Term
| What does Jaundice indicate? |
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Definition
| You have too much bilirubin (hyperbilirubinema) |
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Term
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Definition
| cessation of cile flow and accumulation of billiary substances in the blood. |
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Term
A 38 year old patient comes into the ER with scleral icterus. Biopsy reveals balooned hepatocytes with wispy cytoplasm and bile lakes in parenchyma. What is the diagnosis?
A)Cholestasis
B)Cholangiolitis
C)Cholangitis
D)Canalicular cholestasis
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Definition
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Term
A patient comes in to your office with jaundice. After taiking a history you decide to get a biopsy which reveals portal tract edema, bile duct distention, periductular inflammation. What is the diagnosis?
A)Cholestasis
B)Cholangiolitis
C)Cholangitis
D)Canalicular cholestasis |
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Definition
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Term
As the hospital's pathologist you read a slide. You see many nuetrophils entering the bile ductular lumen iin great numbers along with some rod shapped gram positive structures. What is your diagnosis?
A)Cholestasis
B)Cholangiolitis
C)Cholangitis
D)Canalicular cholestasis |
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Definition
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Term
| Ms. Peabody is a 54 year old women who presents with puritis and lupus. Laboratory tests reveal anti-mitochondrial antibodies. |
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Definition
1) autoimmune disorder of interlobular bile duct
2) causes chronic inflammation of intrahepatic bile ducts, destruction, and cirrhosis
3) |
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Term
A patient comes into the ER and biopsy reveals panacinar/multifocal necorosis. Which of the following would be considered as part of the differential?
A) Hepatocellular damage
B) cholate stasis
C)Pseudoxanthomatous
D)Canicular cholestasis
E) Biliary Fibrosis
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Definition
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Term
| What is the pathological progression of cholestasis? |
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Definition
1) Canicular (perivenular)
2) Chronic (periportal)
3)Biliary Fibrosis |
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Term
| What are some of the the causes of cholestasis? |
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Definition
1)Intrahepatic (hepatocellular or biliary)
2) Extrahepatic (pancreatobiliary)
3)Systemic (drugs) |
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Term
| A patient comes in with cholestasis in caniculi and hepatocytes with abnormal portal tracts (portal paucity). What is the differential diagnosis? |
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Definition
1) PBC
2)PSC
3) Childhood symptomatic and nonsymptomatic bilary paucity |
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Term
| Hanah, A 54 year old women comes into your office with a rash for the last couple of weeks. She has had and still has SLE. Her daughter who is a medical student brought her into see you because she notices yellow in her mother's eyes in the past few days. You do a biopsy, what do you expect to find? |
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Definition
A)Intrahepatic biliary atresia
B)Hemochromatosis and cirrhosis.
C.)Progressive destruction of interlobular and septal bile ducts with no polys but many lymphocytes.
D)concentric clean fibrosis around bile ducts with degeneration of bile duct epithelium and transformation of bile ducts into fibrous cords. |
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Term
| Hanah, A 54 year old women comes into your office with a rash for the last couple of weeks. She has had and still has SLE. Her daughter who is a medical student brought her into see you because she notices yellow in her mother's eyes in the past few days. What do you expect to find from results of further testing that will help you confirm your suspicion? |
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Definition
A)Anti-mitochondrial antibodies and expression of HLA-DRw52a.
B) Anti-mitochondrial antibodies and expression of MHCII on bile duct epithelium.
C) Cooper deposition
D)You detect cholangocarcinoma |
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Term
| Paul, a 42 year old plumber and a prostate cancer survivor presents with bouts of abdominal pain. His skin is mildly jaundiced. What do you expect to find on biopsy? |
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Definition
A)Intrahepatic biliary atresia
B)Hemochromatosis and cirrhosis.
C.)Progressive destruction of interlobular and septal bile ducts with no polys but many lymphocytes.
D)concentric clean fibrosis around bile ducts with degeneration of bile duct epithelium and transformation of bile ducts into fibrous cords. |
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Term
| Paul, a 42 year old plumber and a prostate cancer survivor presents with bouts of abdominal pain (RUQ). He has noticed some weight loss and is worried that is cancer is back. His skin is mildly jaundiced. What our tests do you need to confirm your suspicion and make the diagnosis? |
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Definition
A)Granuloma formation
B) Test for copper deposition
C)Anti-mitochondrial DNA anitbodies
D) ERP and AMA |
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Term
| What is Alagille’s syndrome? |
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Definition
| The syndromatic form of intrahepatic biliary atresia (paucity of intrahepatic bile ducts). A cholestatic syndrome found in infancy and childhood. |
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Term
| What are some complications of biliary atresia? |
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Definition
1) Xanthomas
2) Pigmentation of teeth
3)Alagille's syndrome
4)Giant Cell reaction |
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Term
| What are some possible causes of gall stone formation? |
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Definition
(1) bile supersaturation with cholesterol,
(2) nucleation of cholesterol monohydrate with subsequent crystal retention and stone growth, and
(3) abnormal gallbladder motor function with delayed emptying and stasis |
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Term
| What do jet black biliary gall stones indicate? |
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Definition
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Term
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Definition
| constant and long lasting pain that results from an obstruction of the cystic or common bile duct |
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Term
Patient's lab tests show an elevated bilirubin and alkaline phosphatase. What is the most common location of the patient's gall stone?
1) Cystic bile duct
2) Common Bile duct
3) Interhepatic bile duct |
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Definition
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Term
| What is a Calculus and what causes it? |
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Definition
Calculus (obstruction of cystic duct)
1)mechanical inflammation produced by increased intraluminal pressure and distention with resulting ischemia of the gallbladder mucosa and wall
2) chemical inflammation caused by the release of lysolecithin (due to the action of phospholipase on lecithin in bile) and other local tissue factors
3)bacterial inflammation, which may play a role in 50-85% of patients with acute cholecystitis
E. coli, Klebsiella, Streptococus, and Clostridium spp |
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Term
| What causes Acalculus and how comon is ti compared to other acute colecystitises? |
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Definition
Acalculus (>50% an underlying explanation inflammation is not found, biliary sludge in some cases
associated with serious trauma or burns, the postpartum period, postoperative period, parenteral hyperalimentation, vasculitis, obstructing adenocarcinoma of the gallbladder, diabetes mellitus, torsion of the gallbladder
The complication rate for acalculous cholecystitis exceeds that for calculous cholecystitis |
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Term
Hank, a 65 year old man presents with chills, fever, rigor, and right upper quadrant pain. He has a history of Diabetes? Which of the following is the mostly likely diagnosis?
A) Pancreatitis
B)Emphysematous
C)Caliculus
D)Colangitis
1) |
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Definition
Emphysematous
acute cholecystitis (calculous or acalculous) followed by ischemia or gangrene of the gallbladder wall and infection by gas-producing organisms, ie, C. welchii or C. perfringens, E. coli
This condition occurs most frequently in elderly men and in patients with diabetes mellitus
Prompt surgical intervention coupled with appropriate antibiotics is mandatory |
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Term
| What are Rokitansky - Aschoff Sinuses and in what condition are they found? |
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Definition
| Outpouchings of the mucosa through the muscle of the gall bladder wall and are a characteristic, but not diagnostic, feature of chronic cholecystitis |
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Term
| What are the complication of cholecystitis? |
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Definition
Empyema And Hydrops
Gangrene And Perforation
Fistula Formation And Gallstone Ileus
Porcelain gallbladder
Xanthogranulomatous inflammation |
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Term
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Definition
| Tumor of the gall bladder Notable for slow growth, marked sclerosis, and infrequent distal metastases |
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Term
| What is the difference between Liver Cell adenoma and focal nodular hyperplasia? |
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Definition
1) Focal Nodular hyperplasia is smaller in size. focal nodular hyperplasia of the gall bladder is also nodular with a central scar.
2)Liver adenomas normally hemorrhage |
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Term
| What are some causes of hepatocellular carcinoma? |
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Definition
Chemical carcinogens
product of the Aspergillus fungus, called aflatoxin B1
Hepatitis B and C
HBV-based HCC may arise from rounds of hepatic destruction with subsequent proliferation and not necessarily from frank cirrhosis
Cirrhosis
It is still not clear whether cirrhosis itself is a predisposing factor to the development of HCC or whether the underlying causes of the cirrhosis are actually the carcinogenic factors |
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Term
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Definition
Autosomal recessive disorder of copper metabolism marked by accumulation of toxic levels of copper in the liver, brain and eye.
Defect may involve defective mobilization of copper from hepatocellular lysosomes for excretion into bile. |
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Term
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Definition
| opthalmic cooper deposition in Wilson's disease |
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Term
A patient's lab results show eosinophillic inclusions on biopsy of the liver, and blood work shows low levels of protease inhibitor. Which of the following do you not have to worry about when managing this patient?
A) Neonatal hepatitis
B) Bile Thrombi
C) Cholestasis
D)Chronic hepatitis
E) Cirrhosis |
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Definition
| B. All others are complications of alpha-1 antitrypsin deficiency. |
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