Wed Liver Pathology - AAW Flashcards
(23 cards)
First aid in brainscape - AAW GI
check it
primary biliary cirrhosis - what antibodies, what population
circulating antimitochondrial antibodies (AMA)
middle age female
itching - “hallmark” of what type of disease according to nelson
cholestasis
what do you see when you look at a bile canaliculus in someone with primary biliary cirrhosis
lymphocytic/granulomatous cholangitis
PBC vs alcoholic cirrhosis - what does the regeneration of the liver nodes look like in each
in PBC, the nodes are less round
alcoholic, they are more round
primary sclerosis cholangitis - 70% of cases are assc with what bowel thing.
average patient age/sex of that thing?
IBD, mostly ulcerative cholitis
male ~40 y/o
“cholestatic injury pattern” labs
elevated alkaline phosphatase and GGT (gamma-glutamyltransferase)
seen in primary sclerosing cholangitis and primary biliary cirrhosis
obliterative fibrosing cholangitis is “textbook” for what
primary sclerosing cholangitis
you can see a big fibrous plug next to an artery in the liver
hereditary hemochromatosis - defeciency in what
decreased synthesis of hepcidin
where does iron accumulate in the hepatocytes in early hemochromatosis
periportal region
secondary hemochromatosis - where does the iron initially accumulate
in the kupffer cells (contrasted with in the hepatocytes in primary)
best screening test for hemochromatosis
fasting transferrin saturation
diagnostic tests in wilsons
24 hr copper excretion (increased)
lack of ceruloplasmin causes overall low serum copper
what type of alpha 1 antitrypsin deficiency gives you the mostest liver disease
PiZZ
stain the liver for A1AT with……………………………
PAS ya goof
presence of obstructive, nonthrombotic lesions of the small (central) hepatic veins in patients exposed to radiation and/or hepatotoxins. marked narrowing and obliteration of central vein lumens by subendothelial swelling
called?
it patients who have had what done?
sinusoidal obstruction syndrome (hepatic veno-occlusive disease)
usually in BM transplant patients, chemo patients.
prolonged conjugated hyperbilirubinemia in the neonate
neonatal cholestasis
due to:
biliary atresia: obstruction of lumen of extrahepatic biliary tree within first 3 months of life
neonatal hepatitis: due to A1AT, drugs, biliary atresia itself, etc.
fatty, micronodular cirrhosis
what is wrong
this is the liver in early stages of alcoholic cirrhosis
what type of steatosis is seen in reyes syndrome?
acute fatty liver of pregnancy? non-alcoholic fatty liver disease
microvesicular steatosis in reyes and AFLoP
macrovesicular in non-EtOH fatty liver
AST:ALT ratio in alcoholic liver disease
greater than 2
80% of AST is found in mitochondria, and EtOH is a mitochondrial toxin
ALP is high but you want to make sure its because of the liver and not something else
what do you test
what else would it be?
GGT
if GGT is negative, it could be bone instead of liver disease
you WILL be tested on this
lab tests for
viral hep autoimmune hep wilsons A!AT hemochromatosis primary biliary cirrhosis
viral hep - serology, nuclear testing (HBsAg, anti-HBc (total), HBV DNA, anti-HCV, HCV RNA)
autoimmune hep - ANA, anti-smooth muscle antibodies
wilson’s - ceruloplasmin
A1AT - A1AT level, phenotype
hemochromatosis - Fe, TIBC, Transferrin sat, genetics
primary biliary cirrhosis - anti-mitochondrial antibodies
seen these on liver biopsy - what are you thinking
Ground glass hepatocytes plasma cells lymphocytic/granulomatous cholangitis Fibrous obliterative cholangitis periportal hepatitis with mild steatosis globular hepatocyte inclusions
Ground glass hepatocytes - chronic viral hep B
plasma cells - autoimmune hep, primary biliary cirrhosis
lymphocytic/granulomatous cholangitis - primary biliary cirrhosis
Fibrous obliterative cholangitis - primary sclerosing cholangitis
periportal hepatitis with mild steatosis - chronic viral hepatitis C
globular hepatocyte inclusions - A1AT deficiency
