What are specific liver diseases?
Conditions that directly affect liver function and structure, such as hepatitis, cirrhosis, and liver cancer.
p.1
Hepatitis Types and Pathology
What is hepatitis?
An inflammation of the liver, often caused by viral infections, alcohol use, or toxins.
What is cirrhosis?
A late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases, including hepatitis and chronic alcohol abuse.
p.1
Liver Tumors and Cancer
What are the common causes of liver cancer?
Chronic hepatitis B and C infections, cirrhosis, and excessive alcohol consumption.
p.1
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is Non-Alcoholic Fatty Liver Disease (NAFLD)?
A condition where fat builds up in the liver without alcohol consumption, often associated with obesity and diabetes.
p.1
Drug-Induced Liver Injury (DILI)
What is Drug-Induced Liver Injury (DILI)?
Liver damage caused by medications or herbal supplements.
What is cirrhosis?
A late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
What are common causes of cirrhosis?
Chronic alcohol abuse, viral hepatitis, fatty liver disease, and certain genetic disorders.
p.2
Complications of Cirrhosis
What are the complications associated with cirrhosis?
Liver failure, portal hypertension, varices, and liver cancer.
How does cirrhosis affect liver function?
It impairs the liver's ability to function properly, leading to various health issues.
p.16
Hepatitis Types and Pathology
What are the possible outcomes of chronic hepatitis?
Remit, static, acute on chronic (flare-up), or progress to fibrosis and cirrhosis.
What is metabolic liver disease?
A group of disorders that affect the liver's ability to metabolize substances.
p.146
Inflammation Overview
What are the vascular events associated with acute inflammation?
Vasodilatation and increased permeability.
What are the Four F's associated with gallstone risk?
Fair, Forty, Fat, Fertile.
p.14
Viral Hepatitis Overview
What is the primary cause of infectious liver disease?
Infections caused by viruses, bacteria, or parasites.
p.120
Liver Tumors and Cancer
What does GIST stand for?
Gastrointestinal Stromal Tumor.
p.73
Drug-Induced Liver Injury (DILI)
What is the primary effect of Paracetamol on the liver in cases of overdose?
It causes necrosis, particularly in the pan-acinar region.
p.102
Liver Tumors and Cancer
Can HCC occur in a non-cirrhotic liver?
Yes, HCC can develop in a non-cirrhotic liver.
p.14
Viral Hepatitis Overview
What is a common symptom of infectious liver disease?
Jaundice, which is yellowing of the skin and eyes.
p.105
Liver Tumors and Cancer
What does 'pleomorphism' indicate in tumor cells?
Variability in cell shape and size, indicating malignancy.
p.24
Hepatitis Types and Pathology
What type of cellular damage is associated with mild acute viral hepatitis?
Apoptosis, spotty necrosis, and hydropic change.
p.42
Alcoholic Liver Disease
What types of alcohol-related issues are tracked in the data?
Alcohol-related hospital admissions and deaths, including mental and behavioral disorders and alcoholic liver disease.
p.116
Liver Tumors and Cancer
What is a Klatskin tumor?
A type of perihilar cholangiocarcinoma.
p.105
Liver Tumors and Cancer
What is the architectural composition of hepatocellular carcinoma?
Proliferation of tumor cells with hepatocellular differentiation.
What is another important test for Wilson's Disease?
Elevated hepatic copper content.
p.16
Hepatitis Types and Pathology
What are common symptoms of chronic hepatitis?
Usually asymptomatic or deranged liver enzymes.
p.131
Complications of Cirrhosis
What is smooth muscle hyperplasia?
It is the increase in the number of smooth muscle cells, often in response to injury or irritation.
p.48
Drug-Induced Liver Injury (DILI)
What is a potential consequence of alcohol-drug interactions?
Increased toxicity or reduced effectiveness of medications.
p.98
Liver Tumors and Cancer
What characterizes focal nodular hyperplasia?
A benign liver lesion with a central scar and hyperplastic hepatocytes.
What does 'Halfway to go' imply?
It suggests that a journey or task is at its midpoint.
p.107
Liver Tumors and Cancer
What characterizes moderately differentiated HCC?
Hepatocellular carcinoma with cancer cells that have some features of normal liver cells but are more abnormal than well differentiated cells.
p.107
Liver Tumors and Cancer
What is poorly differentiated HCC?
A type of hepatocellular carcinoma where the cancer cells are very abnormal and do not resemble normal liver cells.
p.104
Liver Tumors and Cancer
What does HCC stand for in the context of liver disease?
Hepatocellular carcinoma.
p.51
Alcoholic Liver Disease
What can repeated attacks of alcohol consumption cause?
Progressive liver damage.
What is an example of a condition that leads to micro-nodular cirrhosis?
Alcoholic fatty liver disease.
p.21
Hepatitis Types and Pathology
In which type of conditions are apoptotic bodies commonly observed?
In conditions involving liver damage or hepatitis.
What are common causes of macro-nodular cirrhosis?
Chronic hepatitis, alcohol abuse, and metabolic disorders.
What is the most common type of acute cholecystitis?
Acute calculous cholecystitis.
p.67
Drug-Induced Liver Injury (DILI)
What are the two types of drug/toxin reactions?
Intrinsic (predictable) and idiosyncratic (unpredictable).
p.143
Complications of Cirrhosis
What causes saponification in peripancreatic fat necrosis?
The release of pancreatic enzymes that digest fat.
p.65
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is a key histological feature of macrovesicular steatosis?
Fatty change in liver cells.
p.64
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is pericellular fibrosis?
A distinctive pattern of fibrosis in fatty liver disease.
What condition is characterized by the destruction of bile ducts leading to cirrhosis?
Primary biliary cholangitis (PBC).
p.102
Liver Tumors and Cancer
What does HCC stand for?
Hepatocellular carcinoma.
What is primary sclerosing cholangitis (PSC)?
A condition that causes inflammation and scarring of the bile ducts, leading to cirrhosis.
What is the gender distribution of Primary Biliary Cholangitis?
Commonly affects women (90%).
What is a secondary cause of biliary cirrhosis?
Chronic biliary obstruction.
What is pancreatic acinar atrophy?
A condition characterized by the loss of acinar cells in the pancreas.
p.28
Hepatitis Types and Pathology
What type of cellular damage is associated with chronic viral hepatitis?
Apoptosis and spotty necrosis.
What is chronic cholecystitis?
A condition that may occur with or without repeated acute cholecystitis.
What is believed to be involved in the pathogenesis of chronic cholecystitis?
Chronic supersaturation of bile by cholesterol.
What indicates elevated urinary copper excretion in Wilson's Disease?
Elevated urinary copper excretion (+/- Penicillamine challenge).
p.68
Drug-Induced Liver Injury (DILI)
What are the possible clinical presentations of drug/toxin-induced liver injury?
They can range from asymptomatic deranged liver function to fulminant hepatic failure.
p.14
Hepatitis Types and Pathology
Which viruses are commonly associated with infectious liver disease?
Hepatitis A, B, C, D, and E viruses.
p.116
Liver Tumors and Cancer
What is the primary characteristic of Klatskin tumors?
They obstruct bile flow due to their location.
p.104
Liver Tumors and Cancer
What is a portal vein thrombus?
A blood clot in the portal vein.
What is the role of the liver in metabolism?
The liver processes nutrients, detoxifies harmful substances, and produces bile.
p.115
Liver Tumors and Cancer
What is intrahepatic cholangiocarcinoma?
A type of cancer that originates in the bile ducts within the liver.
What does cirrhosis represent in terms of liver disease?
A spectrum of advanced liver disease, not just a single 'end-stage' condition.
What does pancreatic fibrosis refer to?
The formation of excess fibrous connective tissue in the pancreas.
How is cirrhosis classically classified?
Into macro-nodular and micro-nodular.
p.120
Liver Tumors and Cancer
What is lymphoblastic leukemic infiltrate?
A type of cancer that involves the infiltration of leukemic cells into tissues.
p.127
Complications of Cirrhosis
What type of necrosis is characterized by transmural involvement of the wall?
Transmural necrosis with neutrophilic infiltrate.
p.98
Liver Tumors and Cancer
What is a hepatocellular adenoma?
