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Year 2- GIT > Hepato-Biliary Pathology > Flashcards

Hepato-Biliary Pathology Flashcards

(61 cards)

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1
Q

What are the two blood supplies of the liver?

A

Hepatic artery
Portal vein

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2
Q

What is the function of the liver?

A

Protein synthesis
Fat and carb metabolism
Detoxification of drugs, toxins and alcohol

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3
Q

The majority of drugs taken orally are metabolised by what?

A

First pass metabolism

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4
Q

Which organ has a role in first class metabolism?

A

Liver

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5
Q

Where is albumin made?

A

Liver

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6
Q

How can liver failure occur?

A

As a complication of acute liver injury or chronic liver condition

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7
Q

Give an example of a chronic liver condition which can lead to liver failure.

A

Cirrhosis of the liver

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8
Q

List some acute liver injuries.

A

Bile duct obstruction
Hepatitis (drugs, alcohol, viruses)

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9
Q

What is hepatitis?

A

Inflammation of the liver

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10
Q

Why is it important that the liver gets rid of bile?

A

Bile is intrinsically toxic and if in the liver for too long, can cause toxicity

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11
Q

Which viruses cause hepatitis in acute liver injury?

A

Hep. A
Hep. B
Hep. C
Hep. E
Other viruses

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12
Q

What are the three outcomes of viral hepatitis?

A
  1. Complete resolution
  2. Liver failure
  3. Progression to chronic hepatitis and cirrhosis
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13
Q

Which types of hepatitis is it more common to have resolution with?

A

A and E

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14
Q

Which types of hepatitis is it more common to have liver failure with?

A

A, B, E

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15
Q

Which types of hepatitis is it more common to have progression to chronic hepatitis and cirrhosis with?

A

B and C

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16
Q

Which types of hepatitis are food and waterbourne?

A

A and E

->that’s why you usually get full resolution after an infection

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17
Q

Which type of hepatitis can you get a vaccination to help protect agasint it?

A

Hep. B

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18
Q

What happens in alcoholic liver disease?

A

Response of liver to excess alcohol- alcohol gives oxidative damage to cells of the liver

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19
Q

What does alcoholic hepatitis progress into?

A

Cirrhosis

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20
Q

What causes alcoholic hepatitis?

A

Fatty changes to the liver

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21
Q

Which term means fatty changes in the liver?

A

Steatosis

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22
Q

What is jaundice caused by?

A

Increased circulating bilirubin

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23
Q

Which part of the body is noticeably affected by jaundice?

A

Whites, or conjunctiva, of the eyes

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24
Q

Which organ breaks down blood cells?

A

Spleen

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25
What are the three pathways of bilirubin metabolsim?
Pre-hepatic Hepatic Post-hepatic
26
What happens in the pre-hepatic pathway of bilirubin metabolism?
Breakdown of haemoglobin into haem and globin. Haem is converted into bilirubin. Bilirubin released into circulation.
27
What happens in the hepatic pathway of bilirubin metabolism?
Uptake of bilirubin by hepatocytes. Conjugation of bilirubin in hepatocytes. Excretion of conjugated bilirubin into biliary system.
28
What does bile do?
Disperses fat
29
What happens in the post-hepatic pathway of bilirubin metabolism?
Transport of conjugated bilirubin in biliary system. Breakdown of conjugated bilirubin in intestine. Re-absorption of bilirubin.
30
Which pathway does bilirubin get reabsorbed into?
Entero-hepatic circulation
31
What can cause pre-hepatic jaundice?
Increased release of haemoglobin from red blood cells.
32
What can cause hepatic jaundice?
Cholestasis Intra-hepatic bile duct obstruction
33
Define cholestasis.
Accumulation of bile within hepatocytes or bile canaliculi
34
What are some of the causes of cholestasis?
Viral hepatitis Alcoholic hepatitis Liver failure Drugs; therapeutic and recreational
35
Which two categories can drug related cholestasis be classified as?
Predictable or unpredictable
36
What is meant by predictable cholestasis?
Dose related
37
What is meant by unpredictable cholestasis?
Not dose related
38
Which conditions can cause bile duct obstruction?
Primary biliary cholangitis Primary sclerosing cholangitis
39
What else may block the bile duct?
Tumours
40
What is primary biliary cholangitis?
Organ specific autoimmune disease which predominantly affects women.
41
Which sign in serology suggests the bile system isn't working properly?
Raised alkaline phosphatase
42
What are some of the pathological changes that occur in primary biliary cholangitis?
Granulomatous inflammation of bile ducts Loss of intra-hepatic bile ducts
43
What is primary sclerosing cholangitis?
Chronic inflammation and fibrous obliteration of bile ducts
44
What is primary sclerosing cholangitis associated with?
Inflammatory bowel disease
45
What can both types of cholangitis progress to?
Cirrhosis of the liver
46
What are you at a higher risk of if you have primary sclerosing cholangitis?
Cholangiocarcinoma
47
What is hepatic cirrhosis?
Healing of the liver by fibrosis because of continual damage
48
Can liver cirrhosis be revered?
No
49
What is the only treatment option for those with cirrhosis of the liver?
Liver transplant
50
What are the causes of cirrhosis?
Alcohol Hepatitis B and C Immune mediated liver disease Metabolic disorders Obesity
51
Name two immune mediated liver dieases.
Acute-immune hepatitis Primary biliary cholangitis
52
Which too metabolic disorders may cause cirrhosis?
Excess copper- Wilson's disease Excess iron- primary haemochromatosis
53
Describe the pathology of cirrhosis.
Loss of normal liver structure, replaced by fibrous tissue and nodules of hepatocytes
54
What are some of the complications of cirrhosis?
Liver failure Abnormal blood flow leading to portal hypertension Increased risk of hepatocellular carcinoma
55
What are some risk factors for gallstones?
Obesity Diabetes
56
What is cholecystitis?
Inflammation of the gallbladder
57
What can acute cholecystitis cause to happen?
Empyema
58
What happens in chronic cholecystitis?
Chronic inflammation and fibrosis of gallbladder
59
What are some causes of bile duct obstructions?
Gallstones Bile duct tumours Benign stricture External compression- tumours
60
What are the effects of a bile duct obstruction?
Jaundice No bile in duodenum Infection of bile proximal to obstruction
61
What may happen if there is a prolonged bile duct obstruction?
Secondary biliary cholangitis

Year 2- GIT (37 decks)

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