Circulatory liver path

Question 1

Liver infarct is due to obstruction of this vessel or its branches

Answer 1

Hepatic artery

Question 2

Pale parenchyma surrounded by hyperemia rim usually occurs in this liver condition

Answer 2

Infarct

Question 3

Does ischemic necrosis cause centrilobular or periportal necrosis of the liver?

Answer 3

Centrilobular
(periportal areas preserved)

Question 4

Thrombosis of this vessel produces the triad of hepatomegaly, severe abdominal pain, and ascites

Answer 4

Hepatic vein

Question 5

Hepatic vein thrombosis often produces this triad

Answer 5

Hepatomegaly
Severe abdominal pain
Ascites

Question 6

What is Budd-Chiari syndrome?

Answer 6

Hepatic vein thrombosis

Question 7

What causes hepatic vein thrombosis?

Answer 7

Underlying condition

Question 8

Congestion and hypoperfusion occur in this part of the liver in hepatic vein thrombosis

Answer 8

Centrilobular

Question 9

In hepatic vein thrombosis, this zone undergoes congestion and sinusoidal dilatation, necrosis

Answer 9

Zone 3

Question 10

Are the majority of cases of hepatic vein thrombosis subacute or chronic?

Answer 10

Subacute/more gradually

Question 11

What are the levels of AST/ALT in hepatic vein thrombosis?

Answer 11

Very high
(due to hepatic necrosis)

Question 12

Myeloproliferative disorders, hypercoagulable states, paroxysmal nocturnal hemoglobinuria, and mass lesions are risk factors for this

Answer 12

hepatic vein thrombosis

Question 13

Is a sudden complete occlusion of portal vein asymptomatic or fatal?

Answer 13

Often fatal
(occludes gastric/esophageal varices, mesenteric veins)

Question 14

Is hepatic artery flow preserved in portal vein thrombosis?

Answer 14

Yes = so usually no liver necrosis

Question 15

Is there liver necrosis in portal vein thrombosis?

Answer 15

Usually no
(since hepatic artery flow is preserved)

Question 16

Is there liver necrosis in hepatic vein thrombosis?

Answer 16

Yes
(due to centrilobular congestion)

Question 17

Does this describe hepatic or portal vein thrombosis:
Thrombus obstructs portal drainage (causing splenomegaly, esophageal varices, ischemic bowel disease/sepsis)

Answer 17

portal vein thrombosis

Question 18

Most cases of this liver vascular condition are due to an underlying condition, and majority are from cirrhosis

Answer 18

portal vein thrombosis

Question 19

Local vascular damage (splanchnic infections), pancreatitis, and umbilical vein thrombosis can cause this liver vasculature condition

Answer 19

portal vein thrombosis

Question 20

In neonates, thrombosis of this vein can occur due to infection

Answer 20

Umbilical vein thrombosis
(which may lead to portal vein thrombosis)

Question 21

Does this describe hepatic or portal vein thrombosis:
Venous congestion causes intestinal ischemia if extensive

Answer 21

portal vein thrombosis

Question 22

Does this describe hepatic or portal vein thrombosis:
Sequelae of portal hypertension

Answer 22

portal vein thrombosis

Question 23

This is congestion around central vein due to heart failure

Answer 23

Central passive congestion

Question 24

Central passive congestion is congestion around central vein due to this

Answer 24

Heart failure

Question 25

In Central passive congestion, there is high outflow pressure because this part of the heart cannot fill Pressure transmits to central vein

Answer 25

Right atrium

Question 26

In Central passive congestion, this part of the heart cannot perfuse liver

Answer 26

Left ventricle

Question 27

Does Central passive congestion involve right or left heart failure?

Answer 27

Both (results in centrilobular hemorrhagic necrosis)

Question 28

In Central passive congestion, there is necrosis in this part of the liver

Answer 28

Centrilobular

Question 29

In Central passive congestion, the right atrium cannot fill, resulting in pressure that transmits to this liver vessel

Answer 29

Central vein

Question 30

In Central passive congestion, the left ventricle cannot perfuse liver, so this vessel has less blood

Answer 30

Hepatic artery

Question 31

"Cardiac cirrhosis" describes this condition

Answer 31

Central passive congestion

Question 32

Hepatomegaly with blunt edges, mild increase AST/ALT, and mild bilirubin elevation are seen in this condition

Answer 32

Central passive congestion

Question 33

What are the levels of AST/ALT in Central passive congestion?

Answer 33

Mild increase

Question 34

What are the levels of bilirubin in Central passive congestion?

Answer 34

Mild elevation

Question 35

Nutmeg liver describes this condition

Answer 35

Central passive congestion (chronic passive congestion shows hemorrhage around central veins)

Question 36

Do periportal areas have congestion in Central passive congestion?

Answer 36

No (centrilobular congestion/necrosis is seen)

Question 37

This is the most common cause of portal hypertension

Answer 37

Cirrhosis

Question 38

What causes transudative effusion in ascites as seen in cirrhosis?

Answer 38

Portal HTN and low albumin

Question 39

Is AST/ALT more elevated in hepatic vein or portal vein thrombosis?

Answer 39

Hepatic vein thrombosis (due to necrosis)

Question 40

Budd-Chiari syndrome is thrombosis of this vein

Answer 40

Hepatic vein