Chronic Liver Injury Flashcards
What is the limiting plate?
the single of hepatocytes immediately adjacent to the portal triad.
When do you classically see ground glass?
hep b, although the minority of pts will actually have them
when the inflammation of chronic hepatitis is not confined to the portal traids, but extends byond them, what do we call this?
interface hepatitis, destroying the limiting plate
what are the key players in hepatic repair responses and what do they do?
ito or stellate cells
they differentitate into myofibroblasts and secrete collagen and other extra-cellular matrix substances into the space of disse
what is central sclerosis and when does it commonly occur?
it is fibrosis developing around the central veins and commonly occurs in chronic alcholics
when central sclerosis occurs, what do we call it?
bridging fibrosis
what is normally in the space of disse?
delicate framework of type iv collagen and other proteins
what is pathologically in the space of disse?
with chronic injury, a dense extracellular matrix with type i collagen and type iii collagen is deposited?
what is the major cytokine effector of liver injury due to alcohol?
tnf, which activate stellate cells along with il-1
eventually, what does the fibrosing repair create?
nodules of regenerating hepatocytes surrounded by fibrous tissuew ith loss of normal lobular architecture and loss or normal vascular and biliary hookups, so blood cannot get in properly and blood and bile cannot get out properly
what is the most clinically important manifestation of cirrhosis?
esophageal varices
what are spider angiomas?
vascular lesions surround by many smaller vessels, commonly seen in cirrhosis
what is dupuytren’s contracture associated with
cirrhosis (esp alcohol) and diabetes
what are hte msot common causes of cirrhosis?
alcohol
hepc
nash
hemochromatosis
nash is associated with elevated levels of?
inflammtory cytokines like tnf il6 and mcp1
