Lecture 25 - Pathology of the Liver Flashcards
Why are liver biopsies not the most accurate tool for diagnosing liver disease?
The sample is a very very small fraction of the liver and may not reflect the disease state.
Abnormal Bilirubin lab results indicate more _______ liver issues while Abnormal serum protein results indicate more _____ liver issues. Keep in mind about 90% of the liver has to be damaged before abnormal serum protein labs will be seen.
Acute
Chronic
Prothrombin time is measured as a test of liver function, as the liver produces clotting factors. What is the International Normalized Ratio (INR) supposed to be in normal patients? What about in patients on anticoag meds for heart disease?
INR about 1 in normal
INR about 2 in patients taking anticoag
Why is elevated ALT more specific for liver disease than AST?
ALT is only produced in the liver, while AST is produced elsewhere as well.
ALP is produced in liver biliary _____ epithelial cells, so it may indicate liver disease of the _____. Keep in mind it is also produced by other tissues, so be careful with elevated results. _____ is related to ALP, but it is ONLY produced in the liver. Thus, it can confirm elevated ALP is from liver damage.
Duct
Ducts
GGT
HBV is the only _____ Hep virus. It is also unique in that it is the only virus that causes the host cell to overproduce its ______ antigen –> you can find high levels of this antigen in the blood indicating ACTIVE infection.
DNA
Surface antigen (HBsAg)
Patients who do not have a robust immune reaction to HBV can become _____. What is the most significant complication for these patients?
Carriers
Hepatocellular carcinoma
What is the reason HDV cannot infect without concomitant infection with HBV?
It cannot create its own surface ag; it must use HBV’s
Hep____ is the most common chronic, blood-borne infection in the US –> it’s the cause in about 50% of chronic liver disease patients. Remember the other Hep viruses either don’t progress to chronic or do so in a much smaller fraction of infected individuals.
HepC (HCV)
One of the histology hallmarks of viral liver disease is _____ degeneration of the hepatocytes –> hydropic swelling of the cells. Also look for ______ cells in the sinusoids.
Ballooning Degeneration
Mononuclear cells
_______ bodies is the term used to describe apoptotic hepatocyes.
Acidophil bodies.
Which hep virus is associated with Fatty change?
HCV
Presence of binucleate hepatocytes (undergoing mitosis) is indicative of what?
Convalescence of Acute hepatitis –> the liver regenerates!
Cholestatic hepatitis (which could be a complication of viral hepatitis) would be indicated if serum _____ is elevated but liver _____ are not.
Bilirubin
Enzymes (e.g. ALT)