A benign tumor of the liver composed of hepatocytes.
p.21
Hepatitis Types and Pathology
What is the significance of apoptotic bodies in pathology?
They indicate cell death and are often seen in liver diseases.
How does macro-nodular cirrhosis differ from micro-nodular cirrhosis?
Macro-nodular cirrhosis features larger nodules, while micro-nodular cirrhosis has smaller, uniform nodules.
p.143
Complications of Cirrhosis
What is peripancreatic fat necrosis?
A condition characterized by the death of fat tissue surrounding the pancreas.
p.46
Alcoholic Liver Disease
What are the main byproducts of alcohol metabolism?
Acetaldehyde and acetate.
How does chronic pancreatitis relate to pancreatic cancer?
It is a great radiological and pathological mimicker of pancreatic cancer.
p.51
Alcoholic Liver Disease
What are the potential conditions associated with Alcoholic Liver Disease?
Cirrhosis, Steatosis, and Hepatitis.
p.42
Alcoholic Liver Disease
Which year had the highest recorded alcohol-related hospital admissions in Hong Kong?
2012, with 70 admissions.
p.16
Hepatitis Types and Pathology
What does 'acute on chronic' refer to in chronic hepatitis?
A flare-up of symptoms in a patient with chronic hepatitis.
p.131
Complications of Cirrhosis
What is fibrosis?
It is the thickening and scarring of connective tissue, usually as a result of injury.
p.42
Alcoholic Liver Disease
What organization provided the data on alcohol-related issues in Hong Kong?
Hospital Authority, Hong Kong.
p.102
Liver Tumors and Cancer
What are some risk factors for HCC in a non-cirrhotic liver?
Chronic hepatitis B or C infection, aflatoxin exposure, and metabolic liver diseases.
Are single pathological changes in liver diseases highly specific?
No, they are not highly specific or pathognomonic.
p.102
Liver Tumors and Cancer
What is the significance of early detection of HCC in a non-cirrhotic liver?
Early detection can lead to better treatment outcomes and increased survival rates.
p.141
Complications of Cirrhosis
What does neutrophilic infiltrate indicate in pancreatic tissue?
It often indicates inflammation or infection.
p.120
Liver Tumors and Cancer
What type of cancer is referred to as metastatic malignant melanoma?
A type of skin cancer that has spread to other parts of the body.
What is a key biochemical test for Wilson's Disease?
Reduced serum ceruloplasmin.
p.68
Drug-Induced Liver Injury (DILI)
What is the variable onset time for drug/toxin-induced liver injury?
It can range from hours to months.
p.48
Drug-Induced Liver Injury (DILI)
How does alcohol affect drug metabolism?
Alcohol can inhibit or enhance the metabolism of certain drugs.
p.20
Hepatitis Types and Pathology
What type of cellular damage is associated with mild acute viral hepatitis?
Apoptosis, spotty necrosis, and hydropic change.
p.105
Liver Tumors and Cancer
What are the cytological features of tumor cells in hepatocellular carcinoma?
Malignant cytology with nuclear enlargement, pleomorphism, hyperchromasia, increased n/c ratio, and frequent mitosis.
p.20
Hepatitis Types and Pathology
What are the characteristics of moderate to severe cellular damage in acute viral hepatitis?
Confluent necrosis, bridging necrosis, and pan-lobular necrosis.
What size defines micro-nodular cirrhosis?
Nodules smaller than 3 mm.
p.75
Complications of Cirrhosis
What are potential complications of metabolic liver disease?
Cirrhosis, liver failure, and liver cancer.
p.132
Complications of Cirrhosis
What are the components of Charcot's triad?
High fever, biliary colic, and jaundice.
p.138
Complications of Cirrhosis
What do Cullen’s sign and Grey Turner’s sign indicate in severe acute pancreatitis?
They are associated with intra-abdominal or retroperitoneal hemorrhage.
p.41
Alcoholic Liver Disease
What psychological issues can arise from alcoholism?
Wernicke syndrome, Korsakoff syndrome, and cerebellar degeneration.
What is the primary function of the biliary tree?
To transport bile from the liver to the gallbladder and small intestine.
What are the key histological features of cirrhosis?
Regenerative nodules surrounded by fibrous septa.
p.107
Liver Tumors and Cancer
What is well differentiated HCC?
A type of hepatocellular carcinoma where the cancer cells closely resemble normal liver cells.
p.68
Drug-Induced Liver Injury (DILI)
What is a characteristic of drug/toxin-induced liver injury?
It has a wide range of presentations.
p.21
Hepatitis Types and Pathology
What are apoptotic bodies also known as?
Councilman bodies or acidophilic bodies.
p.48
Alcoholic Liver Disease
What enzyme is primarily involved in alcohol metabolism?
Alcohol dehydrogenase (ADH).
p.26
Inflammation Overview
What are the vascular events associated with acute inflammation?
Vasodilatation and increased permeability.
p.33
Hepatitis Types and Pathology
What does 'Grade' refer to in chronic hepatitis?
Necroinflammatory activity.
p.67
Drug-Induced Liver Injury (DILI)
What are the mechanisms of liver damage from hepatoxins?
Direct toxicity, toxic metabolites after metabolism, and immune mechanisms.
p.27
Hepatitis Types and Pathology
What is the main difference in inflammatory cell types between acute hepatitis and other conditions?
Acute hepatitis primarily involves lymphocytes, while neutrophils are not the major inflammatory cells.
p.7
Complications of Cirrhosis
What complications can arise from macro-nodular cirrhosis?
Portal hypertension, liver failure, and increased risk of liver cancer.
p.132
Complications of Cirrhosis
What additional symptoms are included in Reynolds' pentad?
Hypotension and confusion.
p.47
Alcoholic Liver Disease
What causes 'Asian Flush'?
It is caused by a deficiency in the enzyme aldehyde dehydrogenase 2 (ALDH2), leading to the accumulation of acetaldehyde.
What is cirrhosis?
A late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
What is immune-mediated liver disease?
A condition where the immune system attacks liver cells, leading to inflammation and damage.
What staining method is used to identify prominent siderosis?
Perls' Prussian blue stain.
p.31
Hepatitis Types and Pathology
What is the significance of HBsAg in relation to ground-glass hepatocytes?
Ground-glass hepatocytes can be indicative of Hepatitis B infection, which is associated with HBsAg.
What can cause biliary tree disease?
Gallstones, infections, and tumors.
p.103
Liver Tumors and Cancer
What does HCC stand for?
Hepatocellular carcinoma.
p.36
Hepatitis Types and Pathology
What is mycobacterial tuberculosis?
An infectious disease caused by Mycobacterium tuberculosis, primarily affecting the lungs.
p.49
Alcoholic Liver Disease
What is the metabolic pathway that converts alcohol to acetaldehyde?
The alcohol dehydrogenase pathway.
What can be inferred from the repetition of 'Halfway to go'?
It emphasizes the progress made and the distance still remaining.
p.64
Non-Alcoholic Fatty Liver Disease (NAFLD)
Is pericellular fibrosis commonly found in other chronic liver diseases?
No, it is not typically encountered in other chronic liver diseases.
What characterizes macro-nodular cirrhosis?
Nodules are larger than 3 mm.
p.116
Liver Tumors and Cancer
Where does perihilar cholangiocarcinoma occur?
At the junction of the right and left hepatic bile ducts.
p.120
Liver Tumors and Cancer
What is the significance of metastatic GIST?
It indicates that the gastrointestinal stromal tumor has spread to other parts of the body.
p.37
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is Fatty Liver Disease?
A condition characterized by the accumulation of fat in liver cells.
What is the primary cause of acute cholecystitis?
Acute obstruction of Hartmann’s pouch by gallstone.
What is cryptogenic cirrhosis?
A type of cirrhosis with no identifiable cause, also known as idiopathic cirrhosis.
p.47
Alcoholic Liver Disease
What is 'Asian Flush'?
A reaction to alcohol consumption characterized by facial flushing and other symptoms.
Name a hereditary condition that can cause cirrhosis.
Hemochromatosis or Wilson disease.
p.33
Hepatitis Types and Pathology
Are the Grade and Stage of chronic hepatitis relevant to malignant tumors?
