Term
| There are three types of liver necrosis: |
|
Definition
Focal necrosis
Zonal necrosis
Massive (diffuse) necrosis |
|
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Term
|
Definition
| Small areas of necrosis develop and are widely scattered all over the liver without particular distribution to special zones of the hepatic lobule. |
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Term
| The commonest cause of Focal necrosis is |
|
Definition
| severe bacterial infections as in typhoid fever and streptococcal infections |
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Term
|
Definition
| Necrosis affects only cells of certain area in each hepatic lobule |
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Term
|
Definition
| Necrosis develops in the central zone around each central vein |
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Term
| Examples of Central-zonal necrosis |
|
Definition
| viral hepatitis and chronic venous congestion |
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Term
|
Definition
| Necrosis occurs in the middle zone of each hepatic lobule |
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Term
| Examples of Mid-zonal necrosis |
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Definition
|
|
Term
| Peripheral-zonal necrosis |
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Definition
| Necrosis develops in the peripheral zone of each hepatic lobule |
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Term
| Examples of Peripheral-zonal necrosis |
|
Definition
| toxemia of pregnancy or eclampsia |
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Term
|
Definition
| Associated with heart failure and viral infections |
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Term
| is finding of viral liver nedcrosis |
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Definition
|
|
Term
| Massive (diffuse) necrosis |
|
Definition
| Necrosis takes place in all the cells of some or most of the hepatic lobules |
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Term
| Massive (diffuse) necrosis aka |
|
Definition
| acute yellow atrophy of the liver |
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Term
|
Definition
| It is a chronic disease caused by liver injury with necrosis and degeneration followed by regeneration of the liver cells |
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Term
| Cirrhosis of the liver associated with |
|
Definition
| 1.increase amount of fibrosis, 2.resulting in loss of the lobar hepatic architecture with 3.the formation of nodules of variable size. |
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Term
| Anatomical classifications of Cirrhosis |
|
Definition
Micro-nodular cirrhosis
Macro-nodular cirrhosis |
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Term
|
Definition
| The liver is finely nodular with the nodules not exceeding 1 cm in diameter. |
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Term
| Micro-nodular cirrhosis corresponds to |
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Definition
|
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Term
|
Definition
The nodules are larger than 1 cm in diameter
and are usually of different sizes. |
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Term
| Etiological classifications of Cirrhosis: |
|
Definition
Portal cirrhosis
Biliary cirrhosis
Hemochromatosis |
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Term
|
Definition
| cardiac cirrhosis, syphilitic cirrhosis and Hepatolenticular degeneration |
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Term
| Types of Portal cirrhosis |
|
Definition
a- Lennec’s cirrhosis (nutritional cirrhosis).
b- Post-hepatitic cirrhosis.
c- Post-necrotic cirrhosis. |
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|
Term
| Types of Biliary cirrhosis |
|
Definition
a- Primary or intra-hepatic biliary cirrhosis.
b- Secondary or extra-hepatic biliary cirrhosis |
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|
Term
|
Definition
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Term
| Nutritional cirrhosis - Lennec’s cirrhosis Cause: |
|
Definition
| Prolonged and severe malnutrition also with Chronic alcoholism |
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Term
| Morbid anatomy of Nutritional cirrhosis - Lennec’s cirrhosis: |
|
Definition
| The liver is small, atrophic, firm in consistency and greasy to the touch, the outer and cut surfaces show characteristic nodules in size between 2-5 mm in diameter (micro- nodular cirrhosis). |
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Term
Post-hepatitic cirrhosis
It is usually due to |
|
Definition
viral hepatitis, following severe massive
necrosis of the liver with chronic aggressive hepatitis. |
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Term
| Post-hepatitic cirrhosis Morbid anatomy: |
|
Definition
| The size of the liver may be normal or reduced. The color is usually normal. No fatty change. The outer and cut surfaces are nodular showing larger nodules varying between 0.5-1.5 cm in diameter. |
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Term
| Post-necrotic cirrhosis: AKA Toxic Cirrhosis |
|
Definition
| Less common and usually follows any cause, which produces diffuse or massive liver necrosis |
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Term
| The end result of Post-hepatitic cirrhosis |
|
Definition
complete distortion of the hepatic
architecture with the appearance of macro-nodular cirrhosis |
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Term
| 90% of Malignant liver tumors: |
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Definition
|
|
Term
| Malignant liver tumors are linked to |
|
Definition
|
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Term
|
Definition
| Yellowish discoloration of the skin, scIera, mucous membrane and internal organs |
|
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Term
|
Definition
| increased amount of bilirubin in the plasma |
|
|
Term
| Bilirubin is formed from the |
|
Definition
| (haem) fraction of the hemoglobin after breakdown of the red blood cells in the spleen and bone marrow |
|
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Term
| Bilirubin is insoluble in water and is kept in solution in the plasma by |
|
Definition
| its firm attachment to albumin |
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Term
| In the liver, bilirubin is de-attached from the albunun and becomes |
|
Definition
| attached to a protein resulting in the water soluble conjugated bilirubin, which is secreted in feces. |
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Term
| Some of the bilirubin is absorbed by the blood and is |
|
Definition
| excreted in the urine as urobilinogen |
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Term
| Common features to both obstructive and hemolytic jaundice are |
|
Definition
| dark urine, pale stools and enlargement of the liver |
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|
Term
Jaundice
could be associated with any of the followings: |
|
Definition
1- Liver Degenerations: fatty, cloudy swelling, and amyloidosis.
2- Chronic venous congestion (nutmeg liver).
3- Causes of suppurative inflammation of the liver.
4- Granulomas of the liver: such as tuberculosis and syphilis.
5 -Parasitic diseases.
6 -Malignant tumors of the liver: primary and metastatic.
7- Metabolic disorders such as: diabetes, rickets, glycogen storage disease and lipid storage disease.
8- Malignant lymphomas: especially Hodgkin's disease.
9- Blood diseases such as: anemia, polycythemia and leukemia. |
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Term
|
Definition
| Icosahedral capsid, ssRNA |
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Term
| Hepatitis A Virus Transmission |
|
Definition
|
|
Term
| Hepatitis A Virus Incubation period |
|
Definition
|
|
Term
| Hepatitis A Virus Carrier state |
|
Definition
|
|
Term
| Hepatitis A Virus Chronic hepatitis |
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Definition
|
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Term
|
Definition
|
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Term
| Hepatitis B Virus Transmission |
|
Definition
| Parenteral; close contact |
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Term
| Hepatitis B Virus Incubation period |
|
Definition
|
|
Term
| Hepatitis B Virus Carrier state |
|
Definition
| 0.1–1.0% of blood donors in U.S. and Western world |
|
|
Term
| Hepatitis B Virus Chronic hepatitis |
|
Definition
| 5–10% of acute infections |
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Term
|
Definition
|
|
Term
| Hepatitis C Virus Transmission |
|
Definition
|
|
Term
| Hepatitis C Virus Incubation period |
|
Definition
|
|
Term
| Hepatitis C Virus Carrier state |
|
Definition
| 0.1–1.0% of blood donors in U.S. and Western world |
|
|
Term
| Hepatitis C Virus Chronic hepatitis |
|
Definition
| 5–10% of acute infections |
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| Hepatitis D Virus Transmission |
|
Definition
|
|
Term
| Hepatitis E Virus Transmission |
|
Definition
|
|
Term
| Hepatitis G Virus Transmission |
|
Definition
|
|
Term
| Hepatitis D Virus Incubation period |
|
Definition
|
|
Term
| Hepatitis E Virus Incubation period |
|
Definition
|
|
Term
| Hepatitis G Virus Incubation period |
|
Definition
|
|
Term
| Hepatitis D Virus Carrier state |
|
Definition
| 1–10% in drug addicts and hemophiliacs |
|
|
Term
| Hepatitis E Virus Carrier state |
|
Definition
|
|
Term
| Hepatitis G Virus Carrier state |
|
Definition
| 1–2% of blood donors in U.S. |
|
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Term
| Hepatitis D Virus Chronic hepatitis |
|
Definition
| <50% coinfection, 80% upon superinfection |
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Term
| Hepatitis E Virus Chronic hepatitis |
|
Definition
|
|
Term
| Hepatitis G Virus Chronic hepatitis |
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Definition
|
|
Term
| Hepatocellular carcinoma-Hep A |
|
Definition
|
|
Term
| Hepatocellular carcinoma-Hep B |
|
Definition
|
|
Term
| Hepatocellular carcinoma-Hep C |
|
Definition
|
|
Term
| Hepatocellular carcinoma-Hep D |
|
Definition
|
|
Term
| Hepatocellular carcinoma-Hep E |
|
Definition
|
|
Term
| Hepatocellular carcinoma-Hep G |
|
Definition
|
|
Term
|
Definition
|
|
Term
Acute hemorrhagic pancreatitis: aka.
acute pancreatic necrosis.
Cause: |
|
Definition
| due to the action of the pancreatic enzymes on the pancreatic tissue leading to necrosis |
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|
Term
| Causes of Acute hemorrhagic pancreatitis: There are two theories |
|
Definition
The common channel theory
Obstruction of the pancreatic ducts |
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Term
| The common channel theory: |
|
Definition
| Results due to the impaction of a gall stone in the ampulla of Vater leading to passage of infected bile into the pancreatic duct with activation of the trypsinogen into trypsin that digest the pancreas. |
|
|
Term
| Obstruction of the pancreatic ducts: |
|
Definition
| Due to squamous metaplasia affecting the small ducts. Obstruction lead to distention with pancreatic enzymes especially after a heavy meals causes digestion and necrosis of the pancreatic tissue. |
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|
Term
Chronic Pancrestitis:
is due to |
|
Definition
| repeated mild attacks of acute pancreatitis leading to progressive necrosis and fibrosis. Chronic alcoholism and gall stones are important predisposing factors |
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Term
| Effects of Chronic Pancreatitis |
|
Definition
| It leads to diabetes mellitus and steatorrhea |
|
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Term
|
Definition
| It is a condition in which there is disturbance in the carbohydrate metabolism with hyperglycaemia and glycosuria |
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|
Term
| Type 1 diabetes is characterized by |
|
Definition
| an absolute deficiency of insulin caused by pancreatic β-cell destruction. |
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|
Term
| Type 1 diabetes accounts for approximately |
|
Definition
|
|
Term
| Type 2 diabetes is caused by a |
|
Definition
| combination of peripheral resistance to insulin action and an inadequate secretory response by the pancreatic β-cells (“relative insulin deficiency”). |
|
|
Term
| Type 2 diabetes accounts for approximately |
|
Definition
| 80% to 90% of patients withdiabetes |
|
|
Term
The cause of Diabetes:
There are many theories: |
|
Definition
Deficiency of insulin
Pituitary growth hormone
Adrenal cortical hormones |
|
|
Term
|
Definition
| either absolute or relative deficiency due to excessive demand for insulin |
|
|
Term
| Pituitary growth hormone: |
|
Definition
| may be a powerful diabetogenic factor |
|
|
Term
| Adrenal cortical hormones: |
|
Definition
| are also diabetogenic factors. Adrenal tumors are usually accompanied with diabetes |
|
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Term
|
Definition
| 25 years and it appears to be hereditary, affecting both sexes |
|
|
Term
|
Definition
| recessive Mendelian pattern |
|
|
Term
|
Definition
above 40 years. The patient is usually
obese with increased appetite.
Insulin deficiency is relative |
|
|
Term
|
Definition
| The pancreas usually appears normal |
|
|
Term
|
Definition
| The islets of Langerhans are usually diminished in number |
|
|
Term
| In most of the cases with type 2, the islets show |
|
Definition
| hyalinisation with the deposition of large amounts of glycogen in the cells |
|
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Term
| Primary Effect and complications of diabetes: |
|
Definition
| Ketosis and diabetic coma |
|
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Term
| Other Effects and complications of diabetes: |
|
Definition
2. pyelonephritis and nephrotic syndrome.
3. Arteriosclerosis, Hypertension, Myocardial infarction, Gangrene of the limbs.
4- Bronchitis and broncho-pneumonia. Pulmonary tuberculosis, Lung abscess and gangrene.
5-peripheral neuritis and cerebral hemorrhage.
6- Diabetic retinopathy: appears as microaneurysms of the capillaries of the retina.
7- Skin complications: carbuncle and cellulitis. |
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|
Term
Tumors of the pancreas
occur more in |
|
Definition
|
|
Term
| Carcinoma of the pancreas is a relatively |
|
Definition
|
|
Term
| Most common sites for pancrease tumors |
|
Definition
|
|
Term
| Least common sites for pancrease tumors |
|
Definition
|
|
Term
| Morbid anatomy of pancrease tumors |
|
Definition
| The pancreas is enlarged, hard and fixed |
|
|
Term
| Spread of pancrease tumors |
|
Definition
1- Local infiltration to the surrounding tissues.
2- Lymphatic spread: to the regional lymph nodes.
3- Via blood: to the liver and lungs. |
|
|
Term
| Effects of Carcinoma of the head of the pancreas |
|
Definition
| obstructive jaundice due to pressure on the common bile duct |
|
|
Term
| Effects of Carcinoma of the body and tail |
|
Definition
| there are multiple venous thrombi |
|
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Term
|
Definition
| It is usually adenoma and rarely carcinoma |
|
|
Term
| Effects of Beta cell tumor |
|
Definition
| The tumor leads to hyperinsulinism with hypoglycemic coma |
|
|
Term
| Beta cell tumor is also accompanied by |
|
Definition
| mental confusion and nervousness |
|
|
Term
|
Definition
|
|
Term
| Effects of Alpha cell adenoma |
|
Definition
| It leads to ( Zollinger-Ellison syndrome) |
|
|
Term
| Alpha Cell adenoma is characterized by |
|
Definition
1- Alpha cell adenoma (rarely a carcinoma).
2- Marked degree of hyperacidity and gastric hypersecretion.
3- Recurrent peptic ulcers usually distal to the first part of the duodenum and may be in the jejunum.
4- Longstanding watery diarrhea. |
|
|
Term
| What results in acute yellow atrophy of the liver? |
|
Definition
|
|
Term
| What causes Lennec’s cirrhosis? |
|
Definition
|
|
Term
| Which Hepatitis Virus spreads through food contamination? |
|
Definition
|
|
Term
| What causes Budd Chiari syndrome |
|
Definition
|
|
