Path-Appendix-Liver

Front 1

pt presents with periumbilical pain that soon migrates to the right lower quadrant with fever, nausea, vomiting, and elevated WBC

Back 1

acute appendicitis

Front 2

pt presents w/ diarrhea, SOB & valvular heart dz.

Back 2

carcinoid tumor

Front 3

liver is responsible for the ____________

Back 3

detoxification of ammonia

Front 4

pt with liver failure presents with impaired cognition and asterixis followed by decreasing levels of consciousness, coma, and death. What is this due to

Back 4

“hepatic encephalopathy”-due to increasing blood ammonia levels

Front 5

This type of liver failure is often drug-induced (e.g. acetaminophen toxicity, halothane, carbon tetrachloride, mushroom poisoning) or due to Hepatitis A&B.

Back 5

Massive hepatic necrosis.

Front 6

Liver failure caused by alcoholism or hepatitis B&C.

Back 6

Chronic liver disease with cirrhosis.

Front 7

liver failure due to Reye syndrome, tetracycline toxicity, acute fatty liver of pregnancy.

Back 7

Hepatic dysfunction without overt necrosis

Front 8

The liver responds to injury with 5 categories of cellular changes. what are they?

Back 8

1) Degeneration and cellular accumulation
2) Necrosis
3) Inflammation (hepatitis)
4) Regeneration
5) Fibrosis

Front 9

name the hepatic cellular injury.

Liver cells can swell & cytoplasmic fluid accumulates making them appear lighter. Triglyceride droplets accumulate resulting in steatosis (AKA fatty change).

Back 9

Degeneration and cellular accumulation

Front 10

pregnant woman taking valproic acid! has fatty change in liver manifested by small droplets that do not displace the nucleus

Back 10

microvesicular fatty change

Front 11

Obese man with diabites and hepatitis presents with fatty change of the liver manifested by larger droplets

Back 11

macrovesicular fatty change

Front 12

_________ can cause both micro and macrovesicular fatty change.

Back 12

Alcoholic liver disease

Front 13

type of liver necrosis where liver cells swell so much that they burst

Back 13

lytic necrosis

Front 14

In chronic passive congestion or certain drug reactions hepatocytes surrounding the central vein die as oxygenation is decreased in the stagnant pooling blood

Back 14

centrolobular necrosis

Front 15

when during inflammation necrotic hepatocytes span from one inflamed portal tract to other

Back 15

bridging necrosis

Front 16

Liver cells are engulfed by resting hepatic macrophages called Kupffer cells and so the identification of necrotic/apoptotic hepatocytes reflects ________

Back 16

very recent damage (hours).

Front 17

viral hepatitis in which lymphocytes accumulate in the portal triad and then spill over into the parenchyma and finally involve all of the liver tissue as fulminant hepatitis reflects this type of Cellular hepatic injury

Back 17

Inflammation (hepatitis

Front 18

large volumes of lost liver could potentially be replaced by hyperplasia of the residual hepatocytes if it were not for interference by fibrosis describes this type of hepatic cellular change

Back 18

regeneration

Front 19

this type of hepatic change caused by chronic inflammation or direct toxic insult. It usually begins in the portal tracts and is irreversible.

Back 19

Fibrosis

Front 20

With continued collagen deposition the fibrosis begins to divide the liver into nodules. At this point the process is called ______

Back 20

cirrhosis

Front 21

The leading causes of cirrhosis

Back 21

Alcoholic liver dz: 60%-70%
Viral hepatitis: 10%
Biliary diseases: 5%-10%
Primary hemochromatosis:5%

Front 22

autopsy done on 65 y/o alcoholic shows diffuse nodularity of livers surface reflecting the interplay between nodular regeneration and scarring. There is a greenish tint of some nodules due to bile stasis. A hepatocellular carcinoma is present as a budding mass at the lower edge of the right lobe. Microscopic view shows nodules of varying sizes entrapped in blue-staining fibrous tissue. What is the dx

Back 22

alcoholic cirrhosis

Front 23

Tell whether the following liver condition is reversable or not:
Steatosis
-fatty change
-perivenular fibrosis

Back 23

reversable

Front 24

Tell whether the following liver condition is reversable or not:
Hepatitis
-liver cell necrosis
-inflammatin
-mallory bodies
-fatty change

Back 24

reversible

Front 25

Tell whether the following liver condition is reversable or not:
cirrhosis
-fibrosis
-hyperplastic nodules

Back 25

irreversible

Front 26

this cell cell is the main culpret in cirrhosis

Back 26

stellate

Front 27

male pt preseents w/ Jaundice and bad smelling breath and evidence feminization. Labs show Hypoalbuminemia, Hyperammonemia, Hypoglycemia. What is the dx?

Back 27

Hepatic dysfunction

Front 28

pt presents with Hemorrhoids, Splenomegaly,Ascites, & Caput medusae. On biopsy the cut liver section, in which major blood vessels are visible, is notable for a variegated, mottled, red appearance (nutmeg liver).

Back 28

Portal hypertension