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186 Cards in this Set

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What physical finding is associated with the inability of a damaged liver to catabolize hormones and serum proteins?
Gynecomastia (Results from the inability of the liver to catabolize estrogen in men; typcially observed in chronic alcoholics with liver disease).
What are the metabolic functions associated with hepatocytes?
- Glycogen storage (fed state)
- Glycogenolysis and gluconeogenesis (when fasting)
What are the catabolic functions associated with hepatocytes?
- Catabolism of hormones and serum proteins
- Detoxification of foreign compounds
What term describes the yellow discoloration of skin, sclerae, and tissues cause by hyperbilirubinemia?
Jaundice
What are three causes of excess production of bilirubin resulting in unconjugated hyperbilirubinemia?
- Hemolytic anemia
- Ineffective erythropoiesis
- Resorption of blood from internal hemorrhage
What type of hereditary hyperbilirubinemia is associated with reduced activity of UGT?
Gilbert syndrome
What hereditary hyperbilirubinemia syndromes result in unconjugated hyperbilirubinemia?
- Crigler-Najjar syndrome
- Gilbert syndrome
What type of hereditary hyperbilirubinemia is associated with a deficiency of UGT?
Crigler-Najjar syndrome (Type I UGT absent, Type II UGT greatly reduced)
What type of hereditary hyperbilirubinemia is caused by a defect in hepatocellular excretion of bilirubin glucuronides across the canalicular membranes, and also a pigment liver?
Dubin-Johnson syndrome
What is the cause of neonatal jaundice?
- Increased bilirubin production
- Immaturity of hepatic UDP-glucuronosyl transferase (UGT)
What diagnosis should be considered if a baby has persistent, marked unconjugated hyperbilirubinema (>20 mg/dL), secondary to hemolytic disease of the newborn?
Erythroblastosis fetalis
What condition in newborns can result from unconjugated bilirubin levels above 20 mg/dL?
Kernicterus
What is Kernicterus?
Bilirubin encephalopathy (unconjugated bilirubin crosses the poorly developed BBB of the neonate resulting in deposition in the basal ganglia and damage to the CNS.
What tests are markers of hepatocellular necrosis?
Elevated:
- AST
- ALT
- LDH
What LFTs are markers of cholestasis?
Elevated:
- Alkaline phosphatase
- GGT
- 5'-Nucleotidase
What type of jaundice is clinically manifested as conjugated hyperbilirubinemia?
Obstructive Jaundice
Why do patients with obstructive jaundice sometimes develop pruritus?
Pruritus is caused by regurgitaed bile acids into blood due to common bile duct obstruction.
What are the five morphological features associated with hepatic injury?
- Degeneration of hepatocyte with intracellular accumulations
- Necrosis and apoptosis of hepatocytes
- Inflammation
- Regeneration
- Fibrosis
What is the most common cause of acute hepatic failure?
Acetaminophen ingestion
What etiologies are associated with hepatic dysfunction without necrosis?
Tetracycline & acute fatty liver of pregnancy (viable hepatocytes, however, they do not perform normal metabolic functions).
What characterizes Cirrhosis of Liver?
- Diffuse fibrosis (irreversible)
- Nodularity (due to regenerating nodules of hepatocytes)
What is the most common etiology associated with Cirrhosis of Liver?
Alcoholic liver disease
What complications of Cirrhosis of Liver are consequences of intrahepatic scarring with portal hypertension?
- Esophageal Varices
- Rectal hemorrhoids
- Caput medusae
- Retroperitoneal shunt
- Splenomegaly
Formation of Ascites in Cirrhosis of Liver is the result of?
- Portal hypertension
- Hypoalbuminemia
- Increased production of hepatic lymph (due to increase venous portal pressure)
- Hyperaldosteronism
What are some neurologic manifestations associated with Hepatic encephalopathy?
- Confusion
- Personality Change
- Asterixis (flapping tremor of hands)
- Knee Clonus
- Ankle Clonus
- Babinski Sign (+)
- Coma
What type of hepatic injury is indicated by feathery degeneration?
Cholestatic liver injury
What mushroom is associated massive hepatic necrosis?
Amanita phylloides
What is steatosis?
Fatty Liver (Most frequent morphologic abnormality caused by alcohol and is reversible).
What is the most common cause of jaundice?
Viral hepatitis
What are the sings/symptoms associated with the Pre-icterus phase of acute viral hepatitis?
