Term
| What are the major causes of cirrhosis |
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Definition
Viral
Fatty Liver: Alcohol, NASH/NAFL
Drugs/Toxin
Autoimmune
Biliary: PBC, PSC
Hereditray: Hemochromatosis, Wilson's, Alpha-I, CF
Vascular: CHF, Budd-chiari |
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Term
| What are the systemic manifestations of hepatic failure |
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Definition
Esophogeal varices, Ascites
Splenomegaly
Jaundice, Puritis
Neurological
Hepatorenal
Low albumin, Low clotting factors
Hepatocellular carcinoma
Decreased Estrogen Metabolism: Spider angiomas, Plamar erythema, Gynecomastia |
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Term
| What are the physiological causes of Ascites? |
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Definition
Increased Hydrostatic
Decreased oncotic pressure
Reduced lymph drainage |
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Term
| What are the causes of ischemic hepatopathy |
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Definition
CHF or right heart lesion
Budd-Chiari: Intra/Extra hepatic vein occlusion from hypercoaguability(Factor V leiden...etc.)
Hepatic Veno-occulsion: Bush tea, or Chemo |
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Term
| When does ischemic necrosis of the liver occur and what area is typically affected? |
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Definition
Shock-related necrosis(bc occlusions only affect one bloody supply route)
Zone 3 |
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Term
| What is the most common malignancy in the liver for the US |
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Definition
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Term
| What are the major risk factors for Hepatocellular carcinoma |
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Definition
Viral
Metabolic: Hemochromatosis, alpha-1 anti-trypsin, Wilson's
Exogenous:
Alcohol
Thorotrast
Steroids
Aflatoxin(aspergillius toxin) |
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Term
What is the tumor marker for hepatocellular carcinoma?
What is the histology?
What could indicate a primary hepatic tumor over a Met on histology? |
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Definition
Alpha-fetoprotein
Histology
Disordered hepatic arrangement(>1 cell layer)
Differentiation: Presence of Bile |
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Term
What are distinguishing features of Fibrolamellar Carcinoma, a variant of Hepatocellular Carcinoma?
Age Range?
Prognosis? |
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Definition
Younger People
No AFP
Better prognosis
Delicate lamellar fibrosis |
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Term
Who gets hepatoblastomas?
What are the signs?
What is the appearence histologically |
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Definition
0-3 year olds
Signs
Abdominal Enlargment
Elevated AFP
Histology:
hemorrhagic mass
Embryonical epithelial cells |
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Term
What substances are associated with hepatic angiosarcoma
What is the histology? |
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Definition
Thorotrast
PVC
Arsenic
Steroids
Histology: blood with dysplastic epithelium |
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Term
What is the most common neoplasm found in the liver?
What is the most common primary neoplasm of the liver? |
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Definition
Most Common: Metastasis
Primary: Cavernous Hemangioma |
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Term
What is the most common presentation of Hepatocellular Adenoma?
What is the histology? |
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Definition
Women of reproductive age on oral contraceptives sustaining minor trauma with continued internal bleeding
Sometimes men on steroids
Histology: Compressed hepatocyte with prominent vascular spaces |
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Term
What is the major pathological feature of Focal nodular hyperplasia of the liver?
What sex is affected more? |
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Definition
Large central scar w/ large vessels and septa radiating outward
Females |
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Term
How is nodular transformation differentiated from fibrosis?
What are the two forms? |
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Definition
Portal HPTN without cirrhosis
Forms:
Partial Nodular Transformation(hilum)
Nodular Regenerative Hyperplasia(Diffuse) |
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Term
| What are two major cystic diseases of the liver? |
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Definition
Von Myenburg Complex: Microhamartomas of bile ducts
Polycystic Liver Disease w/ or w/o PKD |
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