Flashcards in XVI - The Liver, Gallbladder and Biliary Tree Deck (153)
What is the most common congenital anomaly of the gallbladder?
Presence of Phrygian Cap (folded fundus)(TOPNOTCH)
What is the tetralogy of cholesterol stone formation?
1. Supersaturation of bile with cholesterol2. Gallbladder hypomotility3. Cholesterol nucleation4. Hypersecretion of GB mucus(TOPNOTCH)
AKA Strawberry Gallbladder
Acute calculous cholecystitis is most commonly precipitated by what condition?
Obstruction of the neck or cystic duct by a Gallbladder stone(TOPNOTCH)
Morphology: Prominence of Rokitansky-Aschoff sinuses
What is the most common cause of cholangitis?
True or False. Gallstones are seen in 60%-90% of Carcinoma of the Gallbladder.
What is the most common growth pattern of Gallbladder carcinoma? Infiltrating or Exophytic?
These are tumors arising from the part of the common bile duct between the cystic duct junction and the confluence of the right and left hepatic ducts at the liver hilus
Morphology: feathery degeneration and focal detergent dissolution of hepatocytes, giving rise to bile lakes filled with cellular debris and pigment
What does unrelieved cholestasis lead to?
Portal tract fibrosis(TOPNOTCH)
What is the outcome of 85% of Acute Hepatitis infection?
These inclusions are a characteristic but not specific feature of alcoholic liver disease.
Morphology: macrovesicular steatosis, involving most regions of the hepatic lobule. The intracytoplasmic fat is seen as clear vacuoles.
Alcoholic liver disease(TOPNOTCH)
What zone of the liver if particularly vulnerable of ischemic injury and number of drug and toxic reactions?
What zone of the liver is particularly affected in eclampsia?
At least how many percent of the liver must be damaged before hepatic failure ensues?
at least 80%(TOPNOTCH)
What are the 4 major consequences of portal hypertension?
Ascites, formation of portosystemic venous shunts, congestive splenomegaly, and hepatic encephalopathy(TOPNOTCH)
Ascites becomes clinically detectable at what amount?
Morphology: portal tract expansion with inflammatory cells and fibrous tissue and interface hepatitis with spillover of inflammation into the adjacent parenchyma. Lymphoid aggregates can also be seen.
Chronic Viral Hepatitis C(TOPNOTCH)
Morphology: liver biopsy shows steatosis, multifocal parenchymal inflammation, Mallory hyaline, hepatocyte death, and sinusoidal fibrosi
Steatohepatitis or Nonalcoholic Steatohepatitis(TOPNOTCH)
In Hemochromatosis, what is the most common site of hemosiderin deposition?
What are the 3 clinical features of Hemochromatosis?
Deposition of hemosiderin, cirrhosis, and pancreatic fibrosis(TOPNOTCH)
Morphology: characterized by the presence of round to oval cytoplasmic globular inclusions in hepatocytes, which in routine H and E stains are acidophilic and indistinctly demarcated from the surrounding cytoplasm
A1 antitrypsin deficiency(TOPNOTCH)
Morphology: characterized by coarse fibrous septae that subdivide the liver in a jigsaw like pattern
Secondary biliary cirrhosis(TOPNOTCH)
Morphology: florid duct lesion
Primary Biliary Cirrhosis(TOPNOTCH)
The combination of hypoperfusion and retrograde congestion acts synergistically to generate what type of necrosis in the liver?
Centrolobular hemorrhagic necrosis(TOPNOTCH)
Morphology: periportal sinusoids contain fibrin deposits with hemorrhage into the space of Disse, leading to periportal hepatocellular coagulative necrosis
Type of liver transplant rejection : severe obliterative arteritis of small and larger arterial vessels results in ischemic changes in the liver parenchyma