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Flashcards in Toxic liver injury (pathology Deck (49):
1

dose dependent, occurs in all exposed individuals, reproducible in animals, name the pathogenic pattern of hepatoxicity and give an example

predictable, acetaminopehen overdose

2

more frequent type of hepatoxity, state the pathogenic pattern of hepatoxicity

unpredictable/host dependent/ hypersenstivie/ idiosyncratic

3

occurs in small fraction, long latent period, state the pathogenic patter of hepatoxicity

unpredictable/host dependent/ hypersenstivie/ idiosyncratic

4

hepatoceullar fat accumulation

steatosis

5

Bile accumulation in canaliculi or hepatocytes.

cholestasis

6

histological aapearance of _____________is indistinguishable from those of fulminant acute Hepatis A or Hep B

acetaminophen toxicity

7

an example of an idiosyncratic hepatotoxins that can cause a chronic hepatitis precisely mimicking chronic viral hepatitis that may or may not resolve on removal of the instigating agent.

isoniazid

8

drugs or toxins that can induce autommune hepatitis with all histolocal features

minocycline & nitrofurantoin

9

state the 4 vascular lesions that can occur in hepatoxicity

1. peliosis hepatis 2. Thrombosis of hepatic vein 3. sinduosidal obstruction syndrome/venooclusive disease 4. Arteritis

10

state a cause causing both peliosis hepatis and benign liver cell adenoma

contraceptives and steriods

11

Bush-tea poisoning, 6-TG (an anti-cancer drug)
causes Central veins get occluded by reticulin fibers

sinudosial obstruction syndrome/ venooclusive disease

12

vinyl chloride

angiosarcoma

13

aflazatoxins and thorotrast; state the type of neoplasm

hepatocullar carcinoma

14

cholangiocarcinoma, state the drug that causes this

Thorotrast

15

T or F, alcohol commonly causes microvesicular steatosis

false, macro

16

Carbon-tetrachloride, methotrexate, ethanol; state the type of steatosis

macrovesicular steatosis

17

find droplet fatty chance, clinical menifestation of severe liver injury; state a drug cause of this

aprin in children, IV tetracycline

18

acute fatty liver of pregnancy presents as _________steatosis

microvesicular

19

Due to inhibition of mitochondrial fatty acid §-oxidation and mitochondrial dysfunction.
_ Associated with hepatomegaly, elevated ALT, AlkP, _-GT

microvesicular steatosis

20

hepatic posions

CCl4, mushroom amanita phalloids

21

hepatoxic drugs

acetaminophen and chloroform

22

Produce centrilobular necrosis and steatosis

amanita phalloides

23

inorganic Phosphorus produces _________and in large does can cause fatal massive necrosis

periportal necrosis

24

Fibrin ring granuloma

Hypersensitivity to Allopurinol

25

Sulfonamides, Methyldopa, Phenylbutazone

Small epithelioid granulomas.

26

mineral oil granuloma

mineral oil consumed as laxative

27

o Non thrombotic narrowing of central vein lumen by loose connective tissue.
o Caused by pyrrolizidine alkaloids, (herbal= bush tea), radiation, anticancer drugs (6-
thioguanine), conditioning for bone marrow transplantation.

venoocclsive disease

28

Phlebosclerosis of portal vein
o Inorganic arsenicals, Thorotrast, vinyl chloride, 6-thioguanine, Azathioprine in IBD patients

hepatoportal sclerosis

29

State the type of hepatitis: Combines hepatocellular necrosis, inflammation and cholestasis.
_ Indistinguishable from acute viral hepatitis.
_ Immunoallergic idiosyncratic reactions.

acute hepatitis

30

Isoniazid, Halothane, Indomethacin, Sulfonamides; state the type of hepatitis

acute hepatitis

31

Nitrofurantoin, Phenytoin; state the type of hepatitis

chronic hepatitis, granulomatous hepatitis

32

_ Combines features of mild hepatitis with non-caseating granulomas.
_ Cholestasis and eosinophil polymorphs.

drug induced granulomatous hepatitis

33

Ballooning of hepatocytes, liver cell necrosis or apoptosis and Mallory Denk Bodies

steatohepatitis

34

Inflammatory infiltrates predominantly Neutrophil polymorphs

steatohepatitis

35

lymphocytes

viral hepatits

36

plasma cells

autoimmune

37

drug induced inflammation

eosinophils

38

alcohol induced inflammation

neutrophils

39

Pericellular fibrosis (chicken-wire fibrosis)

o Perivenous fibrosis and phlebosclerosis.

steatohepatitis

40

The interrelationships among hepatic steatosis, alcholic hepatitis and alcoholic cirrhosis

alcoholic liver disease

41

The most common cause of fatty change in developed nations is termed

non-alcohol fatty liver

42

Mallory's hyaline is seen here, but there are also neutrophils, necrosis of hepatocytes, collagen deposition, and fatty change.

acute alcoholic hepatitis

43

Detail of centrilobular zone, showing fibrous obliteration of the centrilobular vein (venooclusive lesions; center) and marked pericellular (Òchicken-wireÓ) fibrosis.

acute alcohilic steatohepatiss

44

state 4 diseases that cause micronodular cirrhosis

1. alcoholism 2. wilson disease 3. primary biliary cirrhosis 4. Hemochromatosis

45

most common casue of micronodular cirrhosis

hepatitis b and c

46

primary NASH

OBESITY, INSULIN RESISTANCE

47

secondary NASH

Post-Ileal bypass surgery, drug and toxins Amiodarone, Estrogens, Methotrexate

48

The definitive diagnosis of non-alcoholic liver disease (NAFLD) steatosis

biopsy

49

gene associated with steatosis

PNPLA3