Hepatic Pathology

Question 1

Is jaundice a disease?

Answer 1

No, jaundice is a sign that can occur in many different diseases.

Question 2

List five causes of hepatitis.

Answer 2

Alcohol, viral, non-alcoholic steatohepatitis (NASH), drugs, autoimmune hepatitis.

Question 3

Name 5 viruses (besides Hep A-E) that can cause hepatitis.

Answer 3

CMV, EBV, HSV, varicella, adenovirus.

Question 4

Name 5 more hepatotropic viruses.

Answer 4

Reovirus, mumps, yellow fever, coxsackie B, echovirus.

Question 5

Name another 3 hepatotropic viruses.

Answer 5

Marburg virus, Lassa fever virus, Rift Valley fever virus.

Question 6

What virus causes syncytial giant cell hepatitis?

Answer 6

Syncytial giant cell hepatitis virus.

Question 7

How is hepatitis A transmitted?

Answer 7

Faeco-oral route.

Question 8

Name 3 settings where hepatitis A transmission is common.

Answer 8

Household, intimate contact, institutional settings.

Question 9

How is hepatitis B transmitted?

Answer 9

Blood-to-blood, sexual transmission, unsterile needles, mother-to-baby at childbirth.

Question 10

Name 4 personal items that can transmit hepatitis B.

Answer 10

Razors, toothbrushes, earrings, body piercing tools.

Question 11

Name 2 other ways hepatitis B can be transmitted.

Answer 11

Tattooing and acupuncture.

Question 12

Name 4 ways hepatitis C is transmitted.

Answer 12

Injecting drug use, blood transfusion, household and sexual contact, healthcare exposure.

Question 13

What percentage of hepatitis C cases have an unknown transmission route?

Answer 13

A significant number (exact percentage not stated, but “unknown” noted as a route).

Question 14

What is the most common cause of acute viral hepatitis worldwide?

Answer 14

Hepatitis E.

Question 15

What is the standard mortality rate for hepatitis E?

Answer 15

Less than 1%.

Question 16

What is the mortality rate for hepatitis E in pregnant women?

Answer 16

Up to 25%.

Question 17

What is the mortality if hepatitis E occurs with chronic liver disease?

Answer 17

Up to 70%.

Question 18

What animal is the primary host for hepatitis E?

Answer 18

Pig.

Question 19

What percentage of pig livers tested positive for hepatitis E in a US grocery store?

Answer 19

11%.

Question 20

What food product has been linked to hepatitis E transmission?

Answer 20

Figatelli (pig’s liver sausage).

Question 21

How many hepatitis E cases were notified in the UK in 2011?

Answer 21

454 cases.

Question 22

What is the estimated incidence of hepatitis E in the UK?

Answer 22

0.2% (about 120,000 cases/year).

Question 23

Are most hepatitis E cases symptomatic or asymptomatic?

Answer 23

Most are asymptomatic or unrecognised.

Question 24

What are the 3 key processes in the pathogenesis of cirrhosis?

Answer 24

Development of fibrosis, formation of nodules, portal hypertension.

Question 25

Name 4 complications of cirrhosis.

Answer 25

Hepatic encephalopathy, portal hypertension, ascites/spontaneous bacterial peritonitis (SBP), hepatorenal syndrome.

Question 26

What is the liver’s role in glucose metabolism?

Answer 26

Storage of glycogen, release of glucose, gluconeogenesis.

Question 27

Name two proteins synthesized by the liver.

Answer 27

Albumin and coagulation factors.

Question 28

What waste product does the liver produce from amino acid catabolism?

Answer 28

Urea.

Question 29

How does the liver handle nitrogenous molecules from the gut?

Answer 29

Detoxifies them.

Question 30

Name 2 roles of the liver in lipid metabolism.

Answer 30

Lipoprotein synthesis and conjugation/excretion of bilirubin.

Question 31

What does the liver produce and excrete to aid fat digestion?

Answer 31

Bile salts.

Question 32

What pigment is responsible for the yellow color in jaundice?

Answer 32

Bilirubin.

Question 33

How does the liver participate in immunity?

Answer 33

It participates in immune processes (Kupffer cells, antigen processing, etc.).

Question 34

Where is bilirubin produced?

Answer 34

From the breakdown of haem in the reticuloendothelial system.

Question 35

How is bilirubin made water-soluble?

Answer 35

By conjugation in the liver.

Question 36

How is conjugated bilirubin excreted?

Answer 36

Into bile and then the intestine.