Introduction to Liver Pathology

Question 1

what are the three mechanisms by which jaundice occurs?

Answer 1

Red blood cell destruction
Hepatocellular disease
Obstruction of the intrahepatic or extrahepatic bile ducts

Question 2

Normal direct bilirubin levels

Answer 2

0.0-0.3 mg/dL

Question 3

what do high levels of direct bilirubin indicate?

Answer 3

High levels implicate jaundice and hemolytic anemia

Question 4

Normal Total bilirubin levels

Answer 4

0.3-1.9 mg/dL

Question 5

what do high levels of total bilirubin indicate?

Answer 5

High levels implicate liver disease, gallstones, hepatitis

Question 6

ALT

Answer 6

Alanine aminotransferase

Question 7

what is ALT?

Answer 7

Previously referred to as serum glutamic pyruvic transaminase (SGPT). ALT is normally present in large concentrations in the liver.

Question 8

ALT normal level

Answer 8

Normal level 10-40 IU/L

Question 9

what do high levels of ALT indicate

Answer 9

High levels implicate hepatitis, cirrhosis, liver necrosis

Question 10

AST normal level

Answer 10

Normal level 10-34 IU/L

Question 11

what do high levels of AST indicate?

Answer 11

High levels implicate heart attack, muscle trauma, hepatitis, cirrhosis

Question 12

what is AST?

Answer 12

Previously referred to as serum glutamic oxaloacetic transaminase (SGOT). AST is present in brain, kidney, muscle, heart and liver.

Question 13

AST

Answer 13

Aspartate aminotransferase

Question 14

ALP normal levels

Answer 14

Normal levels 44-147 IU/L

Question 15

high levels of ALP

Answer 15

implicate leukemia, lymphoma, hepatitis

Question 16

low levels of ALP

Answer 16

protein deficiency, malnutrition

Question 17

ALP

Answer 17

Alkaline phosphatase

Question 18

total protein normal level

Answer 18

Normal level 6.0-8.3 g/dL

Question 19

High levels of total protein

Answer 19

implicate pregnancy, chronic inflammation, HIV

Question 20

Low levels of total protein

Answer 20

hemorrhage, extensive burns, liver disease

Question 21

what are developmental anomalies of the liver?

Answer 21

Agenesis
Anomalies of position
Accessory fissures
Vascular anomalies

Question 22

agenesis of the liver is ______with life

Answer 22

Incompatible

Question 23

where can agenesis of the liver occur?

Answer 23

the right, left, or caudate lobes.

Question 24

what occurs when there is agenesis of the liver

Answer 24

Hypertrophy of other lobes

Question 25

what two conditions cause the liver to be found in other locations

Answer 25

situs inversus, in which the organs are reversed, with the liver on the left and spleen on the right congenital diaphragmatic hernia or omphalocele, where varying amounts of liver tissue may herniate into the thorax or outside the abdominal cavity.

Question 26

what are true accessory fissures caused by?

Answer 26

caused by infolding of the peritoneum.

Question 27

Are true accessory fissures common

Answer 27

No

Question 28

inferior accessory hepatic fissure

Answer 28

is a true accessory fissure that stretches inferiorly from the right portal vein to the inferior surface of the right lobe of the liver.

Question 29

Are vascular anomalies common?

Answer 29

in 45% of patients

Question 30

what are common vascular anomalies?

Answer 30

Replaced left hepatic artery originating from the left gastric artery Replaced right hepatic artery originating from the superior mesenteric artery Replaced common hepatic artery originating from the superior mesenteric artery

Question 31

Variations in the portal venous anatomy

Answer 31

include atresias, strictures, and obstructing valves

Question 32

Variations in the branching of the hepatic veins

Answer 32

are common

Question 33

most common hepatic vein variation

Answer 33

when the accessory vein drains the superoanterior segment of the right lobe. It may empty into the middle hepatic vein or join the right hepatic vein

Question 34

Reidel’s Lobe

Answer 34

tongue-like, inferior projection of the right lobe of the liver beyond the level of the most inferior costal cartilage on cross-sectional images 1. It is not considered a true accessory lobe of the liver but an anatomical variant of the right lobe of the liver 3.

Question 35

heptaceullar disease

Answer 35

``` Liver cells (hepatocytes) are the immediate problem. Usually treated medically with supportive measures and drugs ```

Question 36

Obstructive disorders

Answer 36

Bile excretion is blocked. | Usually treated surgically

Question 37

Diffuse heptacellular disease

Answer 37

disease affects the hepatocytes and interferes with liver function.

Question 38

Functions of the liver

Answer 38

metabolism, digestion, storage and detoxification

Question 39

What is bilirubin

Answer 39

The pigment that is released when the red blood cells are broken down

Question 40

Hepatocellular disease

Answer 40

Liver cells (hepatocytes) are the problem

Question 41

Obstructive disease

Answer 41

Bile excretion is blocked

Question 42

Prothrombin time

Answer 42

liver enzyme that is part of the blood clotting mechanism

Question 43

Does the prothrombin time increase or decrease with cellular damage?

Answer 43

increased in the presence of liver disease with cellular damage

Question 44

Indirect Bilirubin

Answer 44

unconjugated bilirubin.

Question 45

Direct bilirubin

Answer 45

conjugated bilirubin

Question 46

LDH

Answer 46

Lactic Acid Dehydrogenase

Question 47

where is lactic acid dehydrogenase found

Answer 47

kidneys, heart, skeletal muscle, | brain, liver, and lungs

Question 48

When is LDH elevated

Answer 48

infectious mononucleosis and mildly elevated in hepatitis, cirrhosis, and obstructive jaundice. I

Question 49

Heptapetal

Answer 49

Towards the liver

Question 50

Heptafugal

Answer 50

Away from the liver