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51 Cards in this Set
- Front
- Back
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Where is the main storage for Vitamin A in the liver? |
Hepatic stellate cells |
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Besides storing vitamin A, what else do hepatic stellate cells do? |
Make collagen for fibrosis |
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What can cause centrilobular necrosis of the liver? (6) |
- Ischemia - Drugs - CHF - Sepsis - Sinusoidal obstructive syndrome - Hepatic vein thrombosis |
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What is steatosis? |
Fatty change hepatic injury |
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What kind of inflammation comes from acute viral hepatitis? |
Lymphocytic inflammation |
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What kind of inflammation comes from chronic viral hepatitis? |
Portal lymphocytic inflammation |
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What kind of inflammation comes from alcoholic hepatitis? |
Neutrophilic reaction |
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What defines cirrhosis? |
Fibrosis and change of hepatic architecture into abnormal nodules |
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What are 8 etiologies of cirrhosis? |
1) Alcohol liver disease 2) Hep B&C 3) Nonalcoholic Fatty Liver Disease (NAFLD) 4) Biliary diseases 5) Hemochromatosis 6) Autoimmune hepatitis 7) Wilson disease 8) Cryptogenic (unknown cause) |
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What are the clinical manifestations of cirrhosis? (6) |
- Anorexia, weightloss, weakness - Spider angiomas, gynecomastia, amenorrhea - Dupuytren's contracture, clubbing - Impaired albumin and clotting factor synthesis - Hepatorenal syndrome - Portal hypertension |
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What are the consequences of portal hypertension? (4) |
- Esophageal varices - Ascites - Splenomegaly - Hepatic encephalopathy |
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What are 3 presentations of alcoholic liver disease? |
- Fatty liver - Alcoholic hepatitis - Cirrhosis |
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Is fatty liver due to alcohol consumption reversible? |
Yes |
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What are the symptoms of fatty liver? (4) |
- Asymptomatic - Malaise - Anorexia - Abdominal discomfort |
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What are 4 histological signs of alcoholic hepatitis? |
- Hepatocyte swelling - Mallory bodies (hyaline inclusions) - Neutrophilic response - Perivenular & sinusoidal necrosis |
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What is a critical element in patient history for someone with NAFLD? |
no history of heavy drinking |
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What are risk factors for NAFLD? (4) |
- Metabolic syndrome - Obesity - Diabetes - Dyslipidemia |
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What drug is thought to cause NAFLD? |
Amiodarone |
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What gender is most susceptible to autoimmune hepatitis? |
Females |
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What demographic often get Type 1 Autoimmune hepatitis? |
- Young and perimenopausal women |
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What demographic often gets Type 2 Autoimmune hepatitis? |
- Children and teenagers |
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What blood signs are evident for Type 1 Autoimmune hepatitis? (3) |
- Anti-smooth muscle antibody (SMA) - ANA - Elevated IgG |
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What blood sign is evident for Type 2 Autoimmune hepatitis? |
Anti-liver kidney microsome-1 antibody (anti-LKM-1 Ab) |
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What is primary biliary cirrhosis? |
Chronic cholestatic liver disease characterized by inflammatory destruction of small and medium bile ducts |
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What cohort is most affect by primary biliary cirrhosis? |
Middle-aged Women |
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What are some symptoms associated with primary biliary cirrhosis? (3) |
- Pruritus - Jaundice - Xanthoma |
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What blood markers are elevated in a patient with primary biliary cirrhosis? (2) |
- Serum Alkaline phosphotase - Antimitochondrial antibodies |
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What drug can slow the progression of primary biliary cirrhosis if caught early? |
Ursodeoxycholic acid (UDCA) |
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What is primary sclerosing cholangitis? |
Inflammation and obliterative fibrosis of all bile ducts |
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What gender is more affected by primary sclerosing cholangitis? |
Males |
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What comorbidity is often found in patient with PSC? |
Ulcerative colitis |
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What blood marker suggest primary sclerosing cholangitis? |
Alkaline phosphotase |
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What is choledocholithiasis? |
Gallstones that have migrated to the biliary tract |
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What type of bacteria can inflame bile ducts? |
Enteric G- aerobes |
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What cohort is most likely to be diagnosed with extraheptic biliary atresia? |
Neonates in the first 3 months of life |
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What is the treatment for biliary atresia? |
Transplant from living relative |
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What are the clinical manifestations of hereditary hemochromatosis? (3) |
- Micronodular cirrhosis - Diabetes mellitus - Skin pigmentation |
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When do symptoms of hereditary hemochromatosis first appear? |
fifth to sixth decade of life |
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In what gender is hereditary hemochromatosis more common?
What gene is associated with it? |
Males
HFE |
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What is mutated in hereditary hemochromatosis and what is the result? |
C282Y
Problem sensing systemic Fe leads to unregulated uptake from GI |
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What histological sign is unique for hereditary hemochromatosis? |
hemosiderin deposits in hepatocytes |
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What is the treatment for hereditary hemochromatosis? |
Donate 100 mL blood once a month |
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What are the signs of Wilson disease? (4) |
- Hepatic disease - Kayser-Fleischer ring (black cornea) - Hemolytic anemia - Neurological signs |
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What gene is defective in Wilson disease?
What is its normal function? |
ATP7B - normally excretes excess copper in bile |
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What is the treatment for Wilson's disease? (3) |
- Chelation - Zinc therapy - Liver transplant |
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What genotype is present in patients with Alpha-1-Antitrypsin Deficiency? |
PiZZ |
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What virus is strongly linked to liver cancer? |
HBV and HCV |
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What toxin is associated with liver cancer?
From what pathogen does the toxin come? |
Aflatoxin B1
Aspergillus flavus |
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What 3 chemicals are associated with angiosarcoma? |
- Vinyl chloride - Arsenic - Thorotrast (an old contrast solution) |
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In what cohort is hepatocellular adenoma more common? |
Young women
oral contraceptive pill |
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What is the most common benign tumor of the liver? |
Hemangioma |
