High Yield Liver

Front 1

three histologic fx of hepatitis

Back 1

1. Portal-based portal inflammation
2. Interface hepatitis = piecemeal necrosis
3. Focal necrosis
– Foci of lobular inflammation & necrosis of single hepatocytes

Front 2

how diagnose hep A, how determine if immunity

Back 2

IgM HAV for diagnosis
IgG HAV for immunity determination

Front 3

type of virus : dna vs. rna HAV

Back 3

ss RNA, picornovirus

Front 4

type of virus: HBV

Back 4

partly ds DNA

Front 5

treatment for HBV

Back 5

α-interferon, lamivudine

Front 6

how diagnose HBV

Back 6

HBsAg or HBcAg

Front 7

see this, think

Back 7

ground glass hepatocytes: hep b (proliferating ER)

Front 8

two histo fx for HBV

Back 8

sanded nuclei (pink nuclear inclusions with HBcAg in it
ground glass cytoplasm (contains HBsAg and HBcAg)

Front 9

histol fx for HCV

Back 9

fat, lymphoid aggregates and bile duct damage

Front 10

if see fat, lymphoid aggregates and bile duct damage, think

Back 10

HCV

Front 11

ab for AIM hepatitis

Back 11

ANA, ASMA, LKM1, soluble liver antigen or LP (liver
pancreas) antibodies

Front 12

trx for AIM

Back 12

only hepatitis that responds to steroids

Front 13

histo fx for AIm hepatitis

Back 13

Marked interface inflammation with bridging necrosis (PT to CV)
and plasma cells!!!

Front 14

how detect hep D

Back 14

can do ihc

Front 15

histologic fx of cholestasis

Back 15

– Portal based damage
– Dilated bile canaliculi with bile plug
– pseudoxanthomatous change or feathery
degeneration
• Bile duct injury and loss
• Ductular (cholangiolar) proliferation
• Cholestatic Mallory bodies, zone I
• Jigsaw cirrhosis (segmental disease)

Front 16

clinical findings for cholestatic dz

Back 16

Elevated Alk phos, bilirubin, GGT
– Pruritis, jaundice, pale stools

Front 17

ihc in cholestasis

Back 17

perivenular hepatocytes are CK7+

Front 18

two copper stains for cholestasis

Back 18

Rhodanine and victoria blue

Front 19

clinical associations PBC

Back 19

women, middle age, HLA DR type, AIM associations (scleroderma, Sjogren's)
often AMA positive
elevated IgM

Front 20

what

Back 20

primary biliary cirrhosis
-Cholestasis
• Florid duct lesion
– Bile duct injury
• Granulomas

Front 21

clinical findings/associations with PSC

Back 21

males, UC, cholangioca,
beading on ERCP

Front 22

what

Back 22

Periductal fibrosis
– Ductopenia

Front 23

macrovescicular steatosis causes (just read)

Back 23

Alcohol
– Diabetes
– Drugs
– Obesity
– Deficient diet (TPN)

Front 24

reye's

Back 24

fatty liver and encephalopathy
kids, flu-like illness, asa
microvesicular/no inflammat

Front 25

findings of steatohepatitis

Back 25

Steatosis
Ballooned hepatocytes
Mallory-Denk bodies
– Zone 3 (perivenular/pericentral) fibrosis
-Inflammed lobules (neutrophils)
Megamitochondria

Front 26

what are mallory bodies composed of

Back 26

intermediate filaments, p62 and ubiquitin positive

Front 27

what are megamitochondria and where found

Back 27

in steatohepatitis, eosinophilic globules

Front 28

what is amiodarone a/w and what specific histologic findings

Back 28

steatohepatitis
Foamy granular hepatocytes from
phospholipids which show lysosome
inclusions by EM

Front 29

histologic findings of acetaminophen

Back 29

hepatocellular necrosis with inflammation

Front 30

see granulomas in liver think

Back 30

infection MAI
cholestasis - PBC

Front 31

see this, what to think

Back 31

Q fever, ring granuloma, Coxiella burnetii

Front 32

what

Back 32

echinococus, laminated layer (can be gms +)

