aspirin use - rare - chilren - mito dysfunction - liver and brain extensive accumulation of fat droplets - microvesicular steatosis

Liver Path V Flashcards by Matt Stanton

autoimmune hepatitis

chronic hepatitis - immune abnormalities
-neg sero tests for virus

type 1 - female
type 2 - children

-elevated IgG

has titers

majority have other autoimmune

How well did you know this?

Not at all

Perfectly

type 1 autoimmune hepatitis

female

ANA, ASMA
negative AMA

How well did you know this?

Not at all

Perfectly

type 2 autoimmune hepatitis

children

ALKM1, ACL-1

How well did you know this?

Not at all

Perfectly

predictable

intrinsic

How well did you know this?

Not at all

Perfectly

unpredicatable

idiosyncratic

How well did you know this?

Not at all

Perfectly

DDx for liver disease

always include exposure to toxin or drug

How well did you know this?

Not at all

Perfectly

budd chiari

oral contraceptives

How well did you know this?

Not at all

Perfectly

angiosarcoma

vinyl chloride

How well did you know this?

Not at all

Perfectly

zone 3 necrosis

acetaminophen

How well did you know this?

Not at all

Perfectly

zone 1 hepatotoxicity

Fe overload

allyl alcohol

How well did you know this?

Not at all

Perfectly

zone 3 hepatotoxicity

acetaminophen
ethanol
CCl4

How well did you know this?

Not at all

Perfectly

acetaminophen and ethanol

increased zone 3 necrosis

How well did you know this?

Not at all

Perfectly

isoniazid

first line anti-TB drug

hepatic damage occurs

How well did you know this?

Not at all

Perfectly

microvesicular fatty change

tetracycline

salicylates

How well did you know this?

Not at all

Perfectly

cholestatic reactions

estrogens

antibiotics

How well did you know this?

Not at all

Perfectly

NAPQI

problematic in path of acetaminophen toxicity

depletion of GSH

acetylcysteine - reduces NAPQ1 to APAP

How well did you know this?

Not at all

Perfectly

drug metabolism

in zone 3 - centrilobular

How well did you know this?

Not at all

Perfectly

reye syndrome

aspirin use

rare
chilren
mito dysfunction - liver and brain

extensive accumulation of fat droplets - microvesicular steatosis**

How well did you know this?

Not at all

Perfectly

oil red O stain

for reye syndrome

stains lipids**

How well did you know this?

Not at all

Perfectly

5th leading cause of death

alcoholic liver disease

alcoholic liver disease path

ethanol > actaldeyde

alters lipid metabolism
decreased export lipoproteins
cell injury caused by ROS and cytokines**

patterns of alcoholic liver disease

zone 3

-hepatic steatosis, alcoholic hepatitis, cirrhosis

fatty liver

all drinkers with moderate intake

microvesicular to macrovesicular

completely reversible***

alcoholic hepatitis

ballooning and necrosis of hepatocytes

mallory bodies

alcoholic hepatitis

AST:ALT >1 and AST <500, malaise, fever, jaundice, RUQ pain

alcoholic hepatitis

PMNs surrounding necrotic hepatocytes

mallory bodies

tangles of keratin complexed with proteins like ubiquitin in alcoholic hepatitis

non-alcoholic fatty liver

fatty change in liver - no alcohol 25% of US adults with metabolic syndrome

diagnosis non-alcoholic fatty liver

biopsy gold standard

NASH

non-alcoholis steatohepatitis | -ballooning degeneration, necrosis, lobular inflammation

fatty liver

with fatty heart, HTN, diabetes

elevated ALT/AST with no symptoms

think NASH

iron overload

hemochromatosis

copper overload

wilson disease

hepcidin

inhibits Fe absorption in GI tract acts as basolateral side of cells

tx for hemochromatosis

bleeding

anemia of chronic disease

IL-6 - increases hepcidin - inhibits iron absorption

HFE

mutated in hereditary hemochromatosis - adults no Fe recognition - and no hepcidin**

childhood hemochromatosis

mutations - HAMP, HJV

secondary hemochromatosis

thalassemia major | sideroblastic anemia

inhibition of hepcidin

erythroblasts release - GDF-15 anf TWSG1

acute phase reactant

hepcidin | -so is released with chronic inflammation**

genetic hemochromatosis

auto recessive increased iron in tissue - oxidative stress damage genet defect HFE -C282Y finding of homozygous C282Y genotype confirms diagnosis of HH

screening test for hemochromatosis

transferrin saturation

specific test for hemochromatosis

iron biopsy MRI of liver HFE mutation - C282Y

skin pigmentation, cirrhosis, diabetes

triad of hemochromatosis also can see hepatocellular carcinoma

prussian blue

Fe stain

TIBC

indirect measure of transferrin normal in hemochromatosis