CHEMICALS

Masson-Trichrome

What chemical stain is used to highlight Type I collagen in the portal tract and fibrous septa of the liver?

Reticulin (Gomori) stain

What chemical stain identifies the framework of the hepatic parenchyma by highlighting Type III collagen?

CK7 and CK19

Which chemical immunohistochemical stains are used to specifically highlight bile ducts and ductular reactions?

CD10 and p-CEA

Which chemical markers highlight the bile canaliculi by sticking to the glycoproteins found there?

Acetylcholinesterase

What chemical enzyme stain is used on rectal biopsies to diagnose Hirschsprung disease by identifying hypertrophic nerve fibers?

Glutamine Synthetase (GS)

What chemical stain is used to identify the characteristic map-like geographic pattern in Focal Nodular Hyperplasia?

Acetaldehyde

What toxic chemical metabolite results from ethanol metabolism and causes lipid peroxidation and DNA damage in the liver?

NADH

In alcohol-induced liver injury, an increase in the NADH/NAD+ ratio leads to a decrease in what chemical process?

Ethanol

Which chemical compound is absorbed in the upper GI tract and metabolized primarily in the Zone 3 perivenular hepatocytes?

Acetate

Acetaldehyde is converted by the enzyme ALDH into which non-toxic chemical compound?

Reactive Oxygen Species (ROS)

Besides acetaldehyde, what reactive chemical molecules are generated during alcohol metabolism, leading to oxidative stress?

Bilirubin

Which chemical molecule, produced by the breakdown of red blood cells, is the primary cause of jaundice when elevated?

Conjugated (Direct) Bilirubin

Which water-soluble chemical form of bilirubin is elevated in obstructive jaundice and causes tea-colored urine?

Unconjugated (Indirect) Bilirubin

Which chemical form of bilirubin is elevated in hemolysis before it enters the liver for processing?

Bile Salts

What chemical substances accumulate inside hepatocytes in cholate stasis, causing them to appear ballooned and pale?

Copper

Which chemical element is found in toxic levels in Wilson's disease and can also be found in chronic cholestatic diseases?

Iron

Hemochromatosis is a metabolic chemical disorder characterized by the excessive deposition of which element?

Triglycerides

Hepatic steatosis is characterized by the accumulation of fat droplets predominantly composed of which lipid molecule?

Acetaminophen (Paracetamol)

Which chemical drug is the most common cause of acute liver failure in the US due to direct toxic damage?

Aflatoxin

Which chemical fungal metabolite is a known environmental factor that causes Hepatocellular Carcinoma?

Methimazole

Exposure to which chemical medication in early pregnancy is a risk factor for esophageal atresia?

Oral Contraceptive Pills (OCPs)

The prolonged use of which hormonal chemical compounds is an environmental factor for esophageal atresia and hepatocellular adenoma?

Erythromycin and Azithromycin

Exposure to which chemical antibiotics in the first 2 weeks of life is associated with pyloric stenosis?

Lipofuscin

Which chemical pigment represents "wear-and-tear" and appears as golden-brown inclusions in an aging liver?

Ammonia

The release of which chemical molecule into the blood following massive hepatic necrosis causes mental disorientation?

Bicarbonate

In cystic fibrosis, a mutation in the CFTR gene limits the secretion of which ion, leading to protein plugging?

Calcium

Which ion plays a key role in trypsin activation and is sensed by the CASR membrane-bound receptor?

Calcium Soaps

In acute pancreatitis, hypocalcemia occurs when calcium precipitates as what chemical compound in necrotic fat?

Lactated Ringer's

Which chemical IV solution is preferred for resuscitation in acute pancreatitis to reduce systemic inflammation?

5-fluorouracil, oxaliplatin, and irinotecan

What are the chemical components of the FOLFIRINOX regimen used for pancreatic cancer?

Crystalline Cholesterol Monohydrate

Cholesterol gallstones are composed of at least 50% of which chemical compound?

Bilirubin Calcium Salts

Pigment gallstones are primarily composed of which insoluble chemical salts?

Calcium Carbonate

The presence of which chemical salt makes impure cholesterol stones appear radiopaque on X-ray?

Lysolecithin

What chemical factor is released during mechanical stone obstruction to cause irritation of the gallbladder mucosa?

Prostaglandins

The chemical release of which inflammatory mediators leads to mural inflammation in acute cholecystitis?

Water-soluble contrast

What chemical material is used during a contrast swallow to diagnose the discontinuity of the esophagus?

Barium

What elemental chemical was traditionally used in enemas to delineate Hirschsprung disease?

Technetium-99m (Tc-99m)

Which radioactive chemical element is used as a radiotracer in HIDA scans?

HIDA or DISIDA

Which technetium-labeled iminodiacetic chemical compounds are used in cholescintigraphy?

Iodinated contrast

A reaction to which chemical material is a potential complication of contrast-enhanced CT?

Glycogen

Serous cystic neoplasms of the pancreas are lined by cuboidal cells rich in which chemical?

Tenacious Mucin

What chemical substance fills the large cyst cavities of mucinous cystic neoplasms?

IgG4

What antibody molecule is secreted by plasma cells in Autoimmune Pancreatitis Type 1?

Alpha-fetoprotein (AFP)

Which glycoprotein molecule is used as a serum tumor marker for surveillance of Hepatocellular Carcinoma?

CA19-9

Which chemical antigen is the main serum marker used to monitor response to therapy in pancreatic cancer?

Carcinoembryonic Antigen (CEA)

Which molecule is a supplementary marker useful for pancreatic cancer non-secretors?

20% Ether

Hepatitis A virus is notably stable to treatment with which organic chemical solvent?

Formalin and Chlorine

HAV can be destroyed by treatment with which two chemical agents?

Sodium hypochlorite

Which chemical compound destroys the antigenicity of HBsAg within 3 minutes?

ssRNA

What type of nucleic acid molecule makes up the genome of HAV, HCV, HDV, and HEV?

dsDNA

What type of nucleic acid molecule is the genome of the Hepatitis B virus?

HBsAg

Which viral protein molecule is the cornerstone of the recombinant Hepatitis B vaccine?

HBcAg

Which viral antigen molecule is associated with the nucleocapsid and found in sanded nuclei?

cccDNA (Covalent Closed-Circular DNA)

Which nucleic acid molecule serves as the stable template for HBV mRNA within the nucleus?

Lecithin

Which phospholipid molecule is decreased in bile when the MDR3 transporter is defective?

Progesterone and Estrogen

Maternal exposure to which hormonal chemicals is an environmental factor for GIT anomalies?

Thalidomide

Which chemical drug is a known environmental factor for congenital GIT anomalies?

Wharton’s Jelly

What chemical substance separates the amnion and peritoneum in the membrane of an omphalocele?

Acetaldehyde

What chemical causes the "Asian flush" and nausea?

Bilirubin

What chemical causes the yellow discoloration of the conjunctiva?

Trypsin

The premature activation of what enzyme chemical causes autodigestion?

Lysolecithin

What chemical causes chemical irritation of the gallbladder mucosa?

Prostaglandins

Which chemical molecules cause mucosal and mural inflammation in the gallbladder wall?

Ammonia

What chemical causes the "ammonia breath" sign in liver failure?

Bicarbonate

Which ion is decreased in pancreatic secretions in cystic fibrosis?

Calcium

Which ion is sensed by the CASR receptor to control luminal levels?

Technetium

What radioactive chemical element is the base for iminodiacetic acid radiotracers?

Iodine

What chemical element in CT contrast can cause allergic reactions?

Sodium hypochlorite

What chemical causes destruction of HBsAg antigenicity?

Formalin

What chemical is used to inactivate HAV?

Water-soluble contrast

What chemical is used to stain and opacify the esophagus in contrast swallows?

Barium

What chemical element is used in radiographs to visualize bowel segments?

18-FDG

Which chemical molecule is the radiotracer used in PET scans?

IgG4

Which molecule is diagnostic for Type 1 Autoimmune Pancreatitis?

IgM

Which molecule is diagnostic for acute Hepatitis A infection?

IgG

Which molecule confirms past infection and immunity to Hepatitis A?

HBsAg

Which viral protein is the first detectable marker for HBV in the blood?

Anti-mitochondrial antibodies (AMA)

What antibody molecule is the serologic marker for Primary Biliary Cholangitis?

p-ANCA

Which antibody molecule is diagnostic for Primary Sclerosing Cholangitis?

Alpha-fetoprotein (AFP)

What molecule is diagnostic for rising levels in Hepatocellular Carcinoma?

CA19-9

What molecule is diagnostic for monitoring response to pancreatic surgery?

Cholesterol

Bile supersaturation with which chemical is the primary step in stone formation?

Bilirubin

Chronic hemolysis causes the excess of which chemical leading to black stones?

Type I Collagen

What molecule is stained blue in Masson-Trichrome?

Type III Collagen

What molecule is stained black in Reticulin?

Glycoproteins

What molecules are stained by CD10 in the bile canaliculi?

Acetylcholinesterase

What chemical is used to stain nerve fibers in Hirschsprung disease?

Glutamine Synthetase

What chemical is used to stain the geographic pattern of FNH?

CK7/CK19

Which chemicals are used to stain the biliary epithelium?

Bilirubin

The excess of which chemical molecule causes kernicterus in neonates?

Bile Acids

What chemical compounds act as detergents on the gallbladder mucosa?

Prophospholipase and Proelastase

What chemical proenzymes are activated by trypsin to degrade fat and blood vessels?

Acetaldehyde Adducts

Which chemical compounds cause Kupffer cell activation in cirrhosis?

Triglycerides

What chemical causes the pale, yellow color of a fatty liver?

Nitrogen (Urea)

BUN measures the serum levels of which chemical metabolic byproduct?

C-reactive Protein (CRP)

Which chemical molecule indicates systemic inflammation in pancreatitis?

Lactated Ringer's

What chemical fluid is resuscitating in acute pancreatitis?

Amylase and Lipase

What two enzymes are pancreatic chemicals used to diagnose pancreatitis?

Direct Bilirubin

What chemical is water-soluble?

Acetaldehyde

What chemical is pathogenic?