- Fever
- Tender (painful) hepatomegaly
- Increased ALT and AST (ALT > AST)
What are the four phases of acute viral hepatitis?
- Incubation
- Pre-icteric Stage
- Icteric Stage
- Convalescence
What is the most common viral hepatitis and cause of jaundice?
Hepatitis A Virus (HAV)
What histopathological findings are associated with acute viral hepatitis?
- Ballooning degeneration of hepatocytes
- Apoptosis of hepatocytes (Councilman bodies)
What marker is specifically indicative of an active Hep A infection?
Anti-HAV-IgM
What marker is indicative of recovery from Hep A or vaccination?
Anti-HAV-IgG (Protective Antibody)
What is the first specific marker of Hep B infection?
HBsAg (Persists up to 4 months in acute hepatitis)
What is indicated by HBsAg persisting > 6 months?
Chronic HBV infection (Chronic Hep B infection is defined by HBsAg > 6 months).
What are the infective particles that appear shortly after HBsAg in HBV infection?
- HBeAg
- HBV-DNA
**HBeAg & HBV-DNA also disappear before HBsAg
What does the Anti-HBs indicate?
- Recovery from HepB infection
- Immunization
What markers will be present in a Chronic infective carrier of HBV?
- HBsAg
- HBeAg
- Anti-HBc-IgG
- HBV-DNA
What markers will be present in a "Healthy" chronic carrier of HBV?
- HBsAg
- Anti-HBc-IgG
What marker will be present in a patient who recovered from HBV or was immunized?
Anti-HBs (anti-HBV surface antibody)
What is indicated by the presence of anti-HCV-IgG?
Infection or recovery (anti-HCV-IgG is not a protective antibody)
What is indicated by the presence of anti-HDV-IgM or anti-HDV-IgG?
Active HDV infection
What is indicated by anti-HEV-IgM?
Active HEV infection
What is indicated by anti-HEV-IgG?
Indicates recovery from HEV infection
What types of viral hepatitis infections do not lead to chronic hepatitis?
- Hep A virus
- Hep E virus
Which Hepatitis virus is dependent upon HBV infection?
HDV does not produce envelop antigens, requires HBsAg to form an envelope.
What laboratory studies other than viral antibodies and antigens are observed in viral hepatitis?
- Increased urine UBG and urine bilirubin
- Increased ALT and AST (ALT > AST)
What LFTs are increased in autoimmune hepatitis?
- Anti-smooth muscle antibody (ASMA)
- Antinuclear antibody (ANA)
What types of Hepatitis virus infections are associated with the Fecal-Oral mode of transmission?
HAV & HEV
What types of hepatitis virus infections are associated with parenteral, sexual, and blood born transmissions?
-HBV
-HCV
-HDV
What histopathological finding is associated with cholestatic liver injury?
Feathery degeneration of hepatocytes
What is fulminant hepatitis?
A severe variant of acute hepatitis with rapid clinical course progressing to hepatic encephalopathy
Which hepatitis viruses can result in Fulminant hepatitis?
- HBV & HCV (HCV > HBV > HBV-HDV > HAV)
What gross morphology describes the appearance of the liver in Fulminant hepatitis?
Shrunken with wrinkled capsule (Limp red liver)
What form chronic hepatitis is associated with a strong female predominance?
Autoimmune hepatitis
What is the predominant portal tract infiltrate seen in autoimmune hepatitis?
Plasma cells
What autosomal recessive disorder results in unrestricted reabsorption of iron in the small intestine?
Hereditary Hemachromatosis
What autosomal recessive mutation is a known etiology of hereditary hemochromatosis?
Mutations in the hereditary hemachromatosis gene (HFE).
What disease is considered to be an acquired iron overload disease?
Hemosiderosis (caused by multiple blood transfusion, alcohol abuse, and well water.
What pathogen/disease is associated with right lobe liver abscess?
Amebiasis (Entamoeba histolytica)
What parasite/disease is associated with increased incidence of cholangiocarcinoma?
Clonorchiasis (Clonorchis sinesis - Chinese liver fluke)
What laboratory findings are associated with Fulminant liver failure (Fulminant hepatitis)?
- Decreased ALT and AST (from previous values)
- Increased PT and ammonia
What type of liver tumors is associated with exposure to vinyl chloride, thorium dioxide, and arsenic?
Angiosarcoma
What type of liver tumor is associated with exposure to thorium dioxide?
