Flashcards in Liver II Deck (38):
What serological markers are found in autoimmune hepatitis?
Anti-nuclear antibodies and anti-smooth muscle actin and elevated IgG
What is seen on biopsy of autoimmune hepatitis?
Plasma cells and inflammation
How do you treat AIH?
What causes most cases of cirrhosis?
Alcoholic liver disease
What are the three main causes of death associated with cirrhosis?
Progressive liver failure
Complications of portal hypertension
What is the most common cause of acute liver failure?
What is the most common cause of chronic liver failure?
What is the clinical manifestation of liver failure?
Decreased drug metabolism
What is the most common cause of portal hypertension?
What are the main complications of portal hypertension?
What cells are often seen on liver biopsy for alcoholic hepatitis?
Swelling liver cells
What can steatofibrosis oftentimes lead to?
What are the major causes of death for alcoholic cirrhosis?
What is the gross appearance of alcoholic cirrhosis?
Early: Enlarged, fatty, micronodular
Late: Shrunken, nonfatty, nodules varying in size, cholestasis
What oftentimes leads to non-alcoholic liver disease?
What is defined as an autoimmune cholangiopathy characterized by porgressive inflammatory destruction of small and medium sized intrahepatic bile ducts?
Primary biliary cirrhosis
How does primary biliary cirrhosis present?
What serological marker is common in primary biliary cirrhosis?
What are the four stages for PBC?
1: Lymphocytic/granulomatous cholangitis in portal tracts
2: Periportal hepatitis with periportal fibrosis
3: Bridging necrosis with bridging fibrosis
What causes secondary biliary cirrhosis?
Anything causing prolonged bile duct obstruction
What is defined as an autoimmune cholangiopathy with progressive, random, uneven fibroinflammatory destruction of extrahepatic and intrahepatic bile ducts?
Primary sclerosing cholangitis
Who usually gets PSC?
People with IBD
What gene is oftentimes mutated in hereditary hemochromatosis? What is the change?
HFE, regulates hepcidin synthesis
What is the clinical triad of Hereditary hemochromatosis?
Cirrhosis, diabetes, skin pigmentation
What is the best screening test for Hereditary Hemochromatosis?
Fasting transferrin saturation
What is different on liver biopsy for primary and secondary hemochromatosis?
In secondary, iron initially accumulates in the Kupffer cells, not hepatocytes
What is the inheritance pattern of Wilson's disease and what is mutated?
ATP7B is mutated
What serum levels are low in Wilson's disease?
What causes liver disease with A1AT deficiency?
Accumulation of A1AT in hepatocytes
What is direct hepatotoxicity in terms of drug induced liver damage?
Toxic in a predictable, dose dependent manner.
What is unpredictable hepatotoxicity (with drugs)?
Idiosyncratic liver injury from drugs. Not all exposed will develop injury
What causes Reye's syndrome?
Aspirin after acute viral illness
What are the symptoms for Reye's syndrome?
Liver injury and encephalopathy
What is seen on liver biopsy for Reye's syndrome?
Small lipid vacuoles in hepatocytes
What is neonatal cholestasis?
Diseases caused by Prolonged conjugated hyperbilirubinemia in theanemia
What is defined as a complete or partial obstruction of the biliary tree in the first three months of life?
What are the most common causes of neonatal hepatitis?
Metabolic disorders (A1AT deficiency, CF)