No, they are completely irrelevant.
What deficiency is associated with cirrhosis?
Alpha-1-antitrypsin (A1AT) deficiency.
p.139
Complications of Cirrhosis
What syndrome can occur as a complication of acute pancreatitis?
Acute respiratory distress syndrome (ARDS).
What inflammatory bowel disease is primarily associated with primary sclerosing cholangitis?
Ulcerative colitis (70% of cases).
p.119
Liver Tumors and Cancer
What are common primary sites for liver metastasis?
Colorectum, lung, and breast.
p.57
Alcoholic Liver Disease
What is alcoholic cirrhosis?
A type of liver damage caused by excessive alcohol consumption leading to scarring of the liver.
p.132
Complications of Cirrhosis
What does the presence of hypotension and confusion indicate in acute cholangitis?
Severe progression of the condition.
p.152
Liver Tumors and Cancer
What is a common local clinical feature of pancreatic carcinoma?
Epigastric or central abdominal pain.
p.47
Alcoholic Liver Disease
How does alcohol metabolism differ in individuals with 'Asian Flush'?
They metabolize alcohol to acetaldehyde normally, but cannot effectively convert acetaldehyde to acetic acid due to ALDH2 deficiency.
p.42
Alcoholic Liver Disease
What trend is observed in alcohol-related hospital admissions in Hong Kong from 2008 to 2012?
There is an overall increase in hospital admissions related to alcohol.
What is one immune-mediated cause of cirrhosis?
Autoimmune hepatitis (AIH).
p.131
Complications of Cirrhosis
What is the Rokitansky-Aschoff sinus?
It is a type of sinus formation in the gallbladder associated with chronic inflammation.
What type of infiltrate is associated with pancreatic acinar atrophy?
Lymphoplasmacytic infiltrate.
What are common causes of metabolic liver disease?
Genetic disorders, obesity, and diabetes.
What are acinar cells responsible for?
Producing digestive enzymes in the pancreas.
p.116
Liver Tumors and Cancer
What are common symptoms of perihilar cholangiocarcinoma?
Jaundice, weight loss, and abdominal pain.
What does lymphoplasmacytic infiltrate indicate?
An immune response, often associated with inflammation.
p.48
Alcoholic Liver Disease
What can chronic alcohol consumption lead to in terms of drug metabolism?
It can lead to tolerance and altered drug clearance.
p.14
Viral Hepatitis Overview
What is a significant risk factor for hepatitis B and C?
Sharing needles or other equipment for drug use.
What does it mean when a pathological change is described as non-pathognomonic?
It means that the change can be associated with multiple conditions, not just one specific disease.
p.102
Liver Tumors and Cancer
What are common symptoms of HCC?
Symptoms may include weight loss, abdominal pain, and jaundice.
p.133
Liver Tumors and Cancer
What is gallbladder carcinoma?
A type of cancer that originates in the gallbladder.
p.46
Alcoholic Liver Disease
What causes the symptoms of a hangover?
Dehydration, acetaldehyde buildup, and electrolyte imbalance.
p.138
Complications of Cirrhosis
What does mild elevation of amylase indicate?
It is nonspecific and may be found in cholecystitis, bowel perforation, or renal failure.
p.41
Alcoholic Liver Disease
What gastrointestinal problems can result from alcoholism?
Gastritis, peptic ulcer, malnutrition, and pancreatitis.
p.71
Non-Alcoholic Fatty Liver Disease (NAFLD)
What does microvesicular steatosis indicate?
It indicates a pathological condition in the liver, often associated with metabolic disturbances.
p.115
Liver Tumors and Cancer
How is intrahepatic cholangiocarcinoma typically diagnosed?
Through imaging studies and biopsy.
p.142
Complications of Cirrhosis
What is the primary characteristic of an abscess?
It is a localized collection of pus.
p.129
Inflammation Overview
What type of cells are involved in chronic inflammation?
Mononuclear cells (monocytes, macrophages, lymphocytes, plasma cells).
p.105
Liver Tumors and Cancer
What type of tumor is hepatocellular carcinoma?
A malignant hepatocellular neoplasm.
What is pancreatic acinar atrophy?
A condition characterized by the loss of acinar cells in the pancreas.
p.150
Liver Tumors and Cancer
What is the rank of pancreatic carcinoma as a cause of cancer in Hong Kong according to the 2020 Cancer Registry?
4th leading cause of cancer.
p.130
Complications of Cirrhosis
What type of infiltrate is characterized by lymphocytes and plasma cells?
Lympho-plasmacytic infiltrate.
p.68
Drug-Induced Liver Injury (DILI)
What type of pathological features can drug/toxin-induced liver injury resemble?
It can resemble all forms of acute, chronic, vascular, or neoplastic liver diseases caused by other etiologies.
p.138
Complications of Cirrhosis
What are the common symptoms of acute pancreatitis?
Gradual or sudden epigastric/central abdominal pain, radiation to the back, nausea, vomiting, and fever.
p.67
Drug-Induced Liver Injury (DILI)
What causes drug/toxin-induced liver injury?
Liver damage due to hepatoxins.
What does NAFLD stand for?
Non-Alcoholic Fatty Liver Disease.
p.14
Hepatitis Types and Pathology
How can hepatitis A be transmitted?
Through contaminated food and water.
p.105
Liver Tumors and Cancer
What does an increased n/c ratio signify in tumor cells?
A higher nucleus-to-cytoplasm ratio, often associated with malignancy.
p.129
Inflammation Overview
What are the vascular events associated with acute inflammation?
Vasodilatation and increased permeability.
p.28
Hepatitis Types and Pathology
What is a characteristic feature of the inflammatory response in chronic viral hepatitis?
Chronic inflammatory infiltrate in the portal area.
p.14
Complications of Cirrhosis
What is the potential outcome of untreated viral hepatitis?
It can lead to chronic liver disease or liver cancer.
p.125
Complications of Cirrhosis
What abdominal signs are characteristic of acute cholecystitis?
RUQ tenderness, guarding, and Murphy’s sign.
p.46
Alcoholic Liver Disease
How does alcohol affect the body's hydration levels?
It acts as a diuretic, leading to increased urination and dehydration.
p.146
Inflammation Overview
What type of cells are involved in chronic inflammation?
Mononuclear cells (monocytes, macrophages, lymphocytes, plasma cells).
p.50
Alcoholic Liver Disease
What are the symptoms of Alcoholic Hepatitis (ASH) in its acute form?
Fever, right upper quadrant pain, jaundice, anorexia, nausea, vomiting.
p.117
Liver Tumors and Cancer
What type of cancer is cholangiocarcinoma?
Adenocarcinoma of the bile duct.
How does chronic alcohol abuse contribute to cirrhosis?
It leads to liver inflammation and damage over time, resulting in scarring.
How does macro-nodular cirrhosis differ from micro-nodular cirrhosis?
Macro-nodular cirrhosis features larger nodules, while micro-nodular cirrhosis has smaller, uniform nodules.
p.41
Alcoholic Liver Disease
What reproductive issues can arise from alcoholism?
Testicular atrophy and spontaneous abortion.
p.129
Inflammation Overview
Is tissue damage present in both acute and chronic inflammation?
Yes, tissue damage is present in both.
What is a key pathological feature of Alpha-1 Antitrypsin Deficiency?
Intracellular accumulation.
p.101
Liver Tumors and Cancer
What type of pain is associated with HCC?
Right upper quadrant abdominal pain.
What is macro-nodular cirrhosis?
A type of liver cirrhosis characterized by large nodules on the liver surface.
What is a key characteristic of histological changes in liver diseases?
They are complex and can have multiple differential diagnoses.
p.131
Complications of Cirrhosis
What role does regeneration play in tissue repair?
Regeneration involves the replacement of damaged tissue with new tissue, restoring function.
p.138
Complications of Cirrhosis
What abdominal signs are characteristic of acute pancreatitis?
Localized or generalized abdominal tenderness, guarding, Cullen’s sign, and Grey Turner’s sign.
p.115
Liver Tumors and Cancer
Where does intrahepatic cholangiocarcinoma occur?
In the bile ducts located inside the liver.
p.60
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is microvesicular steatosis?
