Pathology of the Liver 2 - Week 6

Question 1

Give common causes of viral hepatitis.

Answer 1

Hepatitis A, B, C, E

Question 2

Give less common causes of viral hepatitis.

Answer 2

Ebstein-Barr virus, Yellow fever virus, Herpes Simplex virus, Cytomegalovirus

Question 3

How is Hepatitis A spread?

Answer 3

Faecal-oral spread

Question 4

Is there a carrier state in Hepatitis A?

Answer 4

No

Question 5

How does Hepatitis A present?

Answer 5

Mild illness, usually full recovery. Small % develop acute liver failure

Question 6

How is Hepatitis B spread?

Answer 6

blood, blood products, sexually, vertically (in utero)

Question 7

Do carriers of Hepatitis B exist?

Answer 7

Yes

Question 8

How does liver damage occur by Hepatitis B?

Answer 8

antiviral immune response

Question 9

How is Hepatitis C spread?

Answer 9

by blood, blood products, possibly sexually

Question 10

What is seen histologically for chronic viral hepatitis?

Answer 10

Portal triad inflammation

Question 11

What are the different outcomes of Hepatitis B infection?

Answer 11

Fulminant acute infection (Death)
Chronic hepatitis
Cirrhosis
Hepatocellular carcinoma
Assymptomatic

Question 12

What are the different outcomes of Hepatitis C infection?

Answer 12

Chronic Hepatitis

Cirrhosis

Question 13

Name 3 autoimmune diseases which result in chronic hepatitis.

Answer 13

Primary Biliary Cirrhosis
Autoimmune hepatitis
Primary Sclerosing Cholangitis

Question 14

Which marker would be raised in Primary Biliary Cirrhosis?

Answer 14

AMA

Question 15

Why would biopsy be important in Primary Biliary Cirrhosis?

Answer 15

For staging the disease

Question 16

Which features would be seen in Primary Biliary Cirrhosis?

Answer 16

May see granulomas and bile duct loss

Question 17

Primary Biliary Cirrhosis may result in…

Answer 17

Cholestasis and Cirrhosis

Question 18

Autoantibodies to smooth muscle, nuclear or LKM, raised IgG suggest…

Answer 18

Autoimmune Hepatitis

Question 19

What effects may drugs have on the liver?

Answer 19

hepatitis, granulomas, fibrosis, necrosis, failure, cholestasis or cirrhosis

Question 20

What is meant by Primary Sclerosing Cholangitis?

Answer 20

Chronic inflammatory process affecting intra - and extra-hepatic bile ducts

Question 21

Primary Sclerosing Cholangitis is associated with…

Answer 21

Ulcerative Colitis

Question 22

Primary Sclerosing Cholangitis is most common in which group?

Answer 22

Males

Question 23

What is Haemochromatosis?

Answer 23

excess iron within the liver

Question 24

What is meant by primary Haemochromatosis?

Answer 24

Excess absorption of iron from intestine, abnormal iron metabolism

Question 25

What is the effect of Primary Haemochromatosis on the liver?

Answer 25

Eventually deposited in portal connective tissue and stimulates fibrosis, Cirrhosis if not treated

Question 26

Iron in the liver is confirmed by…

Answer 26

Perl’s stain

Question 27

Haemochromatosis leads to increased risk of…

Answer 27

Hepatocellular carcinoma

Question 28

What is the pathology of Wilson’s disease?

Answer 28

Copper accumulates in liver and brain, low caeruloplasmin

Question 29

What is the effect of Wilson’s disease?

Answer 29

Cirrhosis and neurological complications

Question 30

Which clinical sign may be present in Wilson’s disease?

Answer 30

Kayser-Fleischer rings

Question 31

Alpha-1-antitrypsin deficiency results in…

Answer 31

Cirrhosis & Emphysema

Question 32

What is a Hepatocellular Adenoma?

Answer 32

Benign tumour of the liver, usually asymptomatic