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Gastrointestinal - Pathology > Liver II > Flashcards

Flashcards in Liver II Deck (38):
1

What serological markers are found in autoimmune hepatitis?

Anti-nuclear antibodies and anti-smooth muscle actin and elevated IgG

2

What is seen on biopsy of autoimmune hepatitis?

Plasma cells and inflammation

3

How do you treat AIH?

Corticosteroids

4

What causes most cases of cirrhosis?

Alcoholic liver disease

5

What are the three main causes of death associated with cirrhosis?

Progressive liver failure
Complications of portal hypertension
Hepatocellular carcinoma

6

What is the most common cause of acute liver failure?

Acetaminophen overdose

7

What is the most common cause of chronic liver failure?

Cirrhosis

8

What is the clinical manifestation of liver failure?

Jaundice
Hypoalbumin
Coagulopathy
Hyperammonemia
Fetor hepaticus
AST/ALT
Hypoglycemia
Endocrine changes
Decreased drug metabolism

9

What is the most common cause of portal hypertension?

Cirrhosis

10

What are the main complications of portal hypertension?

Splenomegaly
Hepatic Encephelopathy
Esophageal Varices
Ascites

11

What cells are often seen on liver biopsy for alcoholic hepatitis?

Swelling liver cells
Mallory bodies
Neutrophils

12

What can steatofibrosis oftentimes lead to?

cirrhosis

13

What are the major causes of death for alcoholic cirrhosis?

Encephalopathy, coma
Esophageal varices
Infection
Hepatorenal syndrome
Hepatocellular carcinoma

14

What is the gross appearance of alcoholic cirrhosis?

Early: Enlarged, fatty, micronodular
Late: Shrunken, nonfatty, nodules varying in size, cholestasis

15

What oftentimes leads to non-alcoholic liver disease?

Insulin resistance

16

What is defined as an autoimmune cholangiopathy characterized by porgressive inflammatory destruction of small and medium sized intrahepatic bile ducts?

Primary biliary cirrhosis

17

How does primary biliary cirrhosis present?

Anicteric pruritis
Xanthomas
Bile stuff

18

What serological marker is common in primary biliary cirrhosis?

Antimitochondrial antibodies

19

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
4: Cirrhosis

20

What causes secondary biliary cirrhosis?

Anything causing prolonged bile duct obstruction

21

What is defined as an autoimmune cholangiopathy with progressive, random, uneven fibroinflammatory destruction of extrahepatic and intrahepatic bile ducts?

Primary sclerosing cholangitis

22

Who usually gets PSC?

People with IBD
Male
40 years

23

What gene is oftentimes mutated in hereditary hemochromatosis? What is the change?

HFE, regulates hepcidin synthesis
C282Y

24

What is the clinical triad of Hereditary hemochromatosis?

Cirrhosis, diabetes, skin pigmentation

25

What is the best screening test for Hereditary Hemochromatosis?

Fasting transferrin saturation

26

What is different on liver biopsy for primary and secondary hemochromatosis?

In secondary, iron initially accumulates in the Kupffer cells, not hepatocytes

27

What is the inheritance pattern of Wilson's disease and what is mutated?

Autosomal recessive
ATP7B is mutated

28

What serum levels are low in Wilson's disease?

Ceruloplasmin

29

What causes liver disease with A1AT deficiency?

Accumulation of A1AT in hepatocytes

30

What is direct hepatotoxicity in terms of drug induced liver damage?

Toxic in a predictable, dose dependent manner.

31

What is unpredictable hepatotoxicity (with drugs)?

Idiosyncratic liver injury from drugs. Not all exposed will develop injury

32

What causes Reye's syndrome?

Aspirin after acute viral illness

33

What are the symptoms for Reye's syndrome?

Liver injury and encephalopathy

34

What is seen on liver biopsy for Reye's syndrome?

Small lipid vacuoles in hepatocytes
Microvesicular steatosis

35

What is neonatal cholestasis?

Diseases caused by Prolonged conjugated hyperbilirubinemia in theanemia

36

What is defined as a complete or partial obstruction of the biliary tree in the first three months of life?

Biliary atresia

37

What are the most common causes of neonatal hepatitis?

Biliary atresia
Metabolic disorders (A1AT deficiency, CF)
Infections
Idopathic

38

What causes granulomatous hepatitis?

Idiopathic (50%)
Sarcoidosis (22%)
Drug related (6%)
Tuberculosis (3%)