Flashcards in 112b liver injury patterns Deck (13)
Fatty liver disease - causes
1) NAFLD - non-accoholic --> silent and progressive; fat people, DM
2) AFLD - alcoholic (>20g/day)
FLD - sequence of disease
1) hepatic steatosis (fatty liver)
2) steatohepatitis - inflammation and mallory bodies
4) liver cancer
liver role in energy storage
adipocytes are overwhlemed so liver stores fat leading to steatosis
short-term, reversible change
macrovesicular fatty change (micro = reye's)
-Sustained, long-term consumption.
-Swollen and necrotic hepatocytes with
neutrophilic infiltration (lipogranulomas); excess long-chain FFA --> apoptosis
-Mallory bodies (intracytoplasmic eosinophilic inclusions) are present.
-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).
defective PPARa sensing
leads to fatty liver (fat sensor in the liver)
PPAR gama function
adipogenesis and energy conservation (makes you fat)
what part of alcohol causes damage?
acetaldehyde (metabolite) - also causre vasodilation, flushing, low blood pressure, sweating, palpitations
what causes liver damage (type of drinking)
chronic, slow and steady - not binge drinking
metabolism of alcohol
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
proliferate and causes fibrosis in liver with AFLD from ROS and acetaldehyde