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27 Cards in this Set
- Front
- Back
where do steatohep adn steatosis sarter?
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Zone 3 around central vein
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where do Hep C and Hep B start?
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Zone 1 portal tract
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why are women more susceptible to ALD?
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less alcohol dehydrogenase
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three forms of ALD:
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hepatic steatosis: fatty change seen in all
steatohepatitis: alcoholic hep 30% cirrhosis: 10% |
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what is the mechanism for Alcholic steatosis?
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shunt from catabolism to lipid synthesis (reduction of NAD to NADH: increase G3P: triglycerides)
impaired lipid synthises and secreation decreaseed mitochondiral fa ox increased peripheral breakdown of fat and incr fat circ to liver |
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what do you see in Alcoholi hepatisis histology?
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ballooning and mallory bodies
chicken wire fibrosis |
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NAFLD
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zone 3 ballooning and mallory bodies
portal fat and fibrosis, chicken wire |
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pathophys of NAFLD:
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incre FFA: recuirt inflam mediators: ROS:
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plasma cells predominant
inflam inflitartes in zone 1 have concurren AI disorder younger pts fulminant liver fail |
Auto immune hepatits
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sjogrens and keratoconjunctivitis sicca
female scandanavia 40-60 in alk phos fatigue pruritus after 2 yrs anitmitochondrial antibodies portal based granuloma |
PBC
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Florid duct lesion
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bile duct eaten up by inflam cels
pigmotic nuclei PBC |
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AIH and PBC can overlap
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usually have one set of symptoms
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20-50s
male associated with UC increased alk phos jaundice,pruritus, RUQ pain |
PSC
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PSC and Cancer:
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PSC and UC risk for colon cancer
PSC: risk for bile duct carc maybe pancreatic carc |
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what is the gold standard for Dx PSC?
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cholangiogram
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onion skinning lesions
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PSC
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AIH and PSC overlap
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younger pts IBD more common
equal genders chol evidence of PSC |
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AMA positive: Antimicrobial anitbodies
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PBC
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AIC (AIH plus PBC)
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PBC w/o AMA antibody
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a nodular lymphoid aggregate in portal tract is specific for:
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HCV; may even see germinal centers develop
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chronic hepatitis staging
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1: portal fibrosis with portola fib expan
2: periport fib w/ smal septa in zones 3: septal fibrosis: bidging fibrosis 4 cirrhosis |
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what are 5 causes of cirrhosis?
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Viral
AI Genetic Alcohol NASH |
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what are clinical feats of decomp cirrhosis?
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jaundice
vascular spiders splenomegaly ascites encephalopathy |
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Xanthelasmas:
male female |
male: PSC
Female: PBC yellow lipid laden nodules (eleveated cholesterol) |
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palmer erythema
gynecomastia |
red palm, cirrhosis pts feel cold bc blood isnt as warm
low t high estrogen |
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dupuytren's contracture:
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muscular contration do to fibrosis
cirrhosis |
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muscle wasting
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due to inability to synthesize albumin: cirrhosis
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