liver pathology part 2

what is hepatitis

inflammation of liver

most common causes of hepatitis

viruses and alcoholism

what is the #1 cause nationally & globally of hepatitis

virus

what can hepatitis result in

cirrhosis, liver failure, and hepatocellular carcinoma

what levels may increase with hepatitis

AST, ALT, and bilirubin

what type of hepatitis is associated with food contamination

Hepatitis A

hepatitis A is spread primarily by the

fecal - oral route

hepatitis B is transmitted through

body fluids

body fluids that cause Hep B

blood, semen, vaginal secretions, sometimes saliva

Hep B is mostly transmitted ______

parenterally

ways Hep B is trasmitted

sexual contact

needle punctures

blood transfusions

mother to infant

Hep C is transmitted ______

parenterally

Hep C can lead to

cirrhosis

Hep C can do what

stay active in your asymptomatic body and slowly damage liver over time (chronic Hep C)

what is the most common infection in the US that is spread through blood

Hep C

fulminant hepatitis

onset is sudden and severed

fulminant hepatitis may lead to

shock, coma, rapid death

acute hepatitis

mild to massive liver necrosis/failure

acute hepatitis may cause

may look normal

hepatosplenomegaly

non tender mild GB wall thickening

acute hepatitis sonographic appearance

hypoechoic

periportal cuffing (starry sky)

starry sky occurs due to

acute hepatitis

starry sky

likely due to acute hepatitis

acute hepatitis with starry sky

starry sky aka

periportal cuffing

chronic hepatitis

liver inflammation for at least 6 months

chronic hepatitis may progress to

cirrhosis causing liver failure and increasing risk for liver cancer (hepatocellular carcinoma)

most specific lab value for hepatocellular damage

increased ALT

steatohepatitis

fatty liver disease characterized by inflammation of the liver

nonalcoholic steatohepatitis (NASH)

Liver inflammation and damage caused by a buildup of fat in the liver.

-It is part of a group of conditions called nonalcoholic fatty liver disease -NASH can progress and lead to cirrhosis

alcoholic steatohepatitis (ASH)

Fatty liver caused by alcoholism.  

- Characterized by inflammation and fibrosis

gold standard for determining hepatic fat content and staging fibrosis

liver biopsy

non alcoholic fatty liver disorder now called

Metabolic dysfunction-associated steatotic liver disease

MASLD

MASLD/NAFLD and NASH are typically

asymptomatic

NAFLD and NASH suspected if tests show

increased ALT and AST

liver cirrhosis

chronic degenerative disease where scar tissue replaced healthy liver tissuei

is liver cirrhosis reversible

no

causes of liver cirrhosis

alcoholism, chronic hepatitis, drug abuse, fatty liver

cirrhosis symptoms

nausea, ascites, light colors stool, weakness, abdominal pain

advanced stage cirrhosis symptom

jaundice (excess bilirubin, increased ascites, portal hypertension, liver failure

cirrhosis sonographic characteristics

isoechoic regenerative nodules

decreased visualization of vascular structures

cirrhosis lab values

increased ALT, AST, alkaline phosphatase, direct bilirubin

cirrhotic liver with ascites

cirrhotic liver

cirrhotic liver

fibrosis and altered architecture of cirrhosis cause a

coarse appearance

inspection of liver surface with what kind of probe demonstrates nodularity

high frequency, linear array

ascites

serous, free fluid that can go anywhere within the peritoneum

caudate lobe hypertrophy

in setting of cirrhosis the caudate lobe may be enlarged

cirrhosis

enlarged caudate lobe

hemochromatosis

disease of iron metabolism

hemochromatosis may lead to

cirrhosis

wilson’s disease

inherited excess deposition of copper in the liver and kidneys

wilsons disease may lead to

cirrhosis

von Gierke’s disease

genetic

most common form of glycogen storage disease

von Gierke’s disease aka

type I glycogen storage disease

von Gierke’s may lead to

cirrhosis

von Gierke’s related to

adenomas

budd chiari

occlusion of hepatic veins

presents with triad of hepatomegaly, abdominal pain, and ascites

may lead to cirrhosis

hepatocellular carcinoma HCC

most common primary liver cancer

may lead to cirrhosis

hemochromatosis

causes body to absorb too much iron

stored in liver and pancreas

caudate lobe hypertrophy

nodular liver surface from cirrhosis

hepatoblastoma

malignant liver tumor found almost exclusively in infants and young children

most common hepatic malignancy in children

hepatoblastoma

what is often associated with Beckwith-Wiedemann syndrome

hepatoblastoma

clinical indication of hepatoblastoma

elevated alpha fetoprotein

hepatoblastoma