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Flashcards in Liver I Deck (27):
1

What transports unconjugated bilirubin?

Albumin

2

What is added to make bilirubin "conjugated"?

Glucuronic acid

3

Which bilirubin is toxic to tissues?

Unconjugated bilirubin

4

What types of processes lead to high levels of unconjugated bilirubin?

Increased bilirubin production
Impaired bilirubin uptake (heart failure, shunts, some drugs)
Impaired conjugation (Gilbert's, Hyperthyroidism, liver diseases)

5

What processes lead to increased conjugated bilirubin?

Extrahepatic cholestasis
Intrahepatic cholestasis

6

What is Gilbert's syndrome?

Decreased glucuronyltransferase activity, leading to increased unconjugated bilirubin

7

What is the inheritance pattern of Gilbert's syndrome?

Autosomal recessive

8

What is the difference between hepatocellular cholestasis, canalicular cholestasis, and acute cholangitis?

Hepatocellular: Bile stasis in hepatocytes
Canalicular: Bile plugged within bile ducts
Acute cholangitis: Inflammation of bile ducts with neutrophils in ducts

9

What is chronic passive congestion?

Centrilobular circulation congestion

10

What is defined as centrilobular congestion with centrilobular necrosis?

Centrilobular hemorrhagic necrosis

11

What is defined as a fibrosing reaction of pericardium following longstanding CPC and/or centrilobular necrosis?

Cardiac sclerosis

12

What is described as a "nutmeg" liver?

Centrilobular hemorrhagic necrosis

13

What areas are spared in centrilobular hemorrhagic necrosis?

periportal areas

14

What is defined as a thrombosis of two or more hepatic vein branches?

Budd chiari syndrome

15

What does Budd-Chiari syndrome often present as?

Triad: Hepatomegaly, ascites, abdominal pain

16

What is the pathology of Budd-Chiari syndrome?

Centrilobular hemorrhagic necrosis
Cardiac sclerosis

17

What is defined as an obstructive, nonthrombotic lesion of central hepatic veins?

Sinusoidal obstruction syndrome

18

What is the main problem with sinusoidal obstruction syndrome?

Increased exposure to hepatotoxins

19

What are acute symptoms of Sinusoidal obstruction syndrome? Chronic?

Acute: Hepatomegaly, weight gain, jaundice
Chronic: Pyrrolizidine alkaloids causing toxic effects, leading to Budd Chiari symptoms

20

Which vessels are affected in Sinusoidal obstruction syndrome?

central veins

21

What is defined as sinusoidal dilatation with rupture, leading to blood filled spaces?

Peliosis hepatis

22

What causes peliosis hepatis?

Anabolic steroids, contraceptives, danazol, AIDS infection, malignancy

23

What is done to prevent perinatal HBV?

treat with HepB immune globulin and HepB vaccine. Prevents chronic carrier state when administered 2-12 hours after birth

24

What are the phases of acute viral hepatitis?

Incubation
Preicteric (symptoms)
Icteric
Convalescence/liver failure/chronic hep

25

What is the pathology of acute hepatitis?

Diffuse liver cell degenration with focal hepatocellular necrosis and apoptosis

26

What liver cells are proliferated in acute hepatitis?

Kupffer cells

27

Do you biopsy acute hepatitis?

Seldom.