Liver Patho

Question 1

Acute hepatitis

Answer 1

Disruption of lobular structure

Apoptic cells

Question 2

CHronic hepatitis

Answer 2

Mononuclear cell infiltration

Parenchyma inflammation

Ground glass hepatocytes

Question 3

Progression of dysfunction in fatty liver

Answer 3

• Steatosis- fatty liver
• non-alcoholic steatohepatitis- fatty and inflammed
• Cirrhosis-scarred inflammed
• Cancer

Question 4

Fatty liv er and hepatitis both lead to

Answer 4

• Cirrhosis
• portal hypertension
• Jaundice

Question 5

Cirrhosis

Manifestations

Answer 5

• Irreversible inflammatory disease, dirupts structure and function of liver
• Manifests
  
  • Decreased hepatic function due to fibrosis
  • Biliary channels become obstructed causing portal hypertension
    
    • hypoxic necrosis bc blood is shunted away

Question 6

3 kinds of Hepatic portal hypeprtension

Answer 6

• Prehepatic- narrowing of vessels pre liver (portal vein thrombosis
• Intrahepatic
  
  • Cirrhosis most common
• POsthepatic
  
  • anything with heart problems

Question 7

Consequences of Hepatic portal hypertension 4

Answer 7

• Hepatic encephalopathy
• Varices - distended veins esophagus, stomach, rectum, bleeding
• Splenomegaly- platelet accural in spleen
• Ascites- altered pressure–> overflow into peritoneal cavity, increased hepatic vessel hydrostatic pressure, decreased albumin and decreased oncotic pressure

Question 8

Bilirubin elimination

Answer 8

• Bilirubin is brought to liver from spleen attached to albumin
• In liver it is conjugated via glucosyl transferase
• Brought to SI for excretion

Question 9

Jaundice caused bc

Answer 9

• Excess bilirubin can accumulate due to excess RBC destruction
  
  • Liver cant keep up with conjugating
• Decreased bilirubin excretion bc
  
  • Reduced liver uptake of bilirubin (hepatitis, cirrhosis)
  • Decreased conjugation (hepatitis, cirrhosis, enzyme deficiency)
  • Bile duct obstruction

Question 10

Light feces dark urine

Answer 10

• Obstructive jaundice
• Bile duct obstruction

Question 11

Normal/ light feces, light urine

Answer 11

• Hepatocellular jaundice / Intrahepatic
• Damaged hepatocytes

Question 12

Dark feces, dark urine

Answer 12

Hemolytic jaundice

Question 13

Liver function test

Answer 13

Plasma proteins

Albumin is reduced

Transaminases increased

Question 14

Hemochromatosis

Answer 14

• Autosomal recessive, gene regulates iron absorption
• Cirrhosis, skin pigmentation, liver carcinoma

Question 15

Wilson disease

Answer 15

• Autosomal recessive, gene for copper excretion
• Liver disease, neurological, Kayser-Fleischer rings in cornea

Question 16

Hepatocellular Carcinoma

Answer 16

• Associated with Hep B and C, aflatoxin exposure
• die from bleeding