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33 Cards in this Set
- Front
- Back
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What are some infectious disorders of the liver?
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viral hepatitis
infectious mononucleosis EBV CMV Yellow fever |
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What is hepatitis A?
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fecal-oral transmission of a self-limited acute disease with no association with cancer and a transient viremia
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What percent of Hep B is chronic?
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15%
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What can you get with Hep B?
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Hep D
hepatocellular carcinoma cirrhosis |
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What is Hep C?
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blood borne chronic liver disease that has a carrier form and causes cirrhosis & hepatocellular carcinoma
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What is Hep E?
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waterborne acute selflimiting infection with no chronic disease, carrier or viremia
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What patinet is at risk with Hep E?
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pregnant women
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What is the acute asymptomatic infection with recovery from Hep?
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HAV & HBV & HEV frequently subclinical in children
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What is the preicteric phase of hep infection?
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non-specific constitutional symptoms
inc serum aminotrasferases with enlarged tender liver |
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What is the icteric phase of hep infection?
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conjugated hyperbilirubinemia
dark colored urine & light colored stool |
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What are the major causes of death with chronic viral hep?
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cirrhosis
hepatocellular carcinoma portal HTN |
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What is the definition of fulminant hepatic failure?
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hepatic insufficiency progresses from onset of symptoms to hepatic encephalopathy
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What is the clinical presentation of fulminant hepatic failure?
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jaundice, encephalopathy, fector hepaticus
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What symptoms of chronic liver failur are absent in fulminant hepatic failure?
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spider angioma & gynomastia
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What do you see histologically with chronic HBV?
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ground glass hepatocytes, inclusions, nodular liver, fibrosis
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What is ascending cholangitis?
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gut bacteria in obstructed bilinary tract
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What are some world wide diseases with liver involvement?
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*schistosomiasis, malaria, strongylodasis, cryptosporidiosis, leishmaniasis, liver flukes & echinococcus
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What are most liver abscesses?
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amebic, echinococcus
pyogenic spread from elsewhere |
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Who most commonly gets autoimmune hepatitis?
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women of northern european descent
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Serologically what do you see with autoimmune hepatitis?
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Negative: viral, anti-mitochondrial Ab
Elevated: IgG, ANA, antiSMA, antiLKM1 |
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What may happen with autoimmune hepatitis?
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progress to cirrhosis, substantial liver injury with scarring
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In alcoholic liver disease what arises from excess reducing equivalents (NADH) from metabolism of EtOH?
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microvesicular & macrovesicular steatosis
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With some hepatotoxins microvesicular steatosis results from what?
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direct mitochondrial injury & impaired oxidative metabolism
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What are some toxins that produce microvesicular fatty changes?
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alcohol
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What are some toxins that produce macrovesicular fatty changes?
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alcohol
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What are some toxins that produce centrolobular necrosis?
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CCL4, acetominophen
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What are some toxins that cause massive necrosis?
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acetominophen
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What are some toxins that produce hepatitis?
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methyldopa
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What are some toxins that cause cholestasis?
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chlorpromasine, erythromycin, oral contraceptives
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What is Reye syndrome?
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mito dysfxn in brain & liver of kids who recieved NSAIDS for relief of a virus related fever
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What does steatosis result from in alcoholic liver disease?
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1. shunting of substrates toward lipid metabolism
2. impaired assembly & secretion of lipoprotiens 3. inc peripheral catabolism of fat |
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What sensitizes the liver to oxidative injury in alcoholic liver disease?
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decreased levels of glutathione
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What are some causes of death in end stage alcoholic liver disease?
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1. hepatic coma
2. massive GI hemorrhage 3. infection 4. heaptorenal syndrome following a bout of hepatitis 5. hepatocellular carcinoma |
