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Histopath > Liver > Flashcards

Liver Flashcards

(63 cards)

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1
Q

What compromises portal triad

A

Bile duct
Hepatic artery
Portal vein

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2
Q

Which zone is closest to portal triad

A

Zone 1

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3
Q

Which hepatocyte in the zone Q receives more oxygen

A

Periportal hepatocyte

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4
Q

Which zone is close to terminal hepatic vein

A

Zone 3

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5
Q

Which zone has the most liver enzymes

A

Zone 3

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6
Q

Which hepatocyte is the most mature and metabolically active in zone 3

A

Perivenular hepatocyte

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7
Q

What cell phagocytoses antigens in liver

A

Kupffer cells

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8
Q

How much bile does liver synthesis per day

A

600 to 1000 ml/ day

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9
Q

Acute hep histopathology

A

Spotty necrosis

Small foci of periportal inflammation and infiltrates)

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10
Q

Biopsy of chronic hepatitis

A

Piecemeal necrosis
Lymphocyte infiltrates
Ground glass hepatocytes

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11
Q

Which aspect of chronic hepatitis histopathology shows critical stage in the evolution of hepatitis to cirrhosis

A

Bridging from portal vein to central vein

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12
Q

Histopathology of cirrhosis liver

A

Hepatocyte necrosis
Fibrosis
Nodules of regenerating hepatocytes (which lack normal acinar structure)
Disturbance of vascular architecture

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13
Q

Gene affected in haemochromatosis

A

HFE gene
Chromosome 6
Autosomal recessive.

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14
Q

Gene affected in Wilson’s disease

A

ATP7B gene
Chromosome 13
Autosomal recessive

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15
Q

Causes of micronodular cirrhosis

A

Modules <3 mm
Alcoholic hepatitis
Biliary tract disease

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16
Q

Causes of macronodular cirrhosis

A

Modules >3mm
Viral hepatitis
Wilson’s disease
Alpha anti trypsin deficiency

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17
Q

What scoring system used to assess prognosis in liver cirrhosis

A

Modified Child’s Pugh Score

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18
Q

What does modified child Pugh score assess

A 
Albumin 
Bilirubin 
Clotting (thrombin time) 
Distension (ascites)
Encephalopathy
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19
Q

Microscopic characteristics of hepatic steatosis (fatty liver)

A

Accumulation of fat droplets in the hepatocytes (Steattosis)
Chronic exposure can cause fibrosis

Fully reversible if alcohol avoided

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20
Q

Microscopic characteristics of alcoholic hepatitis

A

Mallory Denk bodies
Hepatocyte ballooning and necrosis due to accumulation of fat, water and proteins
Fibrosis

Seen acutely after a heavy night of drinking

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21
Q

Microscopic characteristics of alcoholic cirrhosis

A 
Micronodular cirrhosis (nodules <3mm) 
I.e small nodules and bands of fibrosis
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22
Q

Most common cause of liver disease in the West

A

Non alcoholic fatty liver disease

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23
Q

Which type of non alcoholic fatty liver disease can progress to cirrhosis

A

Non alcoholic steatohepatitis (NASH)

