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Flashcards in liver pathology Deck (62):
1

massive liver necrosis inficates

acute liver failure

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casues acute liver failure

drugs or viral hepatitis

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signs of chronic liver failure

palmer erythema
apider angioma
hypogonadism/gynomastia in men

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signs of acute liver failure

jaundice and encephalopathy, coaguopathy

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retention of bile causes

jaundice

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retention of bilirubin, bile salts and cholesterol

cholestasis

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most common causes of jaundice

hepetitis, bile obstruction, hemolytic anemia

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mild, fluctuating unconjugated hyperbilirubinmea - inborn

Gilbert

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charecteristic of hepatic encephalopathy

flapping tremor

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pathenogensis of hepatic encephalopathy

severe loss of hepatocellular function
shunting of blood from portal to systemic circulation around chronically diseased liver

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causes hepatic encephalopathy in actute/chronic setting

ammonia/deranged NT production (especially GABA)

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fibrosis and concersion of normal liver architecture into structuraly abnormal nodules

cirrhosis

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fibrous septa and parachymal nodules

cirrhosis

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pathogenesis process of cirrhosis

death of hepatocytes
extracellular matrix deposition
vascular reorg

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anoerxia, weight loss, weakness may indicate

cirrohsis

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fatal outcomes of liver cirrhosis

progressive liver failure
portal hypertension complications
hepatocellular carcinoma

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signs of portal hypertension

ascites
esophogeal varices
splenomegaly
caput medusae
hemorroids

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can cause massive and fatal bleeding in portal hypertension

esophogeal varices

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most important agent that produces toxic liver injury

EtOH

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clues of heppatopulmonary syndrome

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

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most common toxin leading to acute liver failure needed transplant

acetomenophen

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type of hepititis with less inflammation and more hepatocyte death

acute

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

autoimmune hepatitis

24

"chicken-wire fence" histology

non-alchoholic fatty liver disease

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manifestations of alchoholic liver disease

hepatic steatosis, alchoholic hepatitis, cirrohsis

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years it takes most people to progress to alchoholic cirrhosis

10-15 years

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risk factors of NAFLD

DM type 2
obesity
syslipidemia
hypertension

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pathogensis of NAFLD

impaired oxidation of fatty acids
increasd synthesis and uptake of fatty acids
decreasd hepatic secretion of VLDL cholesterol

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what you see in EtOH fatty liver disease, but not NAFLD

heptocyte balloning
denk bodies
neutophillic infiltration

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casues EtOH fatty liver disease

changes in lipid metabolism
ROS
cytokines

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time period of neonatal cholestasis

birth to 14days

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collapse of liver parenchyma leaving only shriveled organ with wrinkled capsule

fulminant hepatic failure

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most common cause of fulminant hepatic failure

viral hepatitis

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most common cause of cirrhosis

EtOH

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compression of sinusoids and central veins, reduction in number of functional sinusoids

cirrhosis

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metabolism functions affected in liver failure

nitrogen metabolism
circulating protein production
biliary excretory function
steroid hormone metabolism

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most common type of autoimmune hepatitis

type 1

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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

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multinucleated cells

neonateal hepititis

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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

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get from taking asprin with acute viral infections

reye's

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encephalopathy, fatty liver changes, transaminase elevation in kid home-treated with an acute viral infection; think -

reye's

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groosly enlarged, pale, waxy liver

fatty liver

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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

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anti-mitochondiral antibodies

Primary biliary cirrohosis

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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

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associated with inflammatory bowel disease

primary schlerosiing cholangitis

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male, 30-60 with fatige, itching and jaundice

primary schlerosiing cholangitis

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primary schlerosiing cholangitis has increased risk, long term, of

cholangiocarcinoma

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onion skin lesion

cholangiocarcinoma

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diagnosing test of primary schlerosiing cholangitis

ERCP ("beading" of bile ducts)

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leads to obiliteration od bile duct, leading to cholestatis and cirrhoss

primary schlerosiing cholangitis

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primary liver disease with p-ANCA

primary schlerosiing cholangitis