A type of fat accumulation in the liver characterized by small fat droplets.
How can metabolic liver disease be diagnosed?
Through blood tests, imaging studies, and liver biopsy.
What is Primary Sclerosing Cholangitis?
A chronic, cholestatic, fibrosing inflammatory disease of extrahepatic and intrahepatic bile ducts, leading to cirrhosis.
p.79
Complications of Cirrhosis
What type of fibrosis is associated with hereditary hemochromatosis?
Portal/periportal fibrosis, bridging fibrosis, leading to micronodular cirrhosis.
p.132
Complications of Cirrhosis
What is the significance of Charcot's triad in acute cholangitis?
It is a classic presentation of the condition.
p.155
Liver Tumors and Cancer
What characterizes the architecture of pancreatic adenocarcinoma?
Proliferation of tumor cells with glandular differentiation in a desmoplastic stroma.
p.25
Hepatitis Types and Pathology
What type of cellular damage is associated with mild acute viral hepatitis?
Apoptosis, spotty necrosis, and hydropic change.
p.32
Hepatitis Types and Pathology
What type of necroinflammatory activity is observed in chronic viral hepatitis B?
Portal-based necroinflammatory activity.
p.110
Liver Tumors and Cancer
What does HCC stand for?
Hepatocellular Carcinoma.
p.15
Hepatitis Types and Pathology
What are common symptoms of acute hepatitis?
Fever, right upper quadrant pain, jaundice, anorexia, malaise, and deranged liver enzymes.
p.108
Liver Tumors and Cancer
What does tumor staging assess?
The extent of a tumor based on the original tumor and its spread in the body.
What is the significance of '1 u J'?
It appears to be a reference to a unit of energy or measurement, but lacks context.
What is a common clinical presentation of chronic pancreatitis?
Epigastric/central abdominal pain with radiation to the back.
p.25
Hepatitis Types and Pathology
What specific type of infiltrate is noted in the lobules during acute viral hepatitis?
Lobular lymphocytic infiltrate.
p.146
Inflammation Overview
What is hyperemia in the context of acute inflammation?
Increased blood flow, also referred to as congestion.
p.45
Alcoholic Liver Disease
What is the metabolic pathway that converts ethanol to acetaldehyde?
The alcohol dehydrogenase pathway.
What could '111' signify in a numerical context?
It could represent a quantity, code, or identifier, but lacks specific context.
p.61
Drug-Induced Liver Injury (DILI)
What causes ballooning degeneration in cells?
It can be caused by various factors, including toxic substances, viral infections, and metabolic disorders.
p.132
Complications of Cirrhosis
What causes acute cholangitis?
Acute obstruction of the extrahepatic bile duct with secondary bacterial infection.
p.37
Non-Alcoholic Fatty Liver Disease (NAFLD)
What are the two main types of Fatty Liver Disease?
Alcoholic Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease.
p.116
Liver Tumors and Cancer
What is the typical treatment for Klatskin tumors?
Surgical resection, if feasible.
What is NASH?
Non-Alcoholic Steatohepatitis.
What are the two main categories of cirrhosis?
Compensated and decompensated cirrhosis.
p.125
Complications of Cirrhosis
What are the symptoms of acute cholecystitis?
Fever, biliary colic, nausea, and vomiting.
p.67
Drug-Induced Liver Injury (DILI)
Give an example of an intrinsic (predictable) drug reaction.
Panadol (acetaminophen) or CCl4 (carbon tetrachloride).
What is prominent siderosis?
A condition characterized by excessive iron deposits in tissues.
p.71
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is diffuse microvesicular steatosis?
A condition characterized by the accumulation of small fat droplets in liver cells.
What leads to repeated attacks of acute cholangitis in recurrent pyogenic cholangitis?
Stone formation in intrahepatic and extrahepatic ducts.
p.37
Non-Alcoholic Fatty Liver Disease (NAFLD)
How is Fatty Liver Disease diagnosed?
Through imaging tests, blood tests, and sometimes liver biopsy.
What are common causes of cirrhosis?
Chronic alcohol abuse, viral hepatitis, fatty liver disease, and certain genetic disorders.
p.155
Liver Tumors and Cancer
What are the cytological features of tumor cells in pancreatic adenocarcinoma?
Malignant cytology with nuclear enlargement, pleomorphism, hyperchromasia, increased nuclear/cytoplasmic ratio, and frequent mitosis.
p.37
Non-Alcoholic Fatty Liver Disease (NAFLD)
What lifestyle changes can help manage Fatty Liver Disease?
Weight loss, healthy diet, and regular exercise.
What are the multiple factors contributing to pancreatic carcinoma?
Multiple factors include chronic smoking, chronic alcoholism, obesity, high fat diet, low fiber intake, chronic pancreatitis, diabetes mellitus, and hereditary pancreatitis.
What are the symptoms of biliary tree disease?
Jaundice, abdominal pain, and fever.
p.55
Non-Alcoholic Fatty Liver Disease (NAFLD)
How is Non-Alcoholic Fatty Liver Disease (NAFLD) commonly presented?
As incidental findings of elevated liver enzymes in blood tests or fatty liver in ultrasonography.
p.114
Liver Tumors and Cancer
What hereditary condition is a risk factor for cholangiocarcinoma?
Hereditary hemochromatosis.
p.96
Liver Tumors and Cancer
In which liver tumor is AFP commonly elevated?
Hepatocellular carcinoma (HCC) and hepatoblastoma.
p.59
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is the potential consequence of untreated macrovesicular steatosis?
It can progress to non-alcoholic steatohepatitis (NASH) and cirrhosis.
p.41
Alcoholic Liver Disease
What is Fetal Alcohol Syndrome characterized by?
Growth retardation, mental retardation, and birth defects.
Which infections are associated with acute pancreatitis?
Mumps, Coxsackievirus, and Mycoplasma pneumoniae.
p.126
Inflammation Overview
Is tissue damage present in chronic inflammation?
Yes, tissue damage is present.
p.139
Complications of Cirrhosis
What are two complications that can arise in chronic pancreatitis?
Pancreatic abscess and pseudocyst.
What is primary sclerosing cholangitis?
A disease that causes scarring and inflammation of the bile ducts, often associated with inflammatory bowel disease.
p.96
Liver Tumors and Cancer
In what pregnancy-related conditions can AFP be elevated?
Multiple pregnancy and neural tube defect.
p.40
Alcoholic Liver Disease
What defines excessive alcohol intake for females?
>280 g/week or more than 4 standard drinks per day.
p.104
Liver Tumors and Cancer
How does portal vein thrombosis affect HCC prognosis?
It can worsen the prognosis and complicate treatment options.
What is hereditary hemochromatosis characterized by?
Intracellular accumulation of iron (siderosis).
p.31
Hepatitis Types and Pathology
What is a ground-glass hepatocyte?
A hepatocyte that appears glassy and is often associated with certain liver conditions.
p.37
Complications of Cirrhosis
What are potential complications of Fatty Liver Disease?
Liver inflammation, fibrosis, cirrhosis, and liver cancer.
p.114
Liver Tumors and Cancer
What are some chronic biliary diseases that contribute to cholangiocarcinoma?
Primary sclerosing cholangitis, recurrent pyogenic cholangitis, and parasitic infestation.
What are common types of immune-mediated liver diseases?
Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis.
p.71
Drug-Induced Liver Injury (DILI)
What are the potential causes of diffuse microvesicular steatosis?
Can be caused by factors such as drug toxicity, metabolic disorders, or mitochondrial dysfunction.
p.133
Liver Tumors and Cancer
How is gallbladder carcinoma diagnosed?
Through imaging tests, biopsies, and blood tests.
p.71
Non-Alcoholic Fatty Liver Disease (NAFLD)
How does diffuse microvesicular steatosis differ from macrovesicular steatosis?
Microvesicular steatosis involves small fat droplets, while macrovesicular steatosis involves larger fat droplets.
What role does viral hepatitis play in cirrhosis?
Chronic infection with hepatitis B or C can cause long-term liver damage and cirrhosis.
How is cirrhosis currently understood in terms of its progression?
It is believed to be dynamic and bidirectional, potentially reversible, rather than static and persistently progressive.