Cholangiocarcinoma
What type of liver cancer is associated with exposure to alfatoxin (produced by Aspergillus flavus)?
Hepatocellular carcinoma
What drugs mentioned in Goljan are etiological causes of drug-induced hepatitis?
- Isoniazid
- Halothane
- Acetaminophen
- Methyldopa (alpha-methyldopa)
What etiological agents are associated with drug-induced cholestasis?
- Oral contraceptives
- Anabolic steroids
What complication associated with cirrhosis of liver increases the risk of developing spontaneous peritonitis?
Ascites
What physical findings are associated with hyperestrinism that results from cirrhosis of liver?
- Gynecomastia (males)
- Spider telangiectasia
What type of cirrhosis is the result of autoimmune destruction of the bile ducts in the portal triad (portal tract)?
Primary biliary cirrhosis
What is the most common congenital anomaly of the pancreas?
Pancreas divisum (Failure of fusion of the dorsal and ventral portions of the pancreas)
A majority of hereditary pancreatitis cases are due to what specific mutation?
Mutation in cationic trypsinogen gene (PRSS1) - Autosomal dominant inheritance
A mutation in SPINK1 gene is associated with what pathology?
Hereditary pancreatitis (autosomal recessive)
What type of cirrhosis is the result of autoimmune destruction of the bile ducts in the portal triad (portal tract)?
Primary biliary cirrhosis
What is the most common congenital anomaly of the pancreas?
Pancreas divisum (Failure of fusion of the dorsal and ventral portions of the pancreas)
A majority of hereditary pancreatitis cases are due to what specific mutation?
Mutation in cationic trypsinogen gene (PRSS1) - Autosomal dominant inheritance
A mutation in SPINK1 gene is associated with what pathology?
Hereditary pancreatitis (autosomal recessive)
What congenial pancreatic anomaly is defined by the formation of a ring around the duodenum by the dorsal and ventral buds of the pancreas?
Annular Pancreas (associated with duodenal obstruction)
What is the most common site of ectopic pancreatic tissue?
Stomach
What type of pancreatitis is defined as being a reversible process that is the result of biliary tract obstruction or alcoholism?
Acute pancreatitis
What type of pancreatitis is defined as being an irreversible loss of pancreatic tissue as a result of long-term alcohol abuse?
Chronic pancreatitis
What historical finding is the most important finding associated with hereditary pancreatitis?
Recurrent bouts of acute pancreatitis beginning in childhood?
What two genetic mutations are the most strongly associated with hereditary pancreatitis?
- PRSS1
- SPINK1
Which gene encodes for a pancreatic secretory inhibitor?
- SPINK1 (Mutation is SPINK1 is autosomal recessive associated with hereditary pancreatitis)
What is the cationic trypsinogen gene?
- PRSS1 (Autosomal dominant mutation results in trypsin that is resistant to autocleavage; associated with hereditary pancreatitis).
What are the macroscopic findings associated with acute pancreatitis?
Hemorrhage and fat necrosis
What are the microscopic findings associated with acute pancreatitis?
- Edema
- Fat necrosis
- Proteolysis of the pancreas
- Acute inflammation
- Vasucular destruction with hemorrhage.
What type of necrosis is specifically associated with acute pancreatitis?
Fat Necrosis (results in a soapy appearance upon histological examination).
What is the most common cause of acute pancreatitis?
Alcohol abuse
What signs/symptoms are associated with acute pancreatitis?
- Nausea
- Fever
- Vomiting
- Severe (boring) midepigastric pain that radiates into the back
What laboratory findings are associated with acute pancreatitis?
- Increased serum amylase (24 hrs)
- Increased serum lipase (72 hrs to 96 hrs)
What is the treatment for acute pancreatitis?
Resting the pancreas, total restriction of oral intake, IV supportive fluids and analgesia.
What complications are associated with acute pancreatitis?
- Systemic organ failure
- DIC
- Pancreatic abscess
- Pancreatic pseudocyst
- Duodenal obstruction
What defines chronic pancreatitis?
Inflammation of the pancreas with irreversible destruction of the pancreatic parenchyma.
Dilations of the pancreatic ducts is associated with which type of pancreatitis?
Chronic pancreatitis
What complication of acute or chronic pancreatitis should you consider if there is persistent elevation of serum amylase?
