Liver Pathology

Front 1

6 general liver functions:

Back 1

"Excretory/detoxification (in bile)

Front 2

General examples of substances stored in liver

Back 2

vitamin K, iron, copper, fat soluble vitamins, glycogen

Front 3

Examples of substances synthesized in liver

Back 3

albumin, alpha I antitrypsin; proteins of coagulation cascade (fibrinogen, prothrombin, VIII,IX, X, XI, and Xli), bile

Front 4

Liver failure becomes apparent when _______ of liver is destroyed or dysfunctional

Back 4

80%

Front 5

"

Back 5

"Ast (aspartate amlno-transterase) and

Front 6

7 general signs of liver failure:

Back 6

"Jaundice, Hypoalbumenernia, Hepatorenal syndrome, Portal hypertension, Encephalopathy, Endocrine abnormalities, coagulopathy

Front 7

Encephalopathy I liver failure is due to the failure of the liver to remover _________ from the .

Back 7

ammonia

Front 8

"

Back 8

"Inflammation, Degeneration, necrosis, fibrosis, cirrhosis

Front 9

2 major functions of hepatic bile

Back 9

"elimination of bilirubrin and cholesterol

Front 10

_______ occurs if bilirubin levels are greater than _______mg/dl.

Back 10

Jaundice, 1.2

Front 11

"

Back 11

2.0-3.0 mg/dl.

Front 12

Jaundice is best recognized in the __________.

Back 12

sclera

Front 13

"

Back 13

"Conjugated bilirubin

Front 14

Which type of bilirubin is tightly bound to albumin?

Back 14

Unconjugated bilirubin:

Front 15

Which type of bilirubin is water soluble?

Back 15

Conjugated bilirubin

Front 16

Which type of bilirubin can be excreted in ?

Back 16

conjugated

Front 17

Conjugation of bilirubin takes place where?

Back 17

Liver --No Eric, it is not the breast

Front 18

"

Back 18

Unconjugated, hemolysis

Front 19

A manifestation of Gilbert's disease is:

Back 19

Prehepatic Jaundice

Front 20

Hepatic Jaundice is seen under what general conditions?

Back 20

viral or -induced hepatitis, alcoholic hepatitis, tumors, and cirrhosis

Front 21

T/F Hepatic Jaundice is associated with a buildup of conjugated bilirubin only.

Back 21

False: It is mixed conjugated and unconjugated

Front 22

Conjugated hyperbilirubinemia is manifest in what condition?

Back 22

post-hepatic jaundice

Front 23

post-hepatic jaundice is seen in _________ disorders such as gallstones, tumors of bile ducts, pancreas, or duodenum

Back 23

obstructive

Front 24

_________ is the accumulation of unconjugated bilirubin (usually> 20 mg/dl) in the brain causing severe neurologic damage

Back 24

Kernicterus

Front 25

Kernicterus can be seen in this condition that affects infants:

Back 25

hemolytic disease of the newborn (erythroblastosis fetalis)

Front 26

"

Back 26

"2. Impaired/decreased conjugation

Front 27

"

Back 27

"Jaundice resulting from Predominantly conjugated hyperbilirubinemia:

Front 28

Additional causes of jaundice:

Back 28

"antifungals, high amounts of beta-carotene, medications

Front 29

"

Back 29

"A. chronic liver disease --> cirrhosis

Front 30

Elevated ammonia levels in the from liver failure that lead to disturbances in consciousness ranging from behavioral abnormalities to coma is called:

Back 30

hepatic encephalopathy

Front 31

Hepatorenal syndrome:

Back 31

liver fails--> kidneys fail drop in output, increase in urea nitrogen/creatine levels (in end-stage liver disease)

Front 32

______ is synonymous with end-stage liver disease

Back 32

Cirrhosis

Front 33

T/F Cirrhosis is among the top ten causes of I western society.

Back 33

TRUE

Front 34

"

Back 34

"60% from alcohol abuse

Front 35

Cirrhosis may take one to ___ years to develop.

Back 35

20

Front 36

What is the major pathologic process that accompanies cirrhosis?

Back 36

"progressive fibrosis (regenerative firm nodular surface)

Front 37

"

Back 37

"Necrosis of liver cells

Front 38

"

Back 38

"portal cirrhosis

Front 39

"

Back 39

portal hypertension

Front 40

"

Back 40

"A. True

Front 41

"

Back 41

"A. True

Front 42

"

Back 42

formation of anastamoses (shunts) between the portal and systemic circulation (a result of portal hypertension)

Front 43

"

Back 43

"• Viral hepatitis

Front 44

• Necrosis of hepatocytes (councilman bodies) are shrunken eosinophilic apoptotic anuclear fragments of hepatocytes)"

Back 44

"Morphologic changes seen with viral hepatitis

Front 45

• Hepatitis B— ground glass hepatocytes— due to accumulation of HBsAg; sanded nuclei due to abundant HBcAg"

Back 45

"Morphologic changes seen with viral hepatitis

Front 46

With viral hepatitis, what is the timeline established for acute vs. chronic infection?

Back 46

"acute = resolves within 6 months

Front 47

1 in __ patients is a carrier"

Back 47

"4 million

Front 48

"

Back 48

Dark

Front 49

characteristics of fulminant hepatitis include:

Back 49

"severe acute iiver damage, encephalopathy, coaguiopathy with high risk of approaching 80%

Front 50

fulminant hepatitis develops within _____ weeks of the onset of liver disease.

Back 50

8

Front 51

"

Back 51

"Jaundice of skin and eyes

Front 52

• donations not screened for Hepatitis A"

Back 52

"Hepatits A:

Front 53

• Can remain infective on operatory surfaces up to 7 days, cold sterilization ineffective"

Back 53

"Hepatitis B

Front 54

•9 documented cases of transmission from dental provider to patient over past 30 years"

Back 54

"Hepatitis B