What was the trend of recurrent pyogenic cholangitis in Hong Kong from the 1950s to the 1980s?
Decreased from 58% to 12% of patients with biliary calculi.
What medication is related to Reye's Syndrome in children?
Acetylsalicylic acid (Aspirin).
What is hemochromatosis?
Excessive iron accumulation in various organs, particularly the liver and pancreas.
p.38
Alcoholic Liver Disease
What is considered binge drinking?
Consuming ≥ 5 standard drinks in one occasion.
p.69
Drug-Induced Liver Injury (DILI)
Which substances can cause microvesicular fatty change in the liver?
Ethanol, Tetracycline, Aspirin.
What is a key biochemical test for hereditary hemochromatosis?
Elevated transferrin saturation.
p.93
Liver Tumors and Cancer
What is a liver tumor?
An abnormal growth of cells in the liver.
p.40
Alcoholic Liver Disease
What is the CAGE questionnaire used for?
Screening for alcoholism or alcohol dependence.
p.49
Alcoholic Liver Disease
What is the effect of genetic variations in alcohol metabolism enzymes?
They can influence an individual's tolerance to alcohol and risk of alcohol-related diseases.
p.101
Liver Tumors and Cancer
What is a serious complication of HCC?
Massive intra-abdominal bleeding due to tumor rupture.
p.93
Liver Tumors and Cancer
What is the most common type of primary liver cancer?
Hepatocellular carcinoma (HCC).
p.98
Liver Tumors and Cancer
What is a cavernous hemangioma?
A benign vascular tumor of the liver consisting of a mass of blood vessels.
p.20
Hepatitis Types and Pathology
What specific type of infiltrate is noted in the lobules during acute viral hepatitis?
Lobular lymphocytic infiltrate.
What is the appearance of a normal pancreas?
A healthy pancreas has a well-defined structure with no signs of atrophy or fibrosis.
p.139
Complications of Cirrhosis
What is a potential complication of acute pancreatitis related to bleeding?
Intra-abdominal/retroperitoneal bleeding due to erosion of vessels by pancreatic enzymes.
p.28
Hepatitis Types and Pathology
What is a notable finding in the portal area in cases of HCV infection?
Portal lymphoid follicle/aggregate.
p.119
Liver Tumors and Cancer
How does liver metastasis typically spread?
Through hematogenous spread, lymphatic spread, and/or peritoneal seeding.
What are common diseases affecting the biliary tree?
Cholecystitis, cholangitis, and biliary obstruction.
p.4
Child-Pugh Classification
What biochemical factors are used to subcategorize cirrhosis?
Serum bilirubin, INR, and creatinine.
p.65
Non-Alcoholic Fatty Liver Disease (NAFLD)
What are Mallory-Denk bodies?
Abnormal protein aggregates found in liver cells during steatohepatitis.
p.25
Hepatitis Types and Pathology
What are the characteristics of moderate to severe cellular damage in acute viral hepatitis?
Confluent necrosis, bridging necrosis, and pan-lobular necrosis.
p.18
Viral Hepatitis Overview
What has been the trend of acute viral hepatitis cases in Hong Kong from 1997 to 2015?
A decreasing trend from 600-750 cases/year (1997-2001) to 265 cases in 2015.
p.113
Liver Tumors and Cancer
What is a 'Central' or Klatskin tumor?
A tumor around the hepatic hilum, usually featuring biliary obstruction at an early stage.
p.18
Viral Hepatitis Overview
What is a characteristic of asymptomatic viral hepatitis infection?
It can be detected only through serologic evidence.
p.152
Liver Tumors and Cancer
What is a functional clinical feature of pancreatic carcinoma?
Diabetes mellitus (70%; may be the first manifestation).
p.43
Alcoholic Liver Disease
What are the potential effects of a BAC greater than 300 mg/dl?
Loss of consciousness, impaired breathing/heart rate, and potential fatality.
p.106
Liver Tumors and Cancer
What does tumor grade assess?
The degree of differentiation.
What is the primary function of the pancreas?
To produce digestive enzymes and hormones, including insulin.
p.43
Alcoholic Liver Disease
What symptoms are associated with a BAC of 200 - 299 mg/dl?
Confusion, nausea, and vomiting.
What are the symptoms of immune-mediated liver diseases?
Fatigue, jaundice, abdominal pain, and itching.
p.5
Child-Pugh Classification
What is the purpose of the Child-Pugh score?
To assess and monitor the severity of cirrhosis.
What type of cirrhosis can develop due to Alpha-1 Antitrypsin Deficiency?
Micronodular or mixed cirrhosis.
p.93
Liver Tumors and Cancer
What are the two main types of liver tumors?
Benign tumors and malignant tumors (cancer).
p.41
Alcoholic Liver Disease
What are some physical problems associated with excessive alcohol use?
Liver steatosis, alcoholic hepatitis, and alcoholic cirrhosis.
In which cells does iron accumulate in hereditary hemochromatosis?
Hepatocytes, bile duct epithelium, endothelium, and Kupffer cells.
p.24
Hepatitis Types and Pathology
What type of infiltrate is observed in acute viral hepatitis?
Inflammatory infiltrate, specifically lobular lymphocytic infiltrate.
What is recurrent pyogenic cholangitis also known as?
Oriental cholangiohepatitis.
What are the characteristic cholangiogram findings in primary sclerosing cholangitis?
Irregularity, stricture, or 'beads on a string' appearance of bile ducts.
p.24
Hepatitis Types and Pathology
What is the equation representing necroinflammatory activity in acute viral hepatitis?
Cellular damage (hepatocyte) + Inflammatory infiltrate = Necroinflammatory activity.
p.50
Alcoholic Liver Disease
What is a common initial condition of Alcoholic Liver Disease?
Steatosis or fatty liver.
p.47
Alcoholic Liver Disease
What are common symptoms of 'Asian Flush'?
Facial flushing, nausea, rapid heartbeat, and other discomforts after alcohol consumption.
p.63
Non-Alcoholic Fatty Liver Disease (NAFLD)
What are the two types of fibrosis associated with fatty liver disease?
Perivenular and pericellular (perisinusoidal) fibrosis.
p.79
Complications of Cirrhosis
What is the end-stage complication of hereditary hemochromatosis?
Cirrhosis (micronodular).
p.63
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is distinctive about the pattern of fibrosis in fatty liver disease?
It is not typically encountered in other chronic liver diseases.
p.90
Complications of Cirrhosis
What complications can arise from Primary Sclerosing Cholangitis?
Acute bacterial cholangitis and cholangiocarcinoma.
p.101
Liver Tumors and Cancer
What is a common local clinical feature of HCC?
Right upper quadrant abdominal mass.
What is Reye's Syndrome?
A potentially fatal mitochondrial dysfunction mainly involving the liver and brain.
How is biliary tree disease diagnosed?
Through imaging studies like ultrasound or MRI, and blood tests.
p.117
Liver Tumors and Cancer
What characterizes the architecture of cholangiocarcinoma?
Proliferation of tumor cells with glandular differentiation in a desmoplastic stroma.
p.110
Liver Tumors and Cancer
What does BCLC stand for?
Barcelona Clinic Liver Cancer.
p.124
Complications of Cirrhosis
What type of cancer can be associated with gallstones?
Carcinoma of the gallbladder.
p.140
Inflammation Overview
Is tissue damage present in chronic inflammation?
Yes, tissue damage is present.
p.66
Drug-Induced Liver Injury (DILI)
How can DILI be diagnosed?
Through liver function tests and patient history.
p.17
Viral Hepatitis Overview
Which virus is associated with immunocompromised patients and can cause hepatitis?
HIV, Cytomegalovirus (CMV), Epstein-Barr Virus (EBV), Herpes Simplex Virus (HSV), and Adenovirus.
p.52
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is Non-Alcoholic Fatty Liver Disease (NAFLD)?
A common metabolic liver disease worldwide.
p.15
Hepatitis Types and Pathology
What are the main causes of acute hepatitis?
Drug or toxin (50%), viral hepatitis (12%), unknown (18%).
What type of steatosis is observed in Wilson's Disease?
