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GI > Wk5 Liver Pathology > Flashcards

Wk5 Liver Pathology Flashcards

1
Q

Yellow discoloration of skin due to retention of bilirubin:

A

Jaundice

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2
Q

Yellow discoloration of sclera due to retention of bilirubin:

A

Icterus

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3
Q

Site of heme conversion to bilirubun:

A

reticuloendothelial cells

lymph nodes and spleen

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4
Q

bilirubin is transported to liver complexed with ?

A

albumin

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5
Q

Location of bilirubin conjugation?

What is it conjugated with?

Where does is go next?

A

Hepatocytes

glucuronic acid

bile –> feces

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6
Q

Type of bilirubin that is:

water insoluble

bound to albumin

TOXIC to tissues

not excreted in urine

A

Unconjugated

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7
Q

Type of bilirubin that is:

water soluble

not bound to albumin is serum

NOT TOXIC

excreted in urine when serum levels are high

A

conjugated

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8
Q

Impaired secretion of bile:

A

cholestasis

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9
Q

Danger of neonatal jaundice:

A

kernicterus

**long term neurologic sequelae of hyperbilirubinemia

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10
Q

How does phototherapy treat neonatal jaundice?

A

makes unconjugated bilirubin soluble

**does not conjugate it

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11
Q

Liver enzyme that conjugates bilirubin:

A

UGT1A1

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12
Q

Autosomal recessive or dominant

decrease in UGT1A1 activity

usually benign unless stressed

A

Gilbert’s syndrome

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13
Q

Inherited absence of UGT

kernicterus

usually fatal

A

Crigler-Najjar syndrome

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14
Q

Direct hyperbilirubinemia = ?

A

increased Conjugated bilirubin

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15
Q

Indirect hyperbilirubinemia = ?

A

increased Unconjugated bilirubin

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16
Q

Review cholestasis (Intrahepatic vs extrahepatic)

A

slides 16-24

17
Q

hepatitis virus

acute NOT chronic

usually asymptomatic

vaccine available

A

Hep A

HAV

18
Q

hepatitis virus present in body fluids

sexual/close contact

potential for chronic disease

vaccine available

A

Hep B

HBV

19
Q

Define “carrier state” for HBV:

A

persistent HBV infx without significant ongoing necroinflammatory disease

usually a result of exposure at childbirth

20
Q

Defective SS RNA virus

only pathogenic in presence of HBV

increases severity of HBV infx

mostly IVD use in USA

A

Delta hepatitis virus (HDV)

21
Q

80% of infx proceed to chronic hepatitis

20-30% untreated –> cirrhosis

no vaccine

high mutation rate

A

Hep C

22
Q

Tests for HCV:

A

antibody screen

if positive:

active infection detected by:

RNA PCR

23
Q

Rare form of hepatitis virus in USA

not chronic or carrier state

high mortality in pregnancy

A

Hep E (HEV)

24
Q

Two hep viruses that cannot cause chronic hepatitis:

A

A and E

25
Q

Pathological findings of ACUTE viral hepatitis:

A

lobular disarray, including:

hepatocyte degeneration

Kupffer cell hyperplasia

lymphocytic infiltration of portal tracts

26
Q

“Ground glass” hepatocytes

A

Hep B

27
Q

Massive hepatic necrosis:

focal/random

inflammatory infiltrate

likely causes?

A

viral

autoimmune

28
Q

Massive hepatic necrosis:

zonal

non-inflammatory

likely causes?

A

drugs

ischemia

29
Q

middle age female

ANA

SMA (anti-smooth muscle actin)

anti-SLA/LP

HLA-DR3

A

Type 1

Autoimmune Hepatitis

30
Q

child or adolescent

anti-ALKM-1

ALC-1

A

Type 2

Autoimmune hepatitis

31
Q

Dx of AIH:

A

Dx of exclusion

**Tx: immunosuppressives

32
Q

Pathology of AIH:

A

increased plasma cells in periportal lymphocytic infiltrate

lobular inflammation

33
Q

Mech of disease in cirrhosis:

A

stellate cells in space of Disse become fibrogenic due to injury

34
Q

Three main complications of cirrhosis:

A
  1. hepatic failure from decrease hepatic perfusion
  2. portal hypertension
  3. Hepatocellular carcinoma
35
Q

Encephalopathy and/or liver failure in children taking ASA for viral fever:

A

Reye’s syndrome

36
Q

Four manifestations of portal hypertension:

A

Ascites

Esophageal varices

Splenomegaly

Hepatic encephalopathy

37
Q

Basic extrahepatic cause of portal hypertension:

A

portal vein thrombosis

sepsis (acute appendicitis, diverticulitis)

hypercoag states

trauma

pancreatic etiologies

38
Q

Intrahepatic causes of portal HTN:

A

cirrhosis

hepatocellular carcinoma

GI (46 decks)

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