Patterns of Liver Injury 1 - Acute Hepatitis Flashcards Preview

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Flashcards in Patterns of Liver Injury 1 - Acute Hepatitis Deck (17):
1

What is the key clinical feature of acute hepatitis?

Jaundice

2

What is the key liver enzyme test of acute hepatitis?

ALT

3

What is the clinical definition of acute hepatitis?

A significant elevation of ALT of less than 6 months duration in a patient with no history of liver disease

4

Why is ALT increased in acute hepatitis?

Because ALT is in the cytosol of hepatitis and is released with injury and death of hepatocytes

5

What causes the jaundice in acute hepatitis?

Liver cells swelling blocking the bile flow

6

What are the 3 patterns of acute hepatitis?

Acute viral hepatitis, zonal coagulative necrosis and acute alcoholic hepatitis

7

What are the features of acute viral hepatitis?

lobular disarray and apoptosis

8

What is lobular disarray?

Liver cells are not in an orderly arrangement, sinusoids compressed, hepatocytes are swollen, infiltrate surround the swollen hepatocytes - due to cell mediated immune function and ATP depletion

9

What immune cells are seen in acute viral hepatitis?

T cell lymphocytes- not neutrophils

10

What are councilman bodies?

Apoptotic bodies in the liver - shrunken cell with condensed cytoplasm and nuclear fragmentation

11

What causes zonal coagulative necrosis?

Liver toxins such as paracetamol and poisonous mushrooms

12

How is paracetamol toxic to the liver?

Forms a toxic metabolite which causes depletion of glutathione which leads to oxidative injury

13

Where do you see the coagulative necrosis?

In zone 3 of the acinar lobar model

14

What inflammatory cells are seen in zonal coagulative necrosis?

none

15

What are the features of acute alcoholic hepatitis?

fat vacuoles, neutrophils, hepatocellular ballooning, mallory bodies, fibrous tissue around the central vein

16

What are mallory bodies?

collapse of intermediate filaments that forms a C around the hepatocyte nucleus

17

What is cholestasis?

Impaired bile excretion and flow - can see yellow plugs within dilated cannaliculi