112b liver injury patterns Flashcards Preview

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Flashcards in 112b liver injury patterns Deck (13):
1

Fatty liver disease - causes

1) NAFLD - non-accoholic --> silent and progressive; fat people, DM
2) AFLD - alcoholic (>20g/day)

2

FLD - sequence of disease

1) hepatic steatosis (fatty liver)
2) steatohepatitis - inflammation and mallory bodies
3) fibrosis/cirrhosis
4) liver cancer

3

liver role in energy storage

adipocytes are overwhlemed so liver stores fat leading to steatosis

4

hepatic steatosis

short-term, reversible change
macrovesicular fatty change (micro = reye's)

5

alcoholic hepatitis

-Sustained, long-term consumption.
-Swollen and necrotic hepatocytes with
neutrophilic infiltration (lipogranulomas); excess long-chain FFA --> apoptosis
-Mallory bodies (intracytoplasmic eosinophilic inclusions) are present.

6

alcoholic cirrhosis

-Final and irreversible form.
-Micronodular, irregularly shrunken liver with “hobnail” appearance.
-Sclerosis around central vein(zone III).
-Has manifestations of chronic liver
disease (e.g., jaundice, hypoalbuminemia).

7

defective PPARa sensing

leads to fatty liver (fat sensor in the liver)

8

PPAR gama function

adipogenesis and energy conservation (makes you fat)

9

what part of alcohol causes damage?

acetaldehyde (metabolite) - also causre vasodilation, flushing, low blood pressure, sweating, palpitations

10

what causes liver damage (type of drinking)

chronic, slow and steady - not binge drinking

11

metabolism of alcohol

oxidative process
ethanol --> acetaldehyde --> acetate via
1) ADH/ALDH2 system (ALDH2 fast in asians, some can't metabolize acetald so protective)
2) CYP2E1 (ROS generation leading to damage in liver)
3) peroxisomal catalase

12

stellate cells

proliferate and causes fibrosis in liver with AFLD from ROS and acetaldehyde

13

types of hepatic fibrosis

Perivenular Fibrosis: Surrounding central veins
Pericellular Fibrosis: Circling single or groups of liver cells
Perisinusoidal Fibrosis: Within the sinusoids and space of Disse