Liver Pathologies (Exam 1)

Question 1

What are the most common causes of cirrhosis and fibrosis?

Answer 1

-long term alcohol abuse
-viral hep
-non-alcoholic fatty liver disease
-hemochromatosis
-autoimmune hepatitis
-primary biliary cholangitis
-primary sclerosing cholangitis
-wilson’s disease
-cystic fibrosis

Question 2

What are the lab findings for liver cirrhosis and fibrosis?

Answer 2

-decreased albumin
-increased PT/INR
-potentially increased ammonia

Question 3

What pathology is this?
-immune system attacks small bile ducts in the liver
-ducts become inflamed and narrowed
-causes obstruction to the flow of bile out of the liver and into intestines
-may lead to fibrosis and cirrhosis
-bile accumulation= increased synthesis of ALP

Answer 3

primary biliary cholangitis

Question 4

What pathology has these lab findings?
-increased ALP during early stages*
-increased GGT, AST and ALT
-increased conjugated bilirubin
-bilirubinuria
-decreased albumin
-anti-mitochondrial Abs
-increased cholesterol in 50% of patients*

Test q

Answer 4

primary biliary cholangitis

Question 5

AAT deficiency is an inherited disorder. How is it inherited?

Answer 5

autosomal recessive

Question 6

What pathology is this?
-lack of protease inhibitors causes an excess of protease enzymes from neutrophils
-protease enzymes attack the liver and lung tissue and cause liver cirrhosis and lung disease
-lung symptoms usually appear first

Answer 6

AAT deficiency

Question 7

What pathology would have these S&S and lab findings?
-early onset emphysema (panacinar)
-SOB
-excessive cough with sputum production
-hemoptysis
-cirrhosis
-acute and chronic inflammation
-serum AAT will be decreased

Answer 7

AAT deficiency

Question 8

What pathology is this?
-loss of liver function occurs rapidly usually in a person who has no pre-existing liver disease
-most commonly caused by hep virus or drugs such as acetaminophen
-increased liver enzymes
-increased ammonia

Answer 8

acute liver failure/ acute fulminant liver failure

Question 9

What pathology is this?
-late development of liver failure and then eventually hepatic encephalopathy
-increased liver enzymes
-increased ammonia

Answer 9

chronic liver failure/ subfulminant liver failure

Question 10

What are the other names for hemochromatosis?

Answer 10

bronze diabetes or iron overload disorder

Question 11

What pathology is this?
-primary cause: genetic
-secondary: excessive iron in diet or repeated blood transfusions
-results in excessive total body iron and deposition of iron in tissues like skin, spleen, pancreas, heart, liver, thyroid, pituitary

Answer 11

hemochromatosis

Question 12

What is the hemochromatosis triad?

Answer 12

1) cirrhosis
2) diabetes
3) skin pigmentation

Question 13

What pathology has these lab findings?
-increased serum transferrin saturation
-increased serum ferritin
-HFE gene testing

Answer 13

hemochromatosis

Question 14

What is another name for Wilson’s disease?

Answer 14

hepatolenticular disease

Question 15

How is wilson’s disease inherited?

Answer 15

autosomal recessive

Question 16

What pathology is this?
-copper build up in liver, brain, and eyes
-kayser fleischer rings around eye
-decreased serum ceruloplasmin (carrier for copper)
-increased 24 hour urine copper
-decreased or normal serum copper
-liver biopsy will show excess copper (gold standard)

Answer 16

wilson’s disease

Question 17

What is the gold standard of diagnosis for wilson’s disease?

Answer 17

liver biopsy shows excess copper deposition

Question 18

What pathology is this?
-bile stasis due to hormonal changes
-intrahepatic cholestasis temporarily impairs liver function
-causes bile to build up in the liver and bloodstream
-intense pruritis during 2nd/3rd trimester, dark urine, and jaundice
-increased liver enzymes
-increased serum bile acid levels

Answer 18

cholestasis of pregnancy

Question 19

What pathology is this?
-decline in brain function that occurs because of severe liver disease
-liver cannot adequately remove toxins from blood
-causes a build up of toxins in bloodstream and can lead to brain damage
-liver failure leads to ammonia intoxication of the brain
-increased bilirubin
-decreased albumin
-increased ammonia

Answer 19

hepatic encephalopathy/ portosystemic encephalopathy

Question 20

What are the 6 F’s for gallstones?

Answer 20

female, fat, forty, fertile, fair, family hx

Question 21

stones/calculi in the gallbladder resulting from changes in bile components=

Answer 21

cholelithiasis

Question 22

chole=

Answer 22

bile containing

Question 23

docho=

Answer 23

duct

Question 24

gallstones in the common bile duct obstructs bile flow is called

Answer 24

choledocholithiasis

Question 25

Acute or chronic inflammation of gallbladder usually associated with impacted gallstones in the cystic duct causing painful distention =

Answer 25

cholecystitis

Question 26

gallstone ulceration through gallbladder into the intestine and causes obstruction=

Answer 26

gallstone ileus

Question 27

How are gallbladder disorders diagnosed?

Answer 27

HIDA scan or ultrasound

Question 28

Steady gripping or gnawing pain in the RUQ near rib cage which can be serve and radiate to the upper back is known as murphy's sign. What does this sign indicate?

Answer 28

acute cholecystitis, or inflammation of the gallbladder

Question 29

What are the 2 main functions of pancreas?

Answer 29

1) exocrine= help with digestion 2) endocrine= regulate blood sugar

Question 30

What enzyme is this? -digestive enzyme that breaks down carbs -used to diagnose and monitor the clinical course of pancreatitis

Answer 30

serum amylase

Question 31

increased serum amylase indicates?

Answer 31

pancreatitis or salivary gland disorders

Question 32

decreased serum amylase indicates?

Answer 32

cystic fibrosis

Question 33

What enzyme is this? -digestive enzyme that breaks down fat -used in the evaluation of pancreatic disease -more specific for pancreatitis than amylase**

Answer 33

serum lipase

Question 34

increased serum lipase indicates?

Answer 34

pancreatitis!!!!!

Question 35

decreased serum lipase indicates?

Answer 35

cystic fibrosis

Question 36

What conditions can lead to pancreatitis?

Answer 36

-alcoholism -gallstones -cystic fibrosis ***gallstones and alcohol abuse are the leading causes*

Question 37

What are the lab findings for pancreatitis?

Answer 37

increased amylase and lipase!!!! lipase is more specific*

Question 38

What pathology is this? -genetic disorder that primarily affects the lungs, pancreas, and other organs by causing thick, sticky mucus to accumulate in these areas -caused by mutations in the CFTR gene (cystic fibrosis transmembrane conductance regulator), which disrupts chloride and water movement in cells, leading to abnormal mucous production -primarily considered a disorder in the exocrine glands: skin, digestive system, respiratory system, reproductive system -causes buildup of thick viscous mucus secretions in various organs -pancreatic insufficiency leading to malabsorption of fats and fat soluble vitamins (K,A,D,E) resulting in poor weight gain and steatorrhea (fatty stools) -large amounts of fatty, bulky foul smelling stool

Answer 38

cystic fibrosis/ fibrocystic disease of the pancreas

Question 39

What is a common cause of death for someone with cystic fibrosis?

Answer 39

infection with pseudomonas aeruginosa

Question 40

How is cystic fibrosis/ fibrocystic disease of the pancreas diagnosed?

Answer 40

-sweat test/ sweat chloride test (gold standard, will show increased level of chloride in sweat) -CFTR mutation analysis -chest xray