Pancreatic pseudocyst
What are the complications associated with chronic pancreatitis
- Pancreatic pseudocyst
- Pancreatic duct obstruction
- Malabsorption, hypoalbuminemia, steatorrhea
- Secondary diabetes mellitus
- Pancreatic cancer
What characterizes benign serous cystadenoma?
Numerous 1-3 mm cysts, lined by glycogen-rich cuboidal cells, filled with clear/watery fluid.
What morphological features characterizes mucinous cystic neoplasms of the pancreas?
Multilocular (larger than serous cysts) cysts lined by columnar mucin-producing epithelium, filled with thick dense mucin, surrounded by dense ovarian-like stroma.
What characterizes intraductal papillary mucinous neoplasms?
Intraductal mucin producing tumors, usually arise in the head of the pancreas and do not have an ovarian stroma.
What neoplasm is considered to be the 4th leading cause of death in the US?
Pancreatic carcinoma
What risks factors are associated with increased risk of developing pancreatic carcinoma?
- Smoking (2x)
- Alcohol (2x)
- Diets rich in fat
- Chronic pancreatitis
- Hereditary pancreatitis
What characterizes the precursor lesion associated with pancreatic carcinoma?
Pancreatic intraepithelial neoplasms (PanIN)
What genetic mutations are associated with PanIN-1A and PanIN-1B?
KRAS mutations - Most common oncogene mutation associated with pancreatic carcinoma.
What genetic mutations are associated with PanIN-2?
CDNK2A (p16) - Most common tumor suppressor gene inactivated in associated with pancreatic carcinoma.
What are the most common genetic mutations associated with invasive pancreatic adenocarcinoma?
- KRAS mutations and mutations in p16 (CDNK2A) are present in almost all invasive pancreatic adenocarcinoma.
What is Trousseau's sign?
Migratory thrombophlebitis - spontaneously appearing and disappearing thrombophlebitis of the superficial veins. Physical finding associated with pancreatic carcinoma.
What term refers to spontaneously appearing and disappearing migratory thrombophlebitis of the superficial veins that is associated with pancreatic carcinoma?
Trousseau's Sign
What is stated by Courvoisier's Law?
If the common bile duct is obstructed by a stone dilation is rare, however, if the duct is obstructed by something else (i.e. tumor of the head of the pancreas) then dilation is common.
What are the signs of common bile duct obstruction by carcinoma of the head of the pancreas?
- Jaundice (Conjugated Hyperbilirubinemia)
- Light-colored stools (absence of urobilinogen)
- Palpable gallbladder (Courvoisier's Sign)
What portion of the pancreas is most likely to be affected by a pancreatic adenocarcinoma?
Head of the pancreas (65% of cases of pancreatic carcinoma occur in the head of the pancreas).
What pathological features are associated with pancreatic adenocarcinoma?
- Most likely to occur in the head of the pancreas.
- Intensive desmoplastic response
- Propensity to invade nerves (perineural invasion) and retroperitoneum
Where does pancreatic adenocarcinoma typically metastasize?
- Liver
- Diaphragm (Peritoneal Carcinomatosis)
What etiology is associated with secondary biliary cirrhosis?
Extrahepatic obstruction (no sex predilection)
What etiology is associated with primary biliary cirrhosis?
Autoimmune destruction of portal tract bile ducts (Female predominance)
What etiology is associated with primary sclerosing cholangitis?
Periductal fibrotic reaction (Strong association with Ulcerative colitis - male predominance).
What are the signs/symptoms associated with intrahepatic biliary tract diseases?
- Pruritus, jaundice, malaise, dark urine, and light stools
What laboratory findings are associated with intrahepatic biliary tract diseases?
- Conjugated hyperbilirubinemia
- Increase alkaline phosphatase
What radiological finding is indicative of primary sclerosing cholangitis?
A beaded appearance of the common bile duct is a typical finding of primary sclerosing cholangitis.
What histological finding is specific for primary sclerosing cholangitis?
Onion skinning fibrosis (Bile duct in a dense "onion skin" concentric scar - concentric periductal fibrosis).
Which intrahepatic biliary tract disease has a strong association with Ulcerative colitis (IBD)?
Primary sclerosing cholangitis
What autoantibodies will be present in primary scleroisng cholangitis?
- ASMA
- ANA
- atypical p-ANCA
What histological finding is indicative of primary biliary cirrhosis?
Non-suppurative granulomatous destruction of interlobular bile ducts (florid duct lesion).
What laboratory findings are associated with primary biliary cirrhosis?
