Histo/Path of Liver and Gallbladder

Question 1

Hepatic lobules describe the flow of ____

Answer 1

Blood

Question 2

What type of epithelium lines the bile ductules

Answer 2

Cuboidal to columnar epithelium

Question 3

3 things in the portal triad

Answer 3

Hepatic artery proper
Hepatic portal vein
Hepatic duct

Question 4

Stellate cells

Answer 4

Store vitamin A in lipid droplets
Maintain space of Disse
~fibroblasts (help with wound healing)

Question 5

Kupffer cells

Answer 5

Derived from monocytes

Form part of sinusoidal wall

Question 6

Cirrhosis

Answer 6

End stage liver disease with extensive fibrosis
Inflammatory cells in portal tracts
Regenerative nodules
Decreased hepatic function
Impaired blood flow
Can lead to portal HTN

Question 7

3 things in a portal tract

Answer 7

Hepatic portal venule
Hepatic arteriole
Bile ductule

Question 8

2 functional surfaces of hepatocytes

Answer 8

Sinusoidal (absorptive)

Canalicular (secretory)

Question 9

3 portacaval anastomoses

Answer 9

Esophageal varices
Caput medusae
Hemorrhoids

Question 10

Functions of the liver

Answer 10

Bile production and excretion
Excretion of bilirubin, drugs, cholesterol, hormones
Metabolism
Enzyme activation
Storage (glycogen, vitamins, minerals)
Synthesis (plasma proteins)

Question 11

Cholestasis

Answer 11

Decreased bile flow

Question 12

Cholangitis

Answer 12

Inflammation of bile duct

Ex: ascending cholangitis is a bacterial infection ascending up the biliary tract

Question 13

Transudate vs exudate

Answer 13

Transudate: imbalance of starling forces across vessel walls - can get edema
Exudate: inflammation - cells and proteins in the fluid

Question 14

Causes of
1. Acute
2. Chronic
liver disease

Answer 14

1. Viral, alcohol, drugs

2. Alcohol, viral, drugs, immune, metabolic

Question 15

Hepatitis D

Answer 15

Parenteral, possibly sexual transmission
Requires coinfection with HBV
More aggressive than HBV alone

Question 16

Hepatitis E

Answer 16

Fecal oral transmission

No chronic state or vaccine

Question 17

Fatty liver disease

Answer 17

Enlarged, fatty, yellow liver
Steatosis on biopsy
Few if any symptoms
All chronic EtOH use
Can also be caused by metabolic syndrome

Question 18

Steatohepatitis

Answer 18

Steatosis + acute inflammation and fibrosis
Fever, leukocytosis, abN liver tests
Alcohol or non alcohol steatohepatitis

Question 19

Primary biliary cholangitis

Answer 19

Autoimmune destruction of intrahepatic bile ductules