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GI AM > Hepatobiliary pathology > Flashcards

Hepatobiliary pathology Flashcards

1
Q

What are the 2 blood supplies to the liver?

A

Hepatic artery

Portal vein

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2
Q

What are the functions of the liver?

A

Protein synthesis
Metabolism of fat and carbohydrate
Detoxification of drugs and toxins

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3
Q

What is liver failure a complication of?

A

Acute or chronic liver injury

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4
Q

What are the causes of acute liver injury?

A

Hepatitis- viruses, alcohol, drugs

Bile duct obstruction

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5
Q

What are the causes of chronic liver injury?

A

Cirrhosis

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6
Q

What does viral hepatitis do?

A

Targets liver cells and causes inflammation

Causes liver cell damage and death of individual liver cells

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7
Q

What are the outcomes of acute inflammation in the liver?

A

Resolution
Liver failure
Progression to chronic hepatitis and cirrhosis

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8
Q

What is alcoholic liver disease?

A

Response of the liver to excess alcohol

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9
Q

What is the progression of alcoholic liver disease?

A

Acute inflammation –> liver cell death –> liver failure–> progression to cirrhosis

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10
Q

What is jaundice?

A

Increased circulating bilirubin causing the skin and eyes to take on a yellow tone
Caused by altered metabolism of bilirubin

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11
Q

What are the 3 parts of bilirubin metabolism?

A

Prehepatic
Hepatic
Post hepatic

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12
Q

What happens in the pre hepatic stage of bilirubin metabolism?

A

Breakdown of haemoglobin in spleen to form haemorrhage and globin
Globin converted to bilirubin
Release of bilirubin into curculation

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13
Q

What happens in the hepatic stage of bilirubin metabolism?

A

Uptake of bilirubin by hepatocytes
Conjugation of bilirubin in hepatocytes
Excretion of conjugated bilirubin into biliary system

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14
Q

What happens in the post hepatic stage of bilirubin metabolism?

A

Transport of conjugated bilirubin in biliary system
Breakdown on bilirubin conjugate in intestine
Reabsorption of bilirubin

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15
Q

What is the enterohepatic circulation?

A

Circulation of substances, such as bilirubin, from the liver to the bile, entering the small intestine, absorption into he enterocyte and transport back to the liver

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16
Q

What are the 3 classifications of jaundice?

A

Pre hepatic
Hepatic
Post hepatic

17
Q

What is the pre hepatic cause of jaundice?

A

Increased release of haemoglobin from red cells

18
Q

What are the hepatic causes of jaundice?

A

Cholestasis

Intrahepatic bile duct obstruction

19
Q

What is cholestasis?

A

Accumulation of bile in hepatocytes or bile canaliculi

20
Q

What causes cholestasis?

A

Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs- therapeutic or recreational

21
Q

What are the causes of intrahepatic bile duct obstruction?

A

Primary biliary cholangitis
Primary sclerosis cholangitis
Tumours of the liver

22
Q

What is primary biliary cholangitis?

A

Female predominant organ specific autoimmune disease

23
Q

What is the pathology of primary biliary cholangitis?

A

Granulomatous inflammation involving bile ducts
Loss of intrahepatic bile ducts
Progression to cirrhosis

24
Q

What is primary sclerosis cholangitis?

A

Chronic inflammation and fibrous obliteration of bile ducts, causing loss of intrahepatic bile ducts

25
Q

What are the types of tumour of the liver?

A

Hepatocellular carcinoma
Tumours of intrahepatic bile ducts
Metastatic tumours

26
Q

What are the post hepatic causes f jaundice?

A

Cholelithiasis (gallstones)

Extra hepatic bile duct obstruction

27
Q

What are he risk factors of cholelithiasis?

A

Obesity

Diabetes

28
Q

What is the pathology of cholelithiasis?

A

Acute or chronic inflammation

29
Q

What are the causes of extra hepatic bile obstruction?

A

Gallstones
Bile duct tumours
Benign stricture
External compression (tumours)

30
Q

What are the effects of extra hepatic bile obstruction?

A

No bile secreted into duodenum

Infection of bile proximal to obstruction

31
Q

What is cirrhosis?

A

End stage chronic liver disease

Response pf the live to chronic injury

32
Q

What are the causes of cirrhosis?

A 
Alcohol
Hep B, C
Immune mediated liver disease
Metabolic disorders
Obesity
Unknown cause
33
Q

What immune mediated liver diseases can cause cirrhosis?

A

Autoimmune hepatitis

Primary biliary cholangitis

34
Q

What metabolic disorders can cause cirrhosis?

A

Primary haemochromatosis- excess iron

Wilson’s disease- excess copper

35
Q

What is the most common cause of cirrhosis?

A

Unknown cause

36
Q

What is the pathology of cirrhosis?

A

Diffuse process involving the whole liver
Loss of normal liver structure
Hepatocytes replaced by fibrous tissue

37
Q

What are the complications of cirrhosis?

A

Altered liver function- liver failure
Abnormal bloodflow- portal hypertension
Increased risk of hepatocellular carcinoma

GI AM (34 decks)

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