viral and non viral liver diseases [7] Flashcards Preview

DEMS Unit 1 > viral and non viral liver diseases [7] > Flashcards

Flashcards in viral and non viral liver diseases [7] Deck (26):
1

Portal HTN can manifest as what things

increase BP in portal system due to cirrhosis → back up of blood →

- esophageal varices
- hemorrhoids
- caput medusae
- hepatic encephalopathy
- ascites
- splenomegaly

2

ground glass

viral inclusion

3

Which hepatitis is the only dsDNA?

Hep B

(the rest are ssRNA)

4

Which Hep is transmitted via F-O route?

Hep A, Hep E

5

Which Hep is transmitted sexually?

Which Hep is transmitted mother to child?

Hep B, (Hep C minor)

Hep B

6

Which Hep results in chronic liver disease the most?

Hep C - 80%
- cocaine is risk factor

(Hep B is #2 with 10%)

7

Of the acute HCV infxns, how many of them get resolved, and how many go on to develop chronic Hep? How many of those go on to develop cirrhosis? How many of those with cirrhosis die?

85%
20%
50%

8

Of the acute HBV infxns, how many go on to develop into chronic hep and how many resolve?

90% → recover

9

Hep ____ is replication incompetent and depends on Hep ____ coinfection.

Hep D needs Hep B
potentiates the effects of Hep B and causing faster progression to end stage liver disease

10

Primary Biliary Cirrhosis (PBC)

autoimmune liver disease
- immune mediated attack of intrahepatic SMALL caliber bile ducts.

11

Presentation of PBC
-Pop
- test/dx

insidious onset + pruritus before jaundice
middle aged women

elevated GGT, bili, ALT
serology: anti-mitochondrial Ab (90%)

25% will get liver failure after 10 years

12

Histo of PBC

Ductopenia (small-no bile duct)
- duh, PBC is immune med atk of bile ducts
Lymphocytes
- atk bile ducts
Granulomas
- atk bile ducts

13

Primary sclerosing cholangitis (PSC)

autoimmune mediated obliterative fibrosis of intrahepatic and extrahepatic LARGE bile ducts

(similar to PBC of small bile ducts)

14

Presentation of PSC
- Pop
-Test/dx

Asymptomatic
Persistent alkaline phosphatase elevation
progressive fatigue
pruritus
jaundice

Men + UC
(PBC is middle aged women)

Cholangiography → alternating biliary strictures + dilatation

15

Does PBC or PSC have increased risk for cholangiocarcinoma?

PSC

16

Histo of PSC

onion skin fibrosis around bile duct → late fibrous obliteration of bile duct

17

Autoimmune hepatitis
- pop
- dx

immune mediated attack directed at hepatocytes
(PBC and PSC are autoimmune against bile ducts)

Women

Serology BIG role
- ANA, ASMA, Anti-LKMB
- ↑ elevated IgG

18

Toxins (drugs) affect which zone?

zone 3
centrilobular necrosis

19

Alcohol steatosis/steatohepatitis

characteristic histo

large load of carbohydrates into liver →
de novo lipogenesis + modifies oxidative state of hepatocytes →
impedes beta oxidation + prevent lipid escapes + impedes packaging

Neutrophil infiltrates and Mallory bodies
(inclusion in hepatocytes due to abnormal accumulation of cytoskeleton in injured hepatocytes)

20

Hereditary hemochromatosis

generic iron overload disease throughout body
Autosomal recessive inheritance of HFE gene mut

21

malignant tumors commonly found in the liver

hepatocellular carcinoma or cholangiocarcinoma
- most common malignant tumor is actually mets from other areas

22

Most common malignant tumor of the liver
- occurs with which diseases?

Hepatocellular carcinoma
- occurs in cirrhosis and those with chronic liver disease
(HCV, HBV, alcohol)

23

Cholangiocarcinoma

malignant neoplasm of bile ducts
(PBC + PSC are autoimm dmg against bile ducts)

24

Benign neoplasms of liver

hemangioma
focal nodular hyperplasia
hepatocellular adenoma

25

central stellate scar

focal nodular hyperplasia
- benign mass prolif of hepatocytes
- 2nd most common primary hepatic mass (behind hemangioma)
- more common in women

26

Benign neoplasm of hepatocytes associated with oral contraceptives and no underlying chronic liver disease

hepatocellular adenoma
- low risk of malignancy