liver pathology Flashcards

Discuss the common non-infectious entities resulting in liver injury and their clinicopathological characteristics Compare and contrast the clinicopathological characteristics of primary biliary cirrhosis and primary sclerosing cholangitis Describe the clinicopathologic features of fulminant hepatic failure Describe the causes and clinical presentations associated with cirrhosis (62 cards)

1
Q

massive liver necrosis inficates

A

acute liver failure

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2
Q

casues acute liver failure

A

drugs or viral hepatitis

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3
Q

signs of chronic liver failure

A

palmer erythema
apider angioma
hypogonadism/gynomastia in men

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4
Q

signs of acute liver failure

A

jaundice and encephalopathy, coaguopathy

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5
Q

retention of bile causes

A

jaundice

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6
Q

retention of bilirubin, bile salts and cholesterol

A

cholestasis

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7
Q

most common causes of jaundice

A

hepetitis, bile obstruction, hemolytic anemia

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8
Q

mild, fluctuating unconjugated hyperbilirubinmea - inborn

A

Gilbert

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9
Q

charecteristic of hepatic encephalopathy

A

flapping tremor

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10
Q

pathenogensis of hepatic encephalopathy

A

severe loss of hepatocellular function

shunting of blood from portal to systemic circulation around chronically diseased liver

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11
Q

causes hepatic encephalopathy in actute/chronic setting

A

ammonia/deranged NT production (especially GABA)

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12
Q

fibrosis and concersion of normal liver architecture into structuraly abnormal nodules

A

cirrhosis

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13
Q

fibrous septa and parachymal nodules

A

cirrhosis

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14
Q

pathogenesis process of cirrhosis

A

death of hepatocytes
extracellular matrix deposition
vascular reorg

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15
Q

anoerxia, weight loss, weakness may indicate

A

cirrohsis

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16
Q

fatal outcomes of liver cirrhosis

A

progressive liver failure
portal hypertension complications
hepatocellular carcinoma

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17
Q

signs of portal hypertension

A
ascites
esophogeal varices
splenomegaly
caput medusae
hemorroids
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18
Q

can cause massive and fatal bleeding in portal hypertension

A

esophogeal varices

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19
Q

most important agent that produces toxic liver injury

A

EtOH

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20
Q

clues of heppatopulmonary syndrome

A

eaiser breathing lying down, fall of arterial blood oxygen with upright posture

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21
Q

most common toxin leading to acute liver failure needed transplant

A

acetomenophen

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22
Q

type of hepititis with less inflammation and more hepatocyte death

A

acute

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23
Q

female, elevated IgG, high titwers of autoantiboodies and liver damage signs

A

autoimmune hepatitis

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24
Q

“chicken-wire fence” histology

A

non-alchoholic fatty liver disease

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25
manifestations of alchoholic liver disease
hepatic steatosis, alchoholic hepatitis, cirrohsis
26
years it takes most people to progress to alchoholic cirrhosis
10-15 years
27
risk factors of NAFLD
DM type 2 obesity syslipidemia hypertension
28
pathogensis of NAFLD
impaired oxidation of fatty acids increasd synthesis and uptake of fatty acids decreasd hepatic secretion of VLDL cholesterol
29
what you see in EtOH fatty liver disease, but not NAFLD
heptocyte balloning denk bodies neutophillic infiltration
30
casues EtOH fatty liver disease
changes in lipid metabolism ROS cytokines
31
time period of neonatal cholestasis
birth to 14days
32
collapse of liver parenchyma leaving only shriveled organ with wrinkled capsule
fulminant hepatic failure
33
most common cause of fulminant hepatic failure
viral hepatitis
34
most common cause of cirrhosis
EtOH
35
compression of sinusoids and central veins, reduction in number of functional sinusoids
cirrhosis
36
metabolism functions affected in liver failure
nitrogen metabolism circulating protein production biliary excretory function steroid hormone metabolism
37
most common type of autoimmune hepatitis
type 1
38
HLA-DR3/4 associated with
autoimmune hepatitis
39
lab findings in autoimmune hepatitis
positive antinuclear antibody test and anti-smooth muscle antbodies
40
anti-smooth muscle antibodies
autoimmune hepatitis
41
multinucleated cells
neonateal hepititis
42
most common causes of neonate hepatitits
CMV or inborn errors of metabolism
43
causes of microvesicular fatty liver
reye's syndrome fatty liver of pregnancy tetracycline tox
44
get from taking asprin with acute viral infections
reye's
45
encephalopathy, fatty liver changes, transaminase elevation in kid home-treated with an acute viral infection; think -
reye's
46
groosly enlarged, pale, waxy liver
fatty liver
47
treatment for EtOH liver
stop drinking. Can be reversed
48
causes EtOH hepatitis
acetaldehyde damage to hepatocytes
49
hepatocyte swelling and necrosis intracytoplasmic depositis of cytokeratin neutophilic infiltrate
alchoholic hepatits
50
point of no return of alcholic hepatists
fibrosis
51
chronic progressive cholestatic liver disease with destruction of intrahepatic ducts
Primary biliary cirrohosis
52
woman with pruitis, fatige. elevated Alkaline phostphatase and cholersterol
Primary biliary cirrohosis
53
anti-mitochondiral antibodies
Primary biliary cirrohosis
54
franulomatous destruction of intrahepatic bile ducts
Primary biliary cirrohosis
55
inflamation, obiliterative fibrosis, segmental involvement of intra and extra heptic bile ducts
primary schlerosiing cholangitis
56
associated with inflammatory bowel disease
primary schlerosiing cholangitis
57
male, 30-60 with fatige, itching and jaundice
primary schlerosiing cholangitis
58
primary schlerosiing cholangitis has increased risk, long term, of
cholangiocarcinoma
59
onion skin lesion
cholangiocarcinoma
60
diagnosing test of primary schlerosiing cholangitis
ERCP ("beading" of bile ducts)
61
leads to obiliteration od bile duct, leading to cholestatis and cirrhoss
primary schlerosiing cholangitis
62
primary liver disease with p-ANCA
primary schlerosiing cholangitis