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27 Cards in this Set

  • Front
  • Back
where do steatohep adn steatosis sarter?
Zone 3 around central vein
where do Hep C and Hep B start?
Zone 1 portal tract
why are women more susceptible to ALD?
less alcohol dehydrogenase
three forms of ALD:
hepatic steatosis: fatty change seen in all
steatohepatitis: alcoholic hep 30%
cirrhosis: 10%
what is the mechanism for Alcholic steatosis?
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
what do you see in Alcoholi hepatisis histology?
ballooning and mallory bodies

chicken wire fibrosis
NAFLD
zone 3 ballooning and mallory bodies
portal fat and fibrosis, chicken wire
pathophys of NAFLD:
incre FFA: recuirt inflam mediators: ROS:
plasma cells predominant
inflam inflitartes in zone 1
have concurren AI disorder
younger pts
fulminant liver fail
Auto immune hepatits
sjogrens and keratoconjunctivitis sicca
female scandanavia 40-60
in alk phos
fatigue pruritus after 2 yrs
anitmitochondrial antibodies
portal based granuloma
PBC
Florid duct lesion
bile duct eaten up by inflam cels
pigmotic nuclei
PBC
AIH and PBC can overlap
usually have one set of symptoms
20-50s
male
associated with UC
increased alk phos
jaundice,pruritus, RUQ pain
PSC
PSC and Cancer:
PSC and UC risk for colon cancer
PSC: risk for bile duct carc
maybe pancreatic carc
what is the gold standard for Dx PSC?
cholangiogram
onion skinning lesions
PSC
AIH and PSC overlap
younger pts IBD more common
equal genders
chol evidence of PSC
AMA positive: Antimicrobial anitbodies
PBC
AIC (AIH plus PBC)
PBC w/o AMA antibody
a nodular lymphoid aggregate in portal tract is specific for:
HCV; may even see germinal centers develop
chronic hepatitis staging
1: portal fibrosis with portola fib expan
2: periport fib w/ smal septa in zones
3: septal fibrosis: bidging fibrosis
4 cirrhosis
what are 5 causes of cirrhosis?
Viral
AI
Genetic
Alcohol
NASH
what are clinical feats of decomp cirrhosis?
jaundice
vascular spiders
splenomegaly
ascites
encephalopathy
Xanthelasmas:
male
female
male: PSC
Female: PBC

yellow lipid laden nodules (eleveated cholesterol)
palmer erythema
gynecomastia
red palm, cirrhosis pts feel cold bc blood isnt as warm

low t high estrogen
dupuytren's contracture:
muscular contration do to fibrosis
cirrhosis
muscle wasting
due to inability to synthesize albumin: cirrhosis