17
Q

duration of drinking to turn liver into fatty liver? into hepatitis? into fibrotic? into cirrhotic?

A

2-3days (reversible)

4-6weeks (reversible)

mths-years

years

18
Q

how does the liver look histologically after 2 days

A

steatosis

lighter shade, more holes (fat vacuoles)

19
Q

other than alcohol, give 6 examples how a fatty liver can be produced

A 
NASH 
pregnaancy
drugs
nutritional
diabetes (type 2 2nd commonest cause) 
HCV (type 3)
20
Q

4 features of alcoholic hepatitis in heavy drinkin (wks - months)

A

hepatocyte necrosis
neutrophils
mallory bodies
pericellular fibrossi

21
Q

t/f collagen found in alcoholic fibrosis

A

true

this separates cells from blood supply - leading to death

22
Q

t/f metabolic syndrome can produce the same pathology of alcoholic hepatitis

A

true

non-alcoholic steatohepatitis (NASH)

23
Q

commonest cause of liver cancer

A

NASH

24
Q

Hep A - E are the common causes of virla hepatitis, what are some rare causes

A

ebstein-barr virus
yellow fever
herpes

25
Q

which of the commonest viral hepatitis is spread via faecal-oral

A

Hep A and E

26
Q

5 likely outcomes of Hep B infection

A 
death
chronic hepatitis 
cirrhosis
hepatocellular carcinoma
assymptomatic
27
Q

6 causes of chronic hepatitis

A 
Hep B
Hep C
PBC
PSC
Autoimmune 
Drug induced `
28
Q

what is seen histologically in PBC

A

chronic portal inlfammation/ bile inflammation
portal = bile = biliary
granuloma around duct

29
Q

outline the steps to cirrhosis if the patient has PBC

A

untreated leads to bile duct loss
cholestasis
inflammation - fibrosis
cirrhosis

30
Q

PSC is chronic inflammatory process affecting intra hepatic bile ducts alone t/f

A

false

intra and extra hepatic bile ducts

31
Q

which inflammatory disease is PSC related to

A

UC

32
Q

PSC or PBC has an increased risk of malignancy in bile ducts and colon

A

PSC

33
Q

what is used to test for haemochromatosis

A

perls stain

34
Q

treatment of haemochromatosis

A

venesection

35
Q

wilsons disease is due to an inherited autosomal recessive disorder of copper metabolism, where does it accumulate? serology would show low levels of…..

A

liver and brain

low serum caeruloplasmin

36
Q

what does alpha-1-1antitrypsin defiency cause

A

emphysema and cirrhosis

37
Q

how does alpha-1-antitrypsin cause emphsysema

A

used to protect against elastase neutrophils (similar protection for hepatocytes)

38
Q

hepatocellular adenoma are usually tumours which are benign, assymptomatic and found in women, however what can cause complications

A

enlargen - rupture or bleed

39
Q

hepatocellular carcinoma is associated with 3

A

Hep B
Hep C
Cirrhosis

40
Q

t/f multifocal hepatocellular carcinomas are common due to the circulation in liver

A

false

completely bawed yourself rory

Gastrointestinal (73 decks)

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