- Increased alkaline phosphatase
- Increase cholesterol
- Hyperbilirubinemia
- Anitmitochondrial antibodies (AMA)
Individuals with primary sclerosing cholangitis are at increased risk of developing what type of cancer?
Cholangiocarcinoma
Individuals with primary biliary cirrhosis are at increased risk of developing what type of cancer?
Hepatocellular carcinoma
What major feature characterizes bile duct adenoma?
Consists of well-differentiated, cytologically benign bile ducts in a thin fibroconnective stroma (No fibrous capsule).
What tumor is characterized as being essentially an adenocarcinoma with prominent desmoplastic reaction?
Cholangiocarcinoma
Which organs does cholangiocarcinoma metastasize to via hematogenous spread?
- Lungs
- Vertebrae
- Adrenals
- Brain
What is the clinical progression associated with cholangiocarcinoma?
Rapid, definitive treatment liver transplant, without transplant death usually results within six months.
What major features are associated with liver cell adenoma?
Cytologically benign hepatocytes from cords not thicker than 2 cells.
Use of oral contraceptives has a strong association with which type of hepatic neoplasm?
Liver cell adenoma (Usually solitary vascular neoplasms, that are present predominately in the right lobe of the liver).
Does discontinuation of oral contraceptives cause the regression of liver cell adenoma?
Yes, discontinuation of oral contraceptive results in the regression of a liver cell adenoma?
What hepatic tumor-like condition is more common than liver cell adenoma and is characterized by ductules and fibrous septa radiating from a central stellate scar?
Focal Nodular Hyperplasia (Radiological findings will strongly suggest diagnosis)
What characterizes Focal Nodular Hyperplasia?
Central stellate scar in a center of spontaneous lobulated mass/lesion.
What morphological characteristics are associated with nodular regenerating hyperplasia?
Multiple small, well delineated white nodules that resemble a liver cell adenoma.
What liver disease occurs in conditions affecting intrahepatic blood flow?
Nodular Regenerating Hyperplasia
What conditions may cause false positive alpha-fetoprotein results?
- Yolk sac tumors of gonads
- Liver diseases
- Normal pregnancy
- Fetal distress or death
- Fetal neural tube defects (anencephaly and spina bifida)
What is the most common visceral malignant tumor in the world?
Hepatocellular carcinoma
Approximately 40% of patients with hereditary tyrosinemia develop what type of cancer?
Hepatocellular carcinoma
What type of hepatic cancer arises in healthy young adults and is characterized by nest and cords of carcinoma cells that are separated by dense fibrous tissue?
Fibrolamellar Variant of Hepatocellular carcinoma (60% 5-yr survival, better prognosis than diffuse variant hepatocellular carcinoma)
What is the most common liver tumor of young children?
Hepatoblastoma (frequent activation of WNT/beta-catenin signaling pathway)
What is the most common malignancy seen in the liver?
Metastatic adenocarcinoma?
What is HELLP Syndrome?
- Hemolytic anemia
- Elevated serum transaminases
- Low platelets
** May be observed as a complication of preeclampsia **
What is choledocholithiasis?
Presence of gallstone in the common bile duct.
What are the hepatic complications of bone marrow transplantation?
- Drug toxicity
- Graft-versus-host-disease (GVHD)
What are the hepatic complications of liver organ transplantation?
- Graft failure or graft rejection
- Non-immunological damage to liver allografts.
Drug toxicity after bone marrow transplantation may result in what hepatic tumor-like condition?
Nodular regenerating hyperplasia
What is the relative composition of a cholesterol stone?
- > 50% cholesterol
- Calcium salts
- Mucin
Use of what pharmacological agent is associated with a higher incidence of cholesterol stones?
- Oral contraceptives
Why are women more prone to develop cholesterol stones than men?
- Estrogens stimulate the formation of lithogenic bile
- Progesterone inhibits the discharge of bile acids from the gallbladder.
What is the relative composition of pigmented stones?
Mixture of calcium bilirubinate and inorganic calcium salts.
What cause the formation of cholesterol gallstones?
- Supersaturation of bile with cholesterol (Increased cholesterol in bile)
- Decreased bile salts and lecithin
What are risk factors associated with developing cholesterol gallstones?
- Female
- > Forty years old
- Obesity
- Use of oral contraceptives (estrogen increase cholesterol in bile)
- Rapid weight loss, use of lipid-lowering drugs
- Native Americans
What is the most common type of gallstone?