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24
Q

Which HLA CLASS ASSOCIATED WITH AUTOIMMUNE HEPATITIS

A

HLA DR 3

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25
Antibodies associated with type 1 autoimmune hepatitis
Anti nuclear antibody Anti smooth muscle antibody Anti actin antibody Anti soluble liver antigen antibody
26
Antibody associated with type 2 autoimmune hepatitis
Anti liver kidney microsomal antibody
27
Primary biliary cirrhosis | Who is affected more m or f?
Female
28
Autoimmune inflammatory destruction of medium sized INTRAHEPATIC BILE DUCTS and CHOLESTASIS with slow development of cirrhosis over many years
Primary biliary cirrhosis
29
Biochem profile of Primary biliary cirrhosis
High ALP High cholesterol High IgM Hyperbilirubinaemia (late)
30
Antibody associated with Primary biliary cirrhosis
Antimitochondrial antibody
31
What does the ultrasound scan show in Primary biliary cirrhosis
NO bile duct dilation
32
Histology of Primary biliary cirrhosis
Bile duct loss with granulomas
33
What can you treat Primary biliary cirrhosis with
Ursodeoxycholic acid in early phase
34
Primary sclerosing cholangitis | Male or female affected more
Male
35
Inflammation and obliterating fibrosis of extrahelatic and intrahepatic bile ducts and multi focal stricture formation with dilation of preserved segments
Primary sclerosing cholangitis
36
Primary sclerosing cholangitis | Male or female affected more
Male
37
What condition is Primary sclerosing cholangitis associated with
IBD in particular UC
38
Biochem of Primary sclerosing cholangitis
High ALP | pANCA
39
USS of Primary sclerosing cholangitis
Bile duct dilation
40
ercp of Primary sclerosing cholangitis
Heading of bile ducts due to multifocal strictures
41
Histology of Primary sclerosing cholangitis
Onion skinning fibrosis - concentric fibrosis
42
What does Primary sclerosing cholangitis increase your risk of
Cholangiocarcinoma
43
What is hepatic adenoma associated with
Oral contraceptive pill
44
Most common benign lesion of liver
Haemangioma
45
Causes of hepatocellular cirrhosis
``` Hep B Hep C Alcoholic cirrhosis NAFLD Haemochromatosis Aflatoxin Androgenic steroids ```
46
Investigation for hepatocellular carcinoma
``` Alpha fetoprotein (raised) USS ```
47
Most common malignant liver lesion
``` Secondary tumour (metastasis) Usually from GI/breast/bronchus ```
48
CAuses of cholangiocarcinoma
``` Primary sclerosing cholangitis Lynch syndrome type 2 Parasitic liver disease Chronic liver disease Congenital liver abnormalities ```
49
Investigation results of haemochromatosis
Iron RAISED Ferritin RAISED transferrin saturation > 45% TIBC DECREASED
50
Treatment for haemochromatosis
Venesection | Desferrioxamine
51
Signs and sx of haemochromatosis
``` Skin bronzing Hepatomegaly Diabetes Cardiomyopathy Hypogonadosm Pseudo gout ```
52
Haemochromatosis | AR OR AD
Autosomal recessive
53
Wilson’s disease Common affected age is
Common affected age 11-14 years
54
Wilson’s disease AR OR AD
Autosomal recessive
55
Wilson’s disease gene affected
Mutated gene ATP7B. (Chr13) | Mutated means decreases biliary copper excretion and deposition of copper in liver CNS and iris
56
Histology of Wilson’s diseas e
Copper stains with rhodanine stain Mallory bodies Fibrosis
57
Signs and sx of Wilson’s diseas e
Kayser Fleuscher rings - copper deposit in descemets membrane in cornea Neuro - Parkinson’s, psychosis, dementia (basal ganglion involvement) Liver disease - acute hepatitis, fulminant liver failure of cirrhosis
58
Alpha anti 1 antitrypsin deficiency | Autosomal dominant or recessive
Autosomal dominant
59
Alpha anti 1 antitrypsin deficiency | Histology
Intracytoplasmic inclusions of A1AT which stain with PERIODIC ACID SCHIFF
60
Symptoms of Alpha anti 1 antitrypsin deficiency in children and adults
Kids - neonatal jaundice | Adults - emphysema, chronic liver disease
61
Electrophoresis of Alpha anti 1 antitrypsin deficiency
Absent alpha globulin band
62
Fitz Hugh Curtis Syndrome
RUQ pain from peri hepatitis | Violin string peri-hepatic adhesions
63
3 theories of aetiology of endometriosis
Regurgitant/implantation from retrograde menstrual flow of endometrial cells Metaplastic transformation of coelomic epithelial cells

Histopath (6 decks)

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