Term
|
Definition
| refers to yellow pigmentation of the skin or sclerae by bilirubin (a breakdown product of red blood cells). |
|
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Term
| list the processes that can produce jaundice |
|
Definition
| 1) overproduction of bilirubin related to hemolysis; (2) impaired liver cell uptake, conjugation, or secretion of bilirubin (for example in liver cell damage due to hepatitis, cirrhosis, tumor); (3) inhibition of the outflow of bile (cholestasis) (for example blockage due to stones, carcinoma, pancreatitis, or absence of the duct system as in biliary atresia). |
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Term
| the three categories of disorders that commonly lead to liver failure |
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Definition
| (1) massive hepatic necrosis- fulminant viral hepatitis, (2) chroninc liver disease- cirrhosis and (3) hepatic dysfunction without overt necrosis- reye syndrome |
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Term
| causes of chronic passive congestion of the liver |
|
Definition
| heart failure (right sided) |
|
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Term
| gross features of chronic passive congestion of the liver |
|
Definition
| nutmeg liver, Ischemic damage leads to centrilobular necrosis |
|
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Term
| microscopic features of chronic passive congestion of the liver |
|
Definition
| hepatic sinusoids are diluted with blood |
|
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Term
causes of central
hemorrhagic necrosis of the liver |
|
Definition
|
|
Term
gross features of central
hemorrhagic necrosis of the liver |
|
Definition
|
|
Term
microscopic features of central
hemorrhagic necrosis of the liver |
|
Definition
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|
Term
| pathogenesis of viral hepatitis |
|
Definition
| caused by a virus which invades cells |
|
|
Term
| clinical symptoms of viral hepatitis |
|
Definition
| +/- chronic liver disease |
|
|
Term
| morphological features of viral hepatitis |
|
Definition
| Peri-portal mixed inflammatory infiltrate; may be necrosis of peri-portal hepatocytes |
|
|
Term
| course of disease of viral hepatitis |
|
Definition
Chronic hepatitis: peri-portal lymphoid infiltrates and variable fibrosis
Hepatitis A - self-limited disease that does not lead to chronicity or to a carrier state, fecal-oral transmission.
Hepatitis B - can produce acute hepatitis, fulminant hepatitis, a chronic carrier state, chronic hepatitis, cirrhosis,
risk of developing hepatocellular carcinoma. Spread by parenteral routes, close personal contact.
Hepatitis C (Non-A, Non-B hepatitis) - transfusion associated - similar disease states as Hepatitis B. |
|
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Term
| major causes of drug- and toxin-induced liver disease |
|
Definition
| viral hepatitis, drugs or chemical toxicity |
|
|
Term
| clinical course of drug- and toxin-induced liver disease |
|
Definition
| hepatic insufficiency progressing from onset to death (or transplant) in up to 3 months. Massive necrosis - death within 2 to 3 weeks |
|
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Term
|
Definition
| : liver disease characterized by injury of parenchymal cells (hepatocytes), fibrosis, regeneration of parenchymal cells, abnormal vascular architecture |
|
|
Term
| general characteristics of cirrhosis |
|
Definition
| Consequences of cirrhosis in general - esophageal varices (portal veins blocked), gynecomastia in men (liver cells can no longer detoxify estrogens), ascites (defect in albumin production), hepatocellular carcinoma. |
|
|
Term
epidemiology of alcoholic
cirrhosis |
|
Definition
|
|
Term
pathogenesis of alcoholic
cirrhosis |
|
Definition
| moderate alcohol intake microvesicular steotosis, chronic intake --> macrovesicular |
|
|
Term
gross features of alcoholic
cirrhosis |
|
Definition
| : fatty change (accumulation of lipids), subsequent fibrosis, micronodular type due to repeated chronic injury to the hepactocytes |
|
|
Term
clinical course of alcoholic
cirrhosis |
|
Definition
| microvesicular --> macrovescular, fatty change is reversible, hepatomegaly |
|
|
Term
| epidemiology of postnecrotic cirrhosis |
|
Definition
| usually results from a single massive insult to liver. Good example is cirrhosis following liver damage due to chronic active hepatitis |
|
|
Term
| pathogenesis of postnecrotic cirrhosis |
|
Definition
| single insult to the liver |
|
|
Term
| gross features of postnecrotic cirrhosis |
|
Definition
|
|
Term
| clinical course of postnecrotic cirrhosis |
|
Definition
| can follow acute liver damage by hepatotoxin, or single insult to liver |
|
|
Term
| epidemiology of biliary cirrhosis |
|
Definition
| middle aged females, 90% have anti-mitochrondrial antibodies to bile ducts |
|
|
Term
| pathogenesis of biliary cirrhosis |
|
Definition
| destruction of intrahepatic bile ducts |
|
|
Term
| gross features of biliary cirrhosis |
|
Definition
| Granulomatous destruction of bile ducts |
|
|
Term
| clinical course of biliary cirrhosis |
|
Definition
| damage to bile ducts, not hepatocytes, slowly progressive process |
|
|
Term
| epidemiology of pigment cirrhosis |
|
Definition
|
|
Term
| pathogenesis of pigment cirrhosis |
|
Definition
| progressive increase in total body iron stores |
|
|
Term
| gross features of pigment cirrhosis |
|
Definition
| deposition of large quantities of iron in the form of ferritin and hemosiderin in parenchymal cells of the liver, heart, pancreas and other organs; morphologic and functional damage to the sites of iron deposition. |
|
|
Term
| clinical course of pigment cirrhosis |
|
Definition
: iron overload syndrome marked by a progressive increase in total body iron stores; In the liver, with heavy pigment deposition, a micronodular cirrhosis eventually develops.
Previously, without treatment to remove iron, primary carcinoma of liver appeared in 15 to 20% of cases |
|
|
Term
| which is more common, primary or metastatic carcinoma to the liver? |
|
Definition
|
|
Term
| clinical significance of nodular hyperplasia of the liver |
|
Definition
| Considered hamartomas. Regrowth of hepatocytes with bile ducts and central scar, localized regenerative reaction to previous vascular insult |
|
|
Term
| morphology of nodular hyperplasia of the liver |
|
Definition
| proliferation of parenchymal cells and bile ducts, central stellate scar |
|
|
Term
| Clinical significance of liver cell adenoma |
|
Definition
| benigh neoplastic growth in young women due to BCP use |
|
|
Term
| morphology of liver cell adenoma |
|
Definition
| benign tumor of hepatocytes, without bile ducts, may be large an can rupture with intraperitoneal hemorrhage |
|
|
Term
| clinical significance of hemangioma of the liver |
|
Definition
| most common, well circumscribed lesions consisting of endothelial cell-lined vascular channels and intervening stroma, not mistaking them for metastatic tumors, blind percutaneous needled biopsy may cause severe intra-abdominal bleeding |
|
|
Term
| morphology of hemangioma of the liver |
|
Definition
| benigh vascular tumor, discrete red-blue, soft nodules, usually less han 2 cm in diamtere, directly beneth the capsule |
|
|
Term
| clinical significance of bile duct adenoma |
|
Definition
|
|
Term
| morphology of bile duct adenoma |
|
Definition
|
|
Term
| epidemiology of primary liver carcinoma |
|
Definition
| 4.5% of all cancers, 85% in countries with high rates of HBV |
|
|
Term
| etiology of primary liver carcinoma |
|
Definition
| hepatitis B/C infection, cirrohosis, alflatoxin exposure |
|
|
Term
| pathogenesis of primary liver carcinoma |
|
Definition
| develops from a small-cell, high-grade dysplastic nodules in cirrhotic liver, tumors arise from both mature hepatocytes and progenitor cells, presence of structional and numeric chromosomal abnormalities indicative of genomic instability |
|
|
Term
| morphology of primary liver carcinoma |
|
Definition
| unifocal, multifocal, or diffusely infiltrative cancer, strong propensity for vascular invasion, globules of bile may be found within the cytoplasm of cells and in pseudocanaliculi |
|
|
Term
| clinical course of primary liver carcinoma |
|
Definition
Classically a solitary mass in the liver represents a primary hepatocellular carcinoma as opposed to
multiple nodules which would be suggestive of metastatic disease. Alpha-fetoprotein can be identified in
50 to 90% of patients with hepatocellular carcinoma |
|
|
Term
| cholelithiasis definition |
|
Definition
bile contains a combination of bilirubin, bile acid, and cholesterol. When there is some alteration
in composition of the bile, stones can form (cholelithiasis). Most stones are mixed but pure cholesterol stones
can be formed |
|
|
Term
| incidence of cholelithiasis |
|
Definition
| 10-20% of adults in western countriesm 20-40% in latin American countries |
|
|
Term
| pathogenesis of cholelithiasis |
|
Definition
| enhanced by hypomobility of the gallbladder, mucus hypersecretion |
|
|
Term
| Clinical significance of Cholelithiasis |
|
Definition
| Gall stones can block the ducts exiting the gallbladder |
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