Front 33

what

Back 33

echinococcus, scolex, gms+ hooklets, birefringent

Front 34

describe molecular allelic options for alpha 1 antitrypsin deficiency

Back 34

M - normal allele
PiS and PiZ- mutated alleles

PIZZ is bad

Front 35

mutations of heretidary hemochromatosis

Back 35

HFE gene mutations
2 most common
– C282Y, highest iron overload
- H63D

Front 36

sx of hereditary hemochromatosis

Back 36

Cirrhosis, diabetes and skin pigmentation

Front 37

Hereditary hemochromatosis inheritance pattern

Back 37

autosomal recessive

Front 38

other HH mutations

Back 38

• 1 HFE
• 2A hemojuvelin- (kids)
• 2B hepcidin (kids)
• 3 transferrin receptor2
• 4 ferroportin

Front 39

if see iron-free foci in HH, what should you think of

Back 39

HCC

Front 40

wilson dz mutation

Back 40

Mutated ATP7B gene, a copper transport protein in Golgi with accumulation of copper in liver and other organs

Front 41

tests for wilson dz

Back 41

↓Cerruloplasm—not sensitive or specific
– ↑Hepatic copper concentration— best test

Front 42

histol fx of wilson's dz and stains

Back 42

Steatosis, hepatitis, glycogenated nuclei, abnormal mitochondria
Mallory hyaline, copper by Rhodanine or
Orcein stains

Front 43

see black pigment in liver think

Back 43

dubin-johnson syndrome

Front 44

mutation of dubin-johnson syndrom

Back 44

cMOAT/MRP2 gene mutation

Front 45

lab finding in dubin-johnson syndrome

Back 45

isolated conjugated hyperbilirubinemia

Front 46

histochemical stains to confirm dubin johnson syndrome

Back 46

PASD and Fontana Masson stain
pigment

Front 47

ischemic affects what zone first

Back 47

zone 3 necrosis

Front 48

gross pathology of ischemic liver

Back 48

nutmeg liver (note can see in tylenol toxicity)

Front 49

histologic findings in budd-chiari

Back 49

Sinusoidal dilation and hepatocyte atrophy

Front 50

what is hepatoportal sclerosis

Back 50

weird process by which portal regions are abnormally close to central veins, non cirrhotic

Front 51

see nodular regenerative hyperplasia on histology, think what clinically

Back 51

portal HTN

recall: vague nodules, no fibrosis

Front 52

hepatic adenoma: clinical associations

Back 52

ocps
glycogen storage dzs

Front 53

treatment for hepatic adennoma

Back 53

surgery to prevent bleeding/rupture

Front 54

key fx of hepatic adenoma

Back 54

1-2 layers thick, no PT, dilated sinusoids

Front 55

histologic fx of FNH

Back 55

central stellate scar**
liver divided into nodules by thickwalled arteries in fibrous septa
ductular proliferation (CK7+)

Front 56

what is a high grade dysplastic nodule in liver

Back 56

in cirrhotic liver, a nodule >1 cm

Front 57

background and prognosis in fibrolamellar HCC

Back 57

noncirrhotic background
better prognosis

Front 58

what's inside polygonal cells of fibrolamellar HCC

Back 58

- mito in cytoplasm
- pale body inclusions

Front 59

ddx of central scar in liver

Back 59

fnh, fibrolamellar hcc

Front 60

ihc in cholangioca

Back 60

Mucicarmine+, CK7+, HepPar1-

Front 61

infectious a/w cholangioca

Back 61

Clonorchis sinensis, Opisthorchis),

Front 62

big thing for staging of hcc and cholangioca

Back 62

hcc - size (5cm)
cholangioca: periductal invasion

Front 63

what, ihc

Back 63

hemangioma (dendritic) (intracytoplasmic
lumina/vacuoles w RBCs)
CD34, Factor VIII

Front 64

what, ihc

Back 64

epithelioid hemangioma (epithelial cells occlude vessels)
CD34, Factor VIII