Liver

Question 1

Weight of the liver

Answer 1

1400 to 1600 grams

Question 2

Portal vein provides how many percentage of blood flow

Answer 2

60% to 70%

Question 3

Zone of the liver with the highest blood supply

Answer 3

Zone 1

Question 4

Zone of the liver with the lowest blood supply

Answer 4

Zone 1

Question 5

Reversible morpologic changes of the liver

Answer 5

Steatosis
Cholestasis
Ballooning

Question 6

Accumulation of fat

Answer 6

Steatosis

Question 7

Accumulation of bilirubin

Answer 7

Cholestasis

Question 8

A change marked by cell swelling, cytoplasmic clearing and clumping of intermediate filaments

Answer 8

Ballooning

Question 9

A hallmark of alcohol-induced or non-alcoholic steatohepatitis

Answer 9

Ballooning

Question 10

When an injury is irreversible, hepatocytes may die by

Answer 10

Necrosis and apoptosis

Question 11

Apoptotic hepatocytes described in a yellow fever

Answer 11

Councilman bodies

Question 12

Term for apoptotic hepatocytes

Answer 12

Acidophil bodies

Question 13

Hallmarks of hepatocyte apoptosis

Answer 13

Pyknosis
Kayorhrhexi
Karyolysis

Question 14

The principal cell type involved in scar deposition in the liver is the

Answer 14

Hepatic Stellate cell

Question 15

When quiescent, the main function of stellate cells is

Answer 15

Lipid storage (vitamin A)

Question 16

in several forms of acute and chronic injury, stellate cells become activated and differentiate into

Answer 16

Fibrogenic myofibroblasts

Question 17

stimuli for stellate cell activa- tion are varied and include the following except

A. Inflammatory Cytokines and Macroophage
B. ALtered interactions with ECM (Metalloproteinase 2)
C. Toxins and ROS
D. NOTA

Answer 17

D

Question 18

A concurrent loss of sinusoidal endothelial cell fenestration is termed as

Answer 18

Sinusoidal cappilarization

Question 19

The most severe form of liver disease is

Answer 19

Liver failure

Question 20

An acute liver illness associated with encephalopathy and coagulopathy

Answer 20

Acute liver failure

Occurs within 26 weeks of the initial liver injury in the absences of pre-existing liver disease

Question 21

The syndrome of acute liver failure manifests when?

Answer 21

Within 8 weeks of injury

Question 22

Very rapid onset acute liver failure is most often induced by drugs or toxins and is typically the result of

Answer 22

Massive hepatic necrosis

Question 23

Give at least 2 common causes of acute liver failure

Answer 23

1. Accidental or deliberate ingestion of acetaminophen
2. Autoimmune hepatitis
3. Acute Hep A and B
4. Other drug/toxin
5. Rare: abnormalities of blood flow, metabolic disorders, and malignancies, most commonly leukemia or lymphoma (33%), followed by breast cancer (30%) and colon cancer (7%)

Question 24

Gross features of an acute liver failure

Answer 24

Small
Bile-stained
Soft
Congested

Question 25

In acute liver failure, the liver is **initially** enlarged due to

Answer 25

Hepatocyte swelling Inflammatory infiltrates Edema

Question 26

occurs due to alterations of bile formation and flow leading to retention of bilirubin and other solutes normally eliminated in bile

Answer 26

Cholestasis

Question 27

a spectrum of disturbances in consciousness, ranging from subtle behavioral abnormalities, to marked confusion and stupor, to deep coma and death.

Answer 27

Hepatic encephalopathy ## FOOTNOTE caused by elevated ammonia levels, which correlate with impaired neuronal function and cerebral edema.

Question 28

Manifested as **nonrhythmic, rapid extension-flexion movements of the head and extremities**, best seen when the arms are held in extension with dorsiflexed wrists.

Answer 28

Asterixis

Question 29

Easy bruisability is an early sign, which can progress to life-threatening or fatal intracranial bleeding.

Answer 29

Coagulopathy ## FOOTNOTE Hepatocytes are responsible for synthesis of clotting factors II (prothrombin), V, VII, IX, X, XI, and XII, as well as fibrinogen

Question 30

arises when there is **diminished flow through the portal venous system,** which may occur because of obstruction at the prehepatic, intrahepatic, or post-hepatic level.

Answer 30

Portal Hypertension ## FOOTNOTE More commonly seen n acute liver failure

Question 31

a form of renal failure occurring in individuals with liver failure in whom **there is no intrinsic morphologic or functional cause** for kidney dysfunction

Answer 31

Hepatorenal syndrome ## FOOTNOTE onset is marked by a drop in urine output and increasing levels of urea and creatinine in the blood.

Question 32

most often associated with advanced fibrosis/cirrhosis

Answer 32

Chronic Liver Failure

Question 33

a condition marked by diffuse remodeling of the liver into parenchymal nodules (often regenerative) surrounded by fibrous bands and a variable degree of vascular (often portosystemic) shunting

Answer 33

Cirrhosis

Question 34

leading causes of chronic liver failure worldwide are

Answer 34

Hep B and C NAFLD ALD

Question 35

instances in which cirrhosis arises without any clear cause

Answer 35

Cryptogenic cirrhosis

Question 36

Diagnose. Morphologic findings: presence of parenchymal nodules surrounded by dense bands of fibrosis throughout the liver; smooth liver capsule turns into a bumpy surface with depressed areas of scarring and bulging regenerative nodules

Answer 36

Cirrhosis

Question 37

In male patients, hyperestreogenemia produces

Answer 37

hypogonadism and gynecomastia

Question 38

Hyperestrogenemia from the impaired estrogen metabolism caused by chronic liver failure produces

Answer 38

Palmar erythema and spider angioma

Question 39

The four major consequences of portal hypertension are

Answer 39

Hepatic encephalopathy Ascites Formation of portosytemic venous shunts Congeestive splenomegaly

Question 40

involves resistance to portal flow at the level of sinusoids and an increase in portal flow caused by hyperdynamic circulation

Answer 40

Portal hypertension