Pathology of the liver 2 Flashcards Preview

GI pathology > Pathology of the liver 2 > Flashcards

Flashcards in Pathology of the liver 2 Deck (22):
1

Describe Viral hepatitis 

  •   infection of the liver
  • May cause acute injury or chronic liver injury
  • Causes can be common or rare 

2

What are the common types of hepatitis virus 

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis E 

3

What are rare causes of hepatitis 

Ebstein-Barr virus, Yellow fever virus, Herpes simplex cirus and cytomegalovirus 

4

Describe hepatitis A 

  • Transmission: Faecal-oral spread - contaminated food or water
  • Short incubation time 
  • Can be sporadic or endemic (isolated or common)
  • Acute - mild ilness with full recovery usuaully 
  • Directly cytopathis - direct change to host cell 
  • no carrier state 

5

What are the serological markers in HAV 

  • IgM = active infection 
  • IgG = recovery antibody - tells us that there has been recovery from HAV

6

What are the histological features of HAV

  • Periportal inflammation, necrosis and apoptosis

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7

Describe hepatits B virus 

  • Transmission: blood, blood products, sexually and in utero 
  • long intubation time 
  • Liver damage is by antiviral immune response 
  • Carriers exist 
  • only 20% become chronic but depends on age - the younger the patient the more likely to become chronic 

8

Describe hepatitis C virus 

  • Transmission: blood, blood products and sexually 
  • Short intubation time
  • often asymptomatic 
  • Tends to become chronic

9

describe the histological features of HCV

  • Dense portal chronic inflammation - lymphocytosis 
  • Interface hepatitis - piecemeal necrosis 
  • Lobular inflammation 
  • Council man bodies - intracytoplasmic eosinophillic collection of globulate inside the cell of dying hepatocytes 
  • Fibrosis and cirrhosis

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10

What is piecemeal necrosis

Piecemeal necrosis is defined as the appearance of destroyed hepatocytes and lymphocytic infiltration at the interface between the limiting plate of periportal hepatocyte, parenchymal cells and portal tracts 

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11

What does lobular inflammation look like

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12

Describe the outcome of hepatitis B virus 

  • Fulminant acute infection - death
  • Chronic hepatitis 
  • Cirrhosis 
  • Hepatocellular carcinoma
  • Asymptomatic - Carrier 

13

What is the outcome of hepatitis C

  • Chronic hepatits 
  • Cirrhosis

14

What are other causes of chronic hepatits 

  • Hepatitis B, C 
  • pirmary biliary cirrhosis 
  • Autoimmune hepatits 
  • Drug induced hepatitis 
  • Primary Sclerosing cholangitis 

15

Describe primary biliary cirrhosis 

  • Rare autoimmune disease - unknown cause 
  • Associated with autoantibodies to mitochondria 
  • Females - 90% 
  • Biopsy - to stage doisease
  • Presence of granulomas and bile duct loss
  • Outcome: unpredictable 

16

Descirbe the histological features of primary biliary cirrhosis 

  • Dese lymphocytic infiltrate in porta tracts
  • Inflammation of bile duct
  • Granuloma around duct

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17

What does inflammed bile duct look like 

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18

What does the duct granuloma look like 

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19

What is the complication of primary BC

  • Cholestasis
  • Liver injury 
  • inflammation 
  • fribrosis and cirrhosis 

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20

What is autoimmune hepatitis 

Chronic self perpetuating inflammatory liver disease of unknown cause mainly occurring in females of all ages and ethnic groups

  • Associated with other AI diseases
  • Pattern is similar to chronic hepatitis 
  • Numerous plasma cells
  • Autoantibodies to - SM, nuclear, LKM and raised IgG 
  • Trigger : drugs 

21

Describe chronic drug induced hepatitis

  • Similar features to all other types of chornic hepatitis 
  • May lead to autoimmune hepatits 
  • loads to causes 

22