Liver Pathology Flashcards

Flashcards based on Liver Pathology and Related Disorders Lecture Notes.

What are the critical functions of the liver?

Bile secretion, metabolism, detoxification, storage, and protein synthesis.

Name the resident phagocytes of the liver.

Kupffer Cells

What is Acute Liver Failure (ALF)?

Rapid loss of liver function within 26 weeks.

What is Chronic Liver Failure (CLF)?

Progressive hepatic dysfunction typically associated with cirrhosis.

What laboratory value defines coagulopathy in acute liver failure?

INR >1.5

Identify common causes of Acute Liver Failure.

Acetaminophen overdose, Viral Hepatitis (HAV, HBV, HEV), Autoimmune Hepatitis, Wilson’s disease, Budd-Chiari syndrome, Ischemia.

What is the central pathogenic mechanism in Acute Liver Failure?

Massive hepatocellular necrosis

Describe the gross morphology of the liver in Acute Liver Failure.

Shrunken, soft liver

List key clinical features of Acute Liver Failure.

Jaundice, Coagulopathy, Encephalopathy, Hypoglycemia, Renal failure, Sepsis, Multiorgan failure.

Explain the mechanism of jaundice in Acute Liver Failure.

Impaired bilirubin conjugation and excretion due to massive hepatocyte necrosis.

Explain the mechanism of Hepatic Encephalopathy in Acute Liver Failure.

Liver fails to detoxify nitrogenous waste (e.g., ammonia), which then crosses the blood-brain barrier, leading to astrocyte swelling and cerebral edema.

What are some causes of Chronic Liver Failure?

Chronic Viral Hepatitis (HBV, HCV), Alcoholic Liver Disease, Non-alcoholic Steatohepatitis (NASH), Autoimmune Hepatitis, Hemochromatosis, Wilson’s disease, Primary biliary cholangitis, primary sclerosing cholangitis.

Describe the main pathogenic mechanism in Chronic Liver Failure progression.

Repeated injury leads to chronic inflammation and fibrosis.

Describe the macroscopic morphology of the liver in Chronic Liver Failure.

Nodular liver (micronodular or macronodular cirrhosis).

What are some clinical features of Chronic Liver Failure?

Fatigue, weight loss, Jaundice, Spider angiomas, palmar erythema, Gynecomastia, Portal hypertension (splenomegaly, ascites, variceal bleeding), Hypoalbuminemia.

Explain the mechanism of ascites in Chronic Liver Failure.

Fibrosis and regenerative nodules obstruct hepatic blood flow, leading to splanchnic vasodilation and RAAS activation.

Name common Viral Hepatitis viruses.

Hepatitis A, B, C, D, and E.

Which Hepatitis viruses are associated with chronic infections?

HBV, HCV, and HDV.

Outline the common routes of transmission for Hepatitis A Virus (HAV).

Fecal-oral route, often through contaminated food and water.

How Hepatitis B Virus (HBV) is commonly transmitted?

Perinatal (especially in Asia), intravenous drug use, and sexual transmission.

How Hepatitis C Virus (HCV) is commonly transmitted?

Blood-borne (primarily intravenous drug use, blood transfusions).

What is the role of HBsAg in Hepatitis B Virus (HBV) diagnosis?

Key marker for diagnosing infection.

What is autoimmune hepatitis (AIH)?

A chronic autoimmune disease of the liver associated with multiple autoantibodies.

What is the typical gender distribution in autoimmune hepatitis (AIH)?

Affects females more frequently (4:1 ratio).

What are key morphological features of autoimmune hepatitis?

Extensive Parenchymal Destruction, Confluent Necrosis, Inflammatory Infiltrate (abundant plasma cells), Emperipolesis.

What is Alcoholic Liver Disease (ALD)?

A condition caused by excessive alcohol intake that leads to liver damage.

List the three stages of Alcoholic Liver Disease (ALD).

Fatty liver (steatosis), Alcoholic hepatitis, Alcohol cirrhosis.

Describe the gross morphology of Alcoholic Fatty Liver (Steatosis).

Enlarged, soft, yellow, greasy liver.

Outline key microscopic findings in Alcoholic Hepatitis.

Ballooning degeneration of hepatocytes, Mallory-Denk bodies, Neutrophilic infiltrates, Pericentral hepatocyte necrosis.

What is the final, irreversible stage of ALD?

Alcoholic Cirrhosis

What is the most effective treatment for Alcoholic Liver Disease?

Alcohol Abstinence

Define Metabolic Liver Diseases.

Genetically inherited disorders leading to abnormal accumulation of substances (e.g., iron, copper, proteins) within hepatocytes.

Define Hemochromatosis.

Iron overload disorder caused by increased intestinal absorption of iron.

Describe key morphological features of Iron Deposition in Hemochromatosis.

Liver enlarged, brown discoloration, Iron deposition in periportal hepatocytes, Fibrosis → micronodular cirrhosis.

Outline treatment options for hemochromatosis.

Phlebotomy and Iron chelation (defiroximine).

Define Wilson’s Disease

Autosomal recessive disorder of copper metabolism.

What genetic mutation is associated with Wilson's Disease?

Mutation in ATP7B gene → defective hepatic copper excretion into bile.

Describe the inheritance of Alpha-1 Antitrypsin (AAT) Deficiency.

Autosomal codominant disorder due to mutation in SERPINA1 gene.

Define Hepatocellular Adenoma.

Benign epithelial tumor arising from hepatocytes.

Define Focal Nodular Hyperplasia (FNH).

Benign, non-neoplastic lesion due to localized vascular abnormality.

Which benign entity is the most common liver tumor?

Hemangioma

What is the most common primary tumor of the liver?

Hepatocellular Carcinoma (HCC)

What are the etiologies of Hepatocellular Carcinoma?

Chronic Hepatitis B and C, Cirrhosis (alcoholic, non-alcoholic fatty liver disease), Aflatoxin B1 exposure, Hemochromatosis, α1-antitrypsin deficiency

How Hepatocellular Carcinoma is diagnosed?

Imaging (contrast-enhanced CT/MRI), AFP levels, Biopsy (if needed)

Define Cholangiocarcinoma.

Malignant tumor of intrahepatic or extrahepatic bile ducts.

Define Angiosarcoma of the Liver

Rare, aggressive vascular tumor.

In children, what primary liver tumor is most common?

Hepatoblastoma