liver pathology
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- 6 general liver functions:
- "Excretory/detoxification (in bile)
- General examples of substances stored in liver
- vitamin K, iron, copper, fat soluble vitamins, glycogen
- Examples of substances synthesized in liver
- albumin, alpha I antitrypsin; proteins of coagulation cascade (fibrinogen, prothrombin, VIII,IX, X, XI, and Xli), bile
- Liver failure becomes apparent when _______ of liver is destroyed or dysfunctional
- 80%
- "
- "Jaundice of skin and eyes
- 7 general signs of liver failure:
- "Jaundice, Hypoalbumenernia, Hepatorenal syndrome, Portal hypertension, Encephalopathy, Endocrine abnormalities, coagulopathy
- Encephalopathy I liver failure is due to the failure of the liver to remover _________ from the .
- ammonia
- 2 major functions of hepatic bile
- "elimination of bilirubrin and cholesterol
- _______ occurs if bilirubin levels are greater than _______mg/dl.
- Jaundice, 1.2
- Jaundice is best recognized in the __________.
- sclera
- Which type of bilirubin is tightly bound to albumin?
- Unconjugated bilirubin:
- Which type of bilirubin is water soluble?
- Conjugated bilirubin
- Which type of bilirubin can be excreted in ?
- conjugated
- Conjugation of bilirubin takes place where?
- Liver --No Eric, it is not the breast
- A manifestation of Gilbert's disease is:
- Prehepatic Jaundice
- Hepatic Jaundice is seen under what general conditions?
- viral or -induced hepatitis, alcoholic hepatitis, tumors, and cirrhosis
- T/F Hepatic Jaundice is associated with a buildup of conjugated bilirubin only.
- False: It is mixed conjugated and unconjugated
- Conjugated hyperbilirubinemia is manifest in what condition?
- post-hepatic jaundice
- post-hepatic jaundice is seen in _________ disorders such as gallstones, tumors of bile ducts, pancreas, or duodenum
- obstructive
- _________ is the accumulation of unconjugated bilirubin (usually> 20 mg/dl) in the brain causing severe neurologic damage
- Kernicterus
- Kernicterus can be seen in this condition that affects infants:
- hemolytic disease of the newborn (erythroblastosis fetalis)
- Additional causes of jaundice:
- "antifungals, high amounts of beta-carotene, medications
- Elevated ammonia levels in the from liver failure that lead to disturbances in consciousness ranging from behavioral abnormalities to coma is called:
- hepatic encephalopathy
- Hepatorenal syndrome:
- liver fails--> kidneys fail drop in output, increase in urea nitrogen/creatine levels (in end-stage liver disease)
- ______ is synonymous with end-stage liver disease
- Cirrhosis
- T/F Cirrhosis is among the top ten causes of I western society.
- TRUE
- Cirrhosis may take one to ___ years to develop.
- 20
- What is the major pathologic process that accompanies cirrhosis?
- "progressive fibrosis (regenerative firm nodular surface)
- ⬢ Necrosis of hepatocytes (councilman bodies) are shrunken eosinophilic apoptotic anuclear fragments of hepatocytes)"
- "Morphologic changes seen with viral hepatitis
- • Hepatitis B— ground glass hepatocytes— due to accumulation of HBsAg; sanded nuclei due to abundant HBcAg"
- "Morphologic changes seen with viral hepatitis
- With viral hepatitis, what is the timeline established for acute vs. chronic infection?
- "acute = resolves within 6 months
- 1 in __ patients is a carrier"
- "4 million
- characteristics of fulminant hepatitis include:
- "severe acute iiver damage, encephalopathy, coaguiopathy with high risk of approaching 80%
- fulminant hepatitis develops within _____ weeks of the onset of liver disease.
- 8
- ⬢ donations not screened for Hepatitis A"
- "Hepatits A:
- ⬢ Can remain infective on operatory surfaces up to 7 days, cold sterilization ineffective"
- "Hepatitis B
- ⬢9 documented cases of transmission from dental provider to patient over past 30 years"
- "Hepatitis B