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Jason's GI Block > Liver Injury > Flashcards

Liver Injury Flashcards

(58 cards)

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1
Q

in hepatitis, injury is to what? how is the inflammatory response?

A

Sensitive Hepatocytes damages

inflammation is variable

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2
Q

When Jaundiced, what is liver ALT levels?

A

super high in the 1000s

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3
Q

what causes high ALT?

A

hepatocyte membrane damage

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4
Q

enlarged liver causes jaundice how?

A

swelling of hepatocytes obstruct bile flow

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5
Q

In hepatic lobules, there are zones, which ones are most vulnerable?

A

Zone 3 to toxins and ischemia

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6
Q

When do you get Mallory bodies?

A

alcoholic hepatitis

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7
Q

when do you get zonal coagulative necrosis?

A

paracetomol toxicity

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8
Q

acute viral hep A+B causes lobular ____

A

disarray and apoptosis

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9
Q

paracetomol toxicity causes?

A

zonal coagulative necrosis

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10
Q

alcoholic hepatitis you see what histologically?

A

Mallory bodies

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11
Q

in lobular disarray what happens? 3 things

A

hepatocyte swelling
sinusoids compressed
lymphocytes surround

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12
Q

neutrophils in acute viral hepatitis?

A

Nope

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13
Q

what is a Councilman body?

A

hepatocyte undergoing apoptosis

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14
Q

What else can cause zonal coagulative necrosis besides paracetomol? 3 others

A

toxic mushrooms
carbon tetrachloride
ischemia

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15
Q

what is the toxic metabolite that directly injures hepatocyte? causes what?

A

NAPQI

causes depletion of glutathione

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16
Q

tell tale sign of coagulative necrosis histologically?

A

no nucleus

ghost outline

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17
Q

hepatocyte undergoing apoptosis is called?

A

Councilman body

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18
Q

where do you normally get the most severe appearance of coagulative necrosis of hepatocytes histologically?

A

Zone 3

Zone 2 sometimes

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19
Q

inflammation with paracetemol toxicity?

A

Nope

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20
Q

Four dead giveaways of alcoholic hepatitis?

A

Mallory bodies
Neutrophils
Fat vacuoles
ballooned hepatocytes

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21
Q

Why are there neutrophils in alcoholic hepatitis and not other kinds of hepatitis?

A

Mallory bodies attracting them

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22
Q

describe a Mallory body:

A

ā€˜cā€™ shaped collapse of hepatocyte cytoskeleton

in a ballooned hepatocyte

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23
Q

Damage in alcoholic hepatitis more likely in zone?

A

3

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24
Q

What is around the central vein in alcoholic hepatitis?

Study These Flashcards
A

fibrous tissue

25
Cholestasis histologically see?
yellow brown dots in dilated biliary canaliculi
26
chronic liver disease is one or several diseases? causes what hallmark feature?
several diseases | causes scarring
27
is chronic liver disease always symptomatic?
Nope, need to look at liver tests etc.
28
definition of chronic liver disease?
raised ALT for >6 months
29
what is most common cause of chronic liver disease?
chronic hep B and C
30
chronic hepatitis is background for two things:
cirrhosis | hepatocellular carcinoma
31
what is a hallmark feature of acute and chronic viral hepatitis?
APOPTOSIS
32
what happens to portal tracts in chronic hepatitis C? 3 things
1. lymphocytes infiltration 2. germinal centre formation 3. interface hepatitis
33
What is periportal inflammation known as? how to assess it?
interface hepatitis | use grading system to measure extent of fibrosis
34
what is the major reason for cell death in chronic hepatitis?
apoptosis
35
what are the margins like in interface hepatitis?
irregular
36
hallmark feature in chronic hepatitis?
interface hepatitis
37
What kind of collagen and scar tissue deposition do you get in chronic hepatitis?
fibrous septa | Septal Fibrosis >cirrhosis>irreversible damage
38
what is an important progression marker in septal fibrosis?
bridging fibrosis between portal tracts
39
do you get lobular disarray in chronic viral hepatitis?
usually not
40
Fibrosis in acute viral hepatitis?
Nope.
41
What is a increasingly important DDx for abonormal liver function tests?
Non-alcoholic fatty liver disease (NAFLD)
42
Two kinds of Non-alcoholic fatty liver disease?
1. steatosis with or without 2. steatohepatitis/fibrosis (NASH)
43
What is NASH?
non-alcoholic steatohepatitis
44
What is steatosis?
just fat in the liver | fatty liver
45
What is steatosis with steatohepatitis
fat with inflammation AND fibrosis
46
causes of Non-alcoholic fatty liver disease (NAFLD)? 5 things
``` Obesity diabetes Metabolic syndrom drugs GI surgery ```
47
2 types of steatosis are? describe epidemiology
macrovesicular/large droplet (very common) | microvesicular/small droplet (very rare)
48
How big are the macrovesicular steatosis?
larger than background hepatocytes
49
what causes macrovesicular steatosis? 2 reasons
increased triglyceride synthesis | decreased excretion
50
can you tell from histology whether macrovesicular steatosis is from alcohol or NAFLD?
Nope. need clinical info
51
Can you get steatohepatitis without steatosis?
No, steatohepatitis needs steatosis first
52
macrovesicular steatosis alone has risk of fibrosis?
Nope.
53
when do you increase risk of fibrosis with macrovesicular steatosis?
if have inflammation and hepatocyte injury
54
hallmark feature of steatohepatitis?
hepatocellular ballooning degeneration
55
Where else does hepatocellular ballooning degeneration happen besides steatohepatitis? how to distinguish?
alcoholic hepatitis | need to correlate clinical findings
56
non-alcoholic steatohepatitis features? 5 main
``` large fat droplets inflammation hepatocellular ballooning mallory bodies (severe) fibrosis ```
57
What kind of fibrosis in non-alcoholic steatohepatitis? as opposed to chronic hepatitis?
pericellular fibrosis vs. septal fibrosis
58
ASH vs NASH? distinction?
Alcoholic steatohepatitis vs. non-alcoholic steatohepatitis | distinction if clinical

Jason's GI Block (32 decks)

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