[OS 214 Exam 1] Lec 9a: Pathology of Liver Disorders I

Question 1

What are the two sources of the blood supply of the liver?

Answer 1

HPV: 80%

hepatic artery: 20%

Question 2

What are the three ways to cause liver failure?

Answer 2

hepatocyte destruction, lack of blood supply, insulation of hepatocyte

Question 3

What are the three zones of the liver?

Answer 3

I - nearest the portal triad, blood is nutrient-rich
II - intermediate zone
III - blood is devoid of nutrients, cells are first to die in ischemia

Question 4

What is the earliest physiological feature of hepatic damage?

Answer 4

hepatic swelling

Question 5

What is the most common manifestation of hepatic failure?

Answer 5

jaundice

Question 6

Predominantly unconjugated hyperbilirubinemia is associated with disorders in which part of bilirubin metabolism?

Answer 6

1. hemeoxygenase
2. carrier protein
3. glucoronosyltransferase

Question 7

Predominantly unconjugated hyperbilirubinemia is associated with disorders in which part of bilirubin metabolism?

Answer 7

1. hemeoxygenase
2. carrier protein
3. glucoronosyltransferase

Question 8

Predominantly conjugated hyperbilirubinemia is associated with disorders in which part of bilirubin metabolism?

Answer 8

4. excretion of bilirubin glucuronide to bile or blood

5. space occupying lesion occupying bile duct

Question 9

Predominantly unconjugated hyperbilirubinemia is associated with disorders in which part of bilirubin metabolism?

Answer 9

1. hemeoxygenase
2. carrier protein (albumin)
3. glucoronosyltransferase

Question 10

What causes fetor hepaticus?

Answer 10

failure of the liver to metabolize mercaptans, which reach the lungs and are exhaled by the patient (breath of the dead)

Question 11

What is the hepatorenal syndrome?

Answer 11

shunting of blood supply to the kidney away from the cortex and towards the medulla where there is minimal filtration

Question 12

What are the three grades of hepatitis?

Answer 12

acute, chronic persistent, chronic active hepatitis

Question 13

What are the three grades of hepatitis (old classification)?

Answer 13

acute, chronic persistent, chronic active hepatitis

Question 14

What criteria are used by the Knodell Score?

Answer 14

1. number or density of inflammatory cells
2. cell distribution
3. extent of hepatic cell death
   4 extent of cirrhosis

Question 15

What is the pathogenesis of cirrhosis?

Answer 15

combination of fibrosis and regeneration resulting in distortion of parenchymal architecture w/ reorganization of vascular architecture

Question 16

Which cell in the liver produces collagen in response to toxins and cytokines?

Answer 16

ITO cell

Question 17

What is the most common etiology of cirrhosis in western societies?

Answer 17

alcoholic liver disease

Question 18

What is the most common etiology of cirrhosis in the country?

Answer 18

viral hepatitis

Question 19

What are the possible shunts during portal hypertension?

Answer 19

rectal hemorrhoidal veins, esophagogastric veins, periumbilical and abdominal collaterals

Question 20

What drug can cause Reye’s Syndrome?

Answer 20

ASA

Question 21

What is the best form of management for extrahepatic biliary atresia?

Answer 21

surgery