Chronic Liver Injury Flashcards Preview

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Flashcards in Chronic Liver Injury Deck (17):
1

Liver has a unique way of scarring called

Cirrhosis

2

Chronic viral hepatitis usually scars where?

Around Portal Triads

3

What is the single layer of hepatocytes immediately adjacent to a portal triad called?

Limiting Plate

4

Ground glass cytoplasmic appearance due to the presence of viral particles is seen most often in?

Hep B

5

In some cases of chronic viral hepatitis, the inflammation moves out past the portal triads and obscures the limiting plate, what are the two terms for this that you may see?

Interface hepatitis and piecemeal necrosis

6

Chronic active hepatitis?

Hepatitis featuring piecemeal necrosis and interface hepatitis

7

Chronic persistent hepatitis/

Hepatitis where the inflammation is confined to the portal triad

8

Remember that the course of chronic hepatitis fluctuates between periods of active disease and inactive disease. The presence of Piecemeal/interface necrosis simply means that you have biopsied during an active period.

It says nothing about the prognosis of the pt or the level of disease. ok

9

Key cells in hepatic repair?

Stellate (Ito cells)

10

How do stellate cells initiate repair?

They differentiate into myofibroblasts and secrete collagen and other extracellular matric substances into the space of disse

11

Where does the initial deposition of fibrous tissue take place in viral hepatitis?

Periportal region...this is called fibrous portal expansion

12

Where is the initial deposition of fibrous tissue in alcoholic hepatitis?

Centrolobular

13

Major cytokine effector of liver injury due to alcohol?

TNF

14

Eventually, the fibrosing repair
process creates nodules of
regenerating hepatocytes
surrounded by fibrous tissue
with loss of the normal lobular
architecture and hence loss of
the normal vascular and biliary
hookups, so blood cannot get
in properly and blood and bile
cannot get out properly.

Important summary of chronic liver injury


THIS PROCESS = Cirrhosis

That's what cirrhosis is, regeneration attempts surrounded by scarring leading to loss of normal architecture that impeded blood flow through and bile flow out

15

What percentage of alcoholics get cirrhosis?

15%

16

Remember Cirrhosis man and all the different physical effects of Cirrhosis

ok

17

Also remember that Cirrhosis can lead to Dupuytren contracture of the palm genereally involving the 4th and 5th digits

ok