Mild steatosis (without zonal distribution).
p.43
Alcoholic Liver Disease
What are the effects of binge drinking related to BAC levels?
Impaired coordination, sensation, and judgment.
p.24
Hepatitis Types and Pathology
What are the characteristics of moderate to severe cellular damage in acute viral hepatitis?
Confluent necrosis, bridging necrosis, and pan-lobular necrosis.
p.37
Non-Alcoholic Fatty Liver Disease (NAFLD)
What are common risk factors for Non-Alcoholic Fatty Liver Disease?
Obesity, diabetes, high cholesterol, and metabolic syndrome.
p.118
Liver Tumors and Cancer
What type of stroma is associated with malignant glands?
Fibrosing sclerotic stroma.
p.115
Liver Tumors and Cancer
What are common risk factors for intrahepatic cholangiocarcinoma?
Chronic liver diseases, bile duct diseases, and certain infections.
p.60
Non-Alcoholic Fatty Liver Disease (NAFLD)
Is microvesicular steatosis commonly seen in fatty liver disease?
No, it is NOT (or rarely) seen in fatty liver disease.
What autoimmune diseases are associated with Primary Biliary Cholangitis?
Sjogren syndrome, scleroderma, rheumatoid arthritis, autoimmune thyroiditis.
p.115
Liver Tumors and Cancer
What are the symptoms of intrahepatic cholangiocarcinoma?
Symptoms may include jaundice, abdominal pain, and weight loss.
Which demographic is commonly affected by Primary Sclerosing Cholangitis?
Middle-aged men (M:F = 2:1).
p.49
Alcoholic Liver Disease
What enzyme is primarily involved in the oxidation of alcohol?
Alcohol dehydrogenase (ADH).
p.140
Inflammation Overview
What are the vascular events associated with acute inflammation?
Vasodilatation and increased permeability.
p.90
Complications of Cirrhosis
What are common symptoms of Primary Sclerosing Cholangitis?
Intermittent episodes of jaundice, pruritus, weight loss, and progression to cirrhosis and liver failure.
p.114
Liver Tumors and Cancer
How does non-biliary cirrhosis relate to cholangiocarcinoma?
It is a risk factor contributing to tumorigenesis.
What does the presence of prominent siderosis indicate?
Potential iron overload disorders.
What are the primary causes of alcoholic cirrhosis?
Chronic and excessive alcohol intake over a prolonged period.
p.59
Non-Alcoholic Fatty Liver Disease (NAFLD)
What can cause macrovesicular steatosis?
Factors such as obesity, diabetes, and excessive alcohol consumption.
What other condition is associated with primary sclerosing cholangitis?
Retroperitoneal fibrosis.
p.66
Drug-Induced Liver Injury (DILI)
What is the primary cause of DILI?
Adverse reactions to medications.
p.55
Non-Alcoholic Fatty Liver Disease (NAFLD)
What are the pathological features of Non-Alcoholic Fatty Liver Disease (NAFLD) compared to alcoholic liver disease?
They are almost indistinguishable, ranging from steatosis (NAFLD) and steatohepatitis (NASH) to cirrhosis.
p.103
Liver Tumors and Cancer
What is the relationship between cirrhosis and HCC?
Cirrhosis is a major risk factor for developing HCC.
p.123
Complications of Cirrhosis
What is biliary colic?
A type of pain associated with gallstones.
p.40
Alcoholic Liver Disease
What defines excessive alcohol intake for males?
>420 g/week or more than 8 standard drinks per day.
p.54
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is the formula for calculating Body Mass Index (BMI)?
BMI = Weight (kg) / Height (m) / Height (m)
In which age group should Aspirin never be given?
Children younger than 12 years old.
p.126
Inflammation Overview
What type of cells are involved in chronic inflammation?
Mononuclear cells (monocytes, macrophages, lymphocytes, plasma cells).
p.95
Liver Tumors and Cancer
What is one application of tumor markers?
To aid in diagnosis, although they seldom confirm diagnosis alone.
What condition is chronic pancreatitis associated with?
Pancreatic insufficiency.
p.18
Viral Hepatitis Overview
What is chronic hepatitis?
A long-term inflammation of the liver that may lead to cirrhosis.
How are immune-mediated liver diseases diagnosed?
Through blood tests, imaging studies, and liver biopsy.
p.104
Liver Tumors and Cancer
What is the significance of portal vein involvement in HCC?
It indicates advanced disease and can affect surgical eligibility.
p.114
Liver Tumors and Cancer
What is cholangiocarcinoma?
A type of cancer that forms in the bile ducts.
p.133
Liver Tumors and Cancer
What are common risk factors for gallbladder carcinoma?
Gallstones, obesity, and certain genetic conditions.
What is acute acalculous cholecystitis?
A form of cholecystitis found in patients suffering from trauma, burns, and major surgery without gallstones.
What is macro-nodular cirrhosis?
A type of liver cirrhosis characterized by large nodules on the liver surface.
p.46
Alcoholic Liver Disease
What is one way to alleviate hangover symptoms?
Rehydration with water or electrolyte solutions.
p.66
Drug-Induced Liver Injury (DILI)
What does DILI stand for?
Drug-Induced Liver Injury.
p.40
Alcoholic Liver Disease
What is considered significant alcohol intake for males?
>140 g/week or more than 2 standard drinks per day.
p.139
Complications of Cirrhosis
What is disseminated intravascular coagulation (DIC) in the context of acute pancreatitis?
A complication that can occur due to severe inflammation and bleeding.
p.57
Complications of Cirrhosis
What are common symptoms of alcoholic cirrhosis?
Fatigue, jaundice, swelling in the legs and abdomen, and easy bruising.
p.2
Complications of Cirrhosis
What is portal hypertension in the context of cirrhosis?
Increased blood pressure in the portal venous system due to obstruction of blood flow through the liver.
What is Clonorchis?
A genus of parasitic flatworms that can infect the liver and bile ducts.
p.15
Hepatitis Types and Pathology
What is fulminant hepatitis?
Severe acute hepatitis leading to liver failure within 8 weeks.
p.17
Viral Hepatitis Overview
What are the main hepatotropic viruses that cause viral hepatitis?
HAV, HBV, HCV, HDV, HEV, HGV, TTV, and SEN-V.
What are common causes of cirrhosis that can lead to HCC?
Chronic hepatitis B and C infections, alcohol abuse, and non-alcoholic fatty liver disease.
p.45
Alcoholic Liver Disease
What is the second major pathway for alcohol metabolism, especially at high concentrations?
The microsomal ethanol-oxidizing system (MEOS).
p.69
Drug-Induced Liver Injury (DILI)
What causes macrovesicular fatty change in the liver?
Ethanol, Methotrexate, Amiodarone.
p.43
Alcoholic Liver Disease
What effects are observed at a BAC of 80 - 199 mg/dl?
Euphoria, disinhibition, and impaired concentration.
p.17
Viral Hepatitis Overview
What is the Delta Agent (HDV) in relation to viral hepatitis?
It is one of the hepatotropic viruses that can cause viral hepatitis.
p.95
Liver Tumors and Cancer
How can tumor markers be used in treatment?
To predict or monitor response to treatment.
What is a characteristic pathological feature of Reye's Syndrome?
Extensive microvesicular steatosis (fatty change) in the liver.
p.41
Alcoholic Liver Disease
What cardiovascular diseases are linked to excessive alcohol use?
Cardiomyopathy, hypertension, and arrhythmia.
p.114
Liver Tumors and Cancer
What congenital biliary anomalies are associated with cholangiocarcinoma?
Fibrocystic liver disease and choledochal cyst.
What can lead to drug or toxin-induced cirrhosis?
Exposure to certain drugs or toxins.
p.117
Liver Tumors and Cancer
What is the nature of cholangiocarcinoma?
It is a malignant glandular neoplasm.
What is autoimmune hepatitis?
A chronic disease where the immune system attacks liver cells, causing inflammation and liver damage.
What are some metabolic causes of acute pancreatitis?
Alcoholism, hypertriglyceridemia, hypercalcemia, and certain drugs.
What is the primary intracellular accumulation in Wilson's Disease?
Copper/Copper-associated protein in hepatocytes.
What are common causes of macro-nodular cirrhosis?