Cholesterol gallstone
Black pigment gallstones is a sign of what underlying pathology?
- Hemolysis (Hemolytic anemia, sickle cell anemia, and thalassemia)
- Calcium bilirubinate resulting from the hydrolysis of bilirubin glucuronides by microbial beta-glucuronidases.
What is the underlying etiology associated with 90% of the cases of acute calculous cholecystitis?
Gallstone obstruction of the neck of the gallbladder or cystic duct.
What is responsible for the chemical irritation that occurs in acute calculous cholecystitis?
- Lecithin is hydrolyzed to lysolecithin which disrupts mucosal barriers exposing mucosa to direct detergent action of bile acids.
Where does the pain associated with cholecystitis typically radiate?
Right scapula
What is the etiology associated with acute acalculous cholecystitis?
Direct ischemic compromise (the cystic artery is an end artery, poor collateral circulation).
What is the most common symptomatic disorder of the gallbladder?
Chronic cholecystitis
What characterizes the pathogenesis of chronic cholecystitis?
Repeated bouts of acute cholecystitis; almost always due to gallstones.
What clinical findings are associated with chronic cholecystitis?
- Severe pain 1 to 2 hours post-prandially
- Recurrent epigastric distress, belching, and bloating
What histopathological finding is indicative of chronic cholecystitis?
Aschoff-Rokitansky sinus
What is the etiology associated with acute acalculous cholecystitis?
Direct ischemic compromise (the cystic artery is an end artery, poor collateral circulation).
What is the most common symptomatic disorder of the gallbladder?
Chronic cholecystitis
What characterizes the pathogenesis of chronic cholecystitis?
Repeated bouts of acute cholecystitis; almost always due to gallstones.
What clinical findings are associated with chronic cholecystitis?
- Severe pain 1 to 2 hours post-prandially
- Recurrent epigastric distress, belching, and bloating
What histopathological findings are indicative of chronic cholecystitis?
- Aschoff-Rokitansky sinuses
- Mononuclear cell infiltration
What variant of chronic cholecystitis occurs secondary to extensive dystrophic calcification within the gallbladder wall?
Porcelain gallbladder
What variant of chronic cholecystitis occurs as a result of retention of clear secretions in an atrophic chronically obstructed gallbladder?
Hydrops of gallbladder
What is another name for cholesterolosis?
Strawberry gallbladder
What is cholesterolosis?
Excess cholesterol deposition in mucosal macrophages (cluster of foamy macrophages in lamina propria).
What clinical findings are associated with acute cholecystitis?
- Fever, nausea, vomiting (post-prandially)
- Initial midepigastric colicky (constant and dull) pain
- Pain radiating to the scapula
- Jaundice (stone in the CBD)
- Elevated WBC with left shift
What are the complications of persistent obstruction of the common bile duct?
- Jaundice (conjugated hyperbilirubinemia)
- Cholestasis
- Bile lakes and bile infarcts
- Complicated by ascending cholangitis
- Secondary biliary cirrhosis
What cancer is associated with the gallbladder?
Gallbladder adenocarcinoma (60-90% the is cholelithiasis; dominant in elderly women, very poor prognosis)
Which ethnic group is marked by a high incidence of gallbladder adenocarcinoma?
Native Americans (Pima Indians and other Native Americans in the Southwest region).
Gallbladder adenocarcinoma has the propensity to invade what organs?
- Liver (via vascular dissemination and direct spread).
What are the four F's associated with cholelithiasis?
Fat Fertile Female over Forty
What are the types of gallstones (cholelithiasis)?
- Cholesterol stones
- Pigmented stones
- Mixed stones
What are some causes of non-immunological damage to liver allografts?
- Preservation injury (i.e. improper handling and care, hypoxia in donor's life)
- Vascular thrombosis (hepatic artery, occurs during the first several weeks after transplantation, or even 1-3 years later).
- Bile duct obstruction or biliary leaks
What histopathological findings are indicative of chronic liver allograft rejection?
- Foamy cell obilterative arteriopathy
- Interlobular bile duct damage and destruction (vanishing bile duct syndrome).
What histopathological findings are indicative of acute liver allograft rejection?
- Portal tract inflammation with mixed inflammatory infiltrate
- Endothelitis
- Interlobular bile duct inflammation
In what time frame does acute cellular liver allograft rejection typically occur?
Occurs most commonly between 5 and 30 days.