hepatobiliary pathology Flashcards

(32 cards)

1
Q

describe the function of liver

A
  • protein synthesis
  • metabolism of fat and carbohydrates
  • storage
  • detoxification of drugs and toxins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are examples of pathologies of the liver?

A
  • liver failure
  • jaundice
  • intrahepatic bile duct obstruction
  • cirrhosis
  • tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are examples of pathologies of the gallbladder?

A

inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are examples of pathologies of the extrahepatic bile ducts?

A

obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what 2 broad categories is liver failure a complication of?

A
  • acute liver injury
  • chronic liver injury (such as cirrhosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are examples of acute liver injury?

A

hepatitis

bile duct obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what can cause hepatitis which causes acute liver injury?

A
  • viruses: hep A, B, C, E, other viruses
  • alcohol
  • drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the pathology of virus hepatitis?

A
  • inflammation of the liver
  • liver cell damage and death of the individual liver cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the possible outcomes of viral hepatitis

A
  • resolution: liver function returns to normal (hep A &E)
  • liver failure: if severe damage to the liver (hep A, B & E)
  • progression to chronic hepatitis and cirrhosis (hep B & C)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is alcohol liver disease?

A

fatty change of liver to excess alcohol

alcohol hepatitis: acute inflammation, liver cell death, liver failure, progress to cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is jaundice caused by?

A

increased circulating bilirubin

caused by altered metabolism of bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the pathways of bilirubin metabolism?

A
  1. pre-hepatic
  2. hepatic
  3. post-hepatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe the pre-hepatic pathway of bilirubin metabolism

A

breakdown of haemoglobin in spleen to form haem and globin

haem is converted into bilirubin

release of bilirubin into circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe the hepatic pathway of bilirubin metabolism

A

uptake of bilirubin by hepatocytes

conjugation of bilirubin in hepatocytes

excretion of conjugated bilirubin into biliary system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe the post-hepatic pathway of bilirubin metabolism

A

transport of conjugated bilirubin in biliary system

breakdown of bilirubin conjugate in small intestine

re-absorption of bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 3 broad categories of causes of jaundice?

A

pre-hepatic: increased haemolysis

hepatic: cholestasis, intrahepatic bile duct obstruction

post-hepatic: cholelithiasis, gall bladder diseases, extrahepatic bile duct obstruction

17
Q

what is haemolysis

A

increased release of haemoglobin from red cells

18
Q

what is cholestasis?

A

accumulation of bile within hepatocytes or bile canaliculi

19
Q

what are some causes of cholestasis?

A
  • viral hepatitis
  • alcoholic hepatitis
  • liver failure
  • drugs
20
Q

what are causes of intra-hepatic bile duct obstruction?

A
  • primary biliary cholangitis
  • primary sclerosing cholangitis
  • tumours of the liver
21
Q

what is primary biliary cholangitis?

A

an organ specific autoimmune disease

granulomatous inflammation of bile ducts → loss of intrahepatic bile ducts → cirrhosis

F>M

serum: anti-mitochondrial auto antibodies, alkaline phosphatase is raised

22
Q

what is primary sclerosing cholangitis?

A

chronic inflammation and fibrous obliteration of bile ducts → loss of intra-hepatic bile ducts → cirrhosis

increased risk of developing cholangiocarcinoma

23
Q

what is hepatic cirrhosis?

A

the response of liver to chronic liver injury → end stage chronic liver disease

liver is replaced by nodules of hepatocytes and fibrous tissue

24
Q

what causes hepatic cirrhosis?

A
  • alcohol
  • hepatitis B and C
  • immune mediated liver disease (such as auto-immune hepatitis or PBC)
  • metabolic disorders (haemochromatosis, Wilson’s disease)
  • obesity (diabetes mellitus)
25
what are some possible complications of liver cirrhosis?
altered liver function (liver failure) abnormal blood flow (portal hypertension) increased risk of hepatocellular carcinoma
26
what are examples of tumours of the liver?
* hepatocellular carcinoma (tumour of hepatocytes) * cholangiocarcinoma (tumour of bile duct) * metastatic tumours
27
what is cholelithiasis?
gallstones risk factors: obesity, diabetes
28
what are examples of diseases of the gallbladder?
acute cholecystitis chronic cholecystitis
29
what is cholecystitis
inflammation of the gallbladder
30
what causes acute cholecystitis?
empyema: pocket of pus collected inside body cavity - perforation of gallbladder - biliary peritonitis
31
what causes of extra-hepatic obstruction?
* gallstones * bile duct tumours * benign stricture * external compression (such as due to tumours)
32
What are some of the consequences of extra-hepatic bile duct obstruction?
* jaundice * no bile excreted into duodenum * ascending cholangitis (infection of bile proximal to obstruction) * secondary biliary cirrhosis if obstruction prolonged