Chronic hepatitis, alcohol abuse, and certain metabolic disorders.
p.112
Liver Tumors and Cancer
What type of epithelial component is associated with fetal development?
Fetal-type epithelial component.
p.66
Drug-Induced Liver Injury (DILI)
What are common symptoms of DILI?
Jaundice, fatigue, nausea, and abdominal pain.
What is non-alcoholic fatty liver disease (NAFLD)?
A condition where fat builds up in the liver without alcohol consumption, which can lead to cirrhosis.
p.117
Liver Tumors and Cancer
What are the cytological features of cholangiocarcinoma tumor cells?
Malignant cytology with nuclear enlargement, pleomorphism, hyperchromasia, increased nuclear/cytoplasmic ratio, and frequent mitosis.
What age group is most affected by recurrent pyogenic cholangitis?
Adults aged 30 - 40 years.
How does diabetes mellitus affect the risk of pancreatic carcinoma?
It increases the risk by 1.5 to 2 times.
p.57
Complications of Cirrhosis
What is the prognosis for individuals with alcoholic cirrhosis?
The prognosis can vary; early diagnosis and cessation of alcohol can improve outcomes, but advanced cirrhosis can be life-threatening.
What does 'i' often represent in mathematics?
'i' represents the imaginary unit, equal to the square root of -1.
What blood disorders can lead to secondary hemochromatosis?
Ineffective erythropoiesis, hemolysis, and sickle cell anemia.
p.69
Drug-Induced Liver Injury (DILI)
Which drugs are associated with centrilobular necrosis?
Paracetamol, Halothane, Rifampin.
What is the prevalence of Wilson Disease?
1 in 30,000; it is the commonest metabolic liver disease in Chinese.
p.17
Viral Hepatitis Overview
What is the role of transfusion-transmitted virus (TTV) in viral hepatitis?
It is one of the causative agents of viral hepatitis.
p.18
Viral Hepatitis Overview
What is fulminant hepatitis?
A severe form of hepatitis that can lead to rapid liver failure.
p.29
Hepatitis Types and Pathology
What is a notable finding in the liver of patients with Hepatitis C (HCV)?
Portal lymphoid follicle/aggregate.
p.95
Liver Tumors and Cancer
Can tumor markers be elevated in non-tumorous conditions?
Yes, they may be elevated in some non-tumorous benign or even physiological conditions.
p.40
Alcoholic Liver Disease
What does the 'E' in CAGE stand for?
Eye-opener drink in the morning.
p.4
Complications of Cirrhosis
What are some clinical features of decompensated cirrhosis?
Ascites, bleeding varices, and encephalopathy.
p.31
Hepatitis Types and Pathology
What does HBsAg stand for?
Hepatitis B surface antigen.
p.59
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is macrovesicular steatosis?
A condition characterized by the accumulation of large fat droplets in liver cells.
p.28
Hepatitis Types and Pathology
What is interface hepatitis?
A condition characterized by inflammation at the boundary between portal areas and hepatic parenchyma.
p.59
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is the primary feature of macrovesicular steatosis?
The presence of large lipid vacuoles in hepatocytes.
p.126
Inflammation Overview
What are the vascular events associated with acute inflammation?
Vasodilatation and increased permeability.
Where is recurrent pyogenic cholangitis endemic?
In Hong Kong and East Asia.
p.113
Liver Tumors and Cancer
What characterizes 'Peripheral' cholangiocarcinoma?
It is away from the hepatic hilum and usually clinically silent.
What pathological factor is associated with cirrhosis?
Fibrosis, such as collagen proportionate area (CPA).
p.155
Liver Tumors and Cancer
What type of neoplasm is pancreatic adenocarcinoma?
Malignant glandular neoplasm.
What radiological assessments are used for cirrhosis?
Fibroscan®, Fibrometer®, Cirrhometer® and portal hypertension (hepatic venous pressure gradient - HVPG).
p.108
Liver Tumors and Cancer
What is the AJCC/UICC TNM staging system used for?
To stage tumors based on Tumor, Lymph Node, and Distant Metastasis.
What does '1 m' typically represent?
1 meter, a unit of length in the metric system.
p.56
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is the appearance of marked steatosis?
Yellowish greasy appearance.
What is a potential complication of untreated biliary tree disease?
Cholangitis or liver damage.
p.28
Hepatitis Types and Pathology
What are the types of fibrosis associated with chronic viral hepatitis?
Portal/periportal fibrosis, bridging fibrosis, and cirrhosis.
p.18
Viral Hepatitis Overview
What is acute hepatitis?
A sudden onset of liver inflammation, often with symptoms.
What are common diseases associated with the pancreas?
Pancreatitis, pancreatic cancer, and diabetes.
p.49
Alcoholic Liver Disease
What role does the enzyme aldehyde dehydrogenase (ALDH) play in alcohol metabolism?
It converts acetaldehyde to acetate.
What does 's' commonly denote in physics?
's' often represents displacement or distance.
p.69
Drug-Induced Liver Injury (DILI)
What can lead to diffuse or massive necrosis in the liver?
Isoniazid, Paracetamol, Methyldopa, Amanita Phalloides (Mushroom).
p.111
Liver Tumors and Cancer
What is the 5-year survival rate for hepatoblastoma after treatment?
75% after improvement of neo-adjuvant chemotherapy and surgery.
p.93
Liver Tumors and Cancer
How are liver tumors typically diagnosed?
Through imaging tests like ultrasound, CT scans, or MRIs, and sometimes biopsy.
p.124
Complications of Cirrhosis
What is a potential life-threatening complication of gallstones?
Acute or chronic cholecystitis.
p.26
Inflammation Overview
What type of cellular infiltrate is characteristic of chronic inflammation?
Mononuclear cells (monocytes, macrophages, lymphocytes, plasma cells).
p.36
Complications of Cirrhosis
What is a pyogenic abscess?
A localized collection of pus caused by infection.
What is cirrhosis?
Advanced liver disease characterized by a diffuse process with nodulation of regenerative hepatocytes.
p.133
Liver Tumors and Cancer
What are the symptoms of gallbladder carcinoma?
Symptoms may include abdominal pain, jaundice, and weight loss.
p.28
Hepatitis Types and Pathology
What is ground-glass hepatocytes?
Hepatocytes with cytoplasmic inclusion of HBsAg.
What are regenerative nodules in cirrhosis?
Nodulation of regenerative hepatocytes separated by bridging fibrous septa.
p.36
Liver Tumors and Cancer
What is a hydatid cyst?
A cyst formed by the larval stage of the Echinococcus tapeworm, often found in the liver.
p.15
Hepatitis Types and Pathology
What are the possible outcomes of acute hepatitis?
Remit or progress to chronic hepatitis.
p.45
Alcoholic Liver Disease
What enzyme is primarily involved in the oxidation of alcohol?
Alcohol dehydrogenase (ADH).
p.69
Drug-Induced Liver Injury (DILI)
What are common causes of drug/toxin-induced liver injury?
Herbal medicine and 'health products'.
p.18
Viral Hepatitis Overview
What are the types of clinical presentations of viral hepatitis?
Asymptomatic infection, acute hepatitis, chronic hepatitis (± cirrhosis), and fulminant hepatitis.
p.61
Drug-Induced Liver Injury (DILI)
What is ballooning degeneration?
A form of cellular injury characterized by the swelling of cells.
p.123
Complications of Cirrhosis
Describe the pain associated with biliary colic.
Right upper quadrant dull constant pain, lasting for hours, precipitated by fatty meals, aggravated by breathing, with radiation to back or right shoulder.
p.49
Alcoholic Liver Disease
How does chronic alcohol consumption affect liver function?
It can lead to fatty liver, hepatitis, and cirrhosis.
p.96
Liver Tumors and Cancer
What is Carcino-embryonic antigen (CEA) used for?
It is another tumor marker.
p.126
Inflammation Overview
Is fibrosis a characteristic of acute inflammation?
No, fibrosis is not present.
p.30
Inflammation Overview
What type of cellular infiltrate is characteristic of chronic inflammation?
Mononuclear cells (monocytes, macrophages, lymphocytes, plasma cells).
p.109
Liver Tumors and Cancer
What does the AJCC TNM staging system assess?
Tumor extent and status of underlying liver disease.
p.126
Inflammation Overview
What is a key difference in cellular infiltrate between acute and chronic inflammation?
Acute inflammation has neutrophils, while chronic inflammation has mononuclear cells.
What are the symptoms of pancreatic disease?
Abdominal pain, weight loss, and digestive issues.
p.96
Liver Tumors and Cancer
What is CA19.9 used to monitor?
It is a tumor marker often associated with pancreatic cancer.
p.40
Alcoholic Liver Disease
What does the 'A' in CAGE stand for?
Annoyed by criticism of drinking.
Which genetic diseases are associated with chronic pancreatitis?
Cystic fibrosis, hereditary pancreatitis (mutation in PRSS1 or SPINK1 genes), hereditary hemochromatosis.
What is the defect in Wilson Disease?
Impaired biliary secretion of copper.
p.52
Non-Alcoholic Fatty Liver Disease (NAFLD)
How does NAFLD prevalence change for females after menopause?
It increases steadily after menopause.
p.32
Hepatitis Types and Pathology
What indicates the presence of hepatitis B surface antigen in hepatocytes?
Ground-glass hepatocytes.
p.28
Hepatitis Types and Pathology
What are sanded nuclei?
Intranuclear inclusions of HBcAg.
p.49
Alcoholic Liver Disease
What is the second major pathway for alcohol metabolism in the liver?
The microsomal ethanol-oxidizing system (MEOS).
What type of genetic disorder is Alpha-1 Antitrypsin Deficiency?
An autosomal recessive disorder.
p.114
Liver Tumors and Cancer
What was Thorotrast and its relevance to cholangiocarcinoma?
Thorotrast is thorium dioxide, a contrast medium used in diagnostic radiology before the 1950s, associated with increased risk of cholangiocarcinoma.
p.129
Inflammation Overview
Is fibrosis a characteristic of acute inflammation?
No, fibrosis is not present in acute inflammation.
p.30
Inflammation Overview
What is a key vascular event in acute inflammation?
Vasodilatation and increased permeability.
What happens to defective isoforms of Alpha-1 Antitrypsin?
They lead to retention of A1AT within hepatocytes.
p.96
Liver Tumors and Cancer
What does Prostatic specific antigen (PSA) indicate?
It is a marker for prostate cancer.
p.111
Liver Tumors and Cancer
At what age is hepatoblastoma usually presented?
Typically at 18 months, with over 90% diagnosed before 5 years old.
What are the sensitivity and specificity of elevated transferrin saturation?
Sensitivity 92%, Specificity 93%.
What does '9' represent in a numerical context?
It is a digit representing the quantity nine.
p.69
Drug-Induced Liver Injury (DILI)
What substances are linked to fibrosis and cirrhosis?
Ethanol, Methotrexate, Amiodarone.
p.94
Liver Tumors and Cancer
What is essential for the diagnosis of liver mass lesions?
Clinical, radiological, and pathological correlation.
p.13
Complications of Cirrhosis
What syndrome related to cirrhosis affects lung function?
Hepatopulmonary syndrome.
p.65
Non-Alcoholic Fatty Liver Disease (NAFLD)
What type of activity is observed in lobular necroinflammatory conditions?
Necroinflammatory activity.
p.124
Complications of Cirrhosis
What is gallstone ileus?
A condition where a gallstone obstructs the intestine.
p.40
Alcoholic Liver Disease
What is considered significant alcohol intake for females?
>70 g/week or more than 1 standard drink per day.
p.133
Liver Tumors and Cancer
What are the treatment options for gallbladder carcinoma?
Surgery, chemotherapy, and radiation therapy.
p.65
Non-Alcoholic Fatty Liver Disease (NAFLD)
What types of fibrosis can occur in steatohepatitis?
Perivenular/pericellular fibrosis, bridging fibrosis, and cirrhosis.
What is primary biliary cholangitis?
An autoimmune disease that slowly destroys the bile ducts in the liver.
What type of inclusion is associated with Alpha-1 Antitrypsin Deficiency?
Cytoplasmic globular inclusion (A1AT).
p.112
Liver Tumors and Cancer
What type of epithelial component is associated with embryonal development?
Embryonal epithelial component.
What are the two classifications of hemochromatosis?
Primary (hereditary hemochromatosis) and Secondary.
Which bacterium is known to cause tuberculosis that can affect the liver?
Mycobacterium tuberculosis.
p.103
Liver Tumors and Cancer
What is a key feature of HCC in cirrhotic patients?
It often presents at an advanced stage due to underlying liver disease.
p.140
Inflammation Overview
Is fibrosis a characteristic of acute inflammation?
No, fibrosis is not present.
What are some causes of long-standing pancreatic duct obstruction?
Gallstone, pancreatic pseudocyst, pancreatic neoplasm, congenital pancreatic malformation.
p.85
Complications of Cirrhosis
What are some neonatal presentations of Alpha-1 Antitrypsin Deficiency?
Jaundice and acute hepatitis (10-20%).
p.61
Drug-Induced Liver Injury (DILI)
What is a key histological feature of ballooning degeneration?
The presence of swollen hepatocytes with clear cytoplasm.
What is autoimmune pancreatitis also known as?
IgG4 sclerosing pancreatitis.
What is a major risk factor for pancreatic cancer?
Smoking and chronic pancreatitis.
p.109
Liver Tumors and Cancer
What does the CLIP system stand for?
Cancer of the Liver Italian Program.
p.100
Liver Tumors and Cancer
What does NAFLD/NASH stand for and its relation to hepatocellular carcinoma?
Non-Alcoholic Fatty Liver Disease/Non-Alcoholic Steatohepatitis; both are contributing factors.
p.29
Hepatitis Types and Pathology
What types of fibrosis can occur in chronic viral hepatitis?
Portal/periportal fibrosis, bridging fibrosis, and cirrhosis.
p.94
Liver Tumors and Cancer
What type of liver lesion is a Dysplastic Nodule (DN)?
A benign liver lesion that may progress to malignancy.
p.32
Hepatitis Types and Pathology
What type of fibrosis is associated with chronic viral hepatitis B?
Portal-based fibrosis, which can progress to bridging fibrosis and cirrhosis.
p.39
Alcoholic Liver Disease
What is the standard drink measurement in the Asian-Pacific region?
10 grams of pure ethanol.
How does alcoholic cirrhosis affect liver function?
It impairs the liver's ability to perform essential functions, including detoxification and protein synthesis.
p.8
Complications of Cirrhosis
What complications can arise from macro-nodular cirrhosis?
Portal hypertension, liver failure, and increased risk of liver cancer.
p.41
Alcoholic Liver Disease
What are some social problems linked to excessive alcohol use?
Accidents, especially road traffic accidents, and drug interactions.
Can genetic disorders cause cirrhosis?
Yes, certain genetic conditions like hemochromatosis can lead to liver damage and cirrhosis.
What is the significance of the nodules in macro-nodular cirrhosis?
The nodules indicate regenerative liver tissue but also disrupt normal liver architecture.
Is there a sex predilection for recurrent pyogenic cholangitis?
No, it affects males and females equally (M:F = 1:1).
What are the exocrine effects of pancreatic insufficiency?
Steatorrhea and malabsorption.
What type of genetic disorder is hereditary hemochromatosis?
Autosomal recessive disorder.
p.95
Liver Tumors and Cancer
What is another use of tumor markers?
To monitor recurrence or metastasis.
What is the previous name of Primary Biliary Cholangitis?
Primary Biliary Cirrhosis.
p.69
Drug-Induced Liver Injury (DILI)
Which drugs can cause acute and chronic hepatitis?
Methyldopa, Isoniazid, Nitrofurantoin, Phenytoin.
p.126
Inflammation Overview
Is edema a feature of chronic inflammation?
No, edema is not typically present.
What is a copper-associated protein?
A protein found in hepatocytes that is associated with copper metabolism.
p.29
Hepatitis Types and Pathology
What is interface hepatitis?
A condition characterized by inflammation at the boundary between portal areas and hepatic parenchyma.
p.81
Complications of Cirrhosis
What are some liver-related symptoms of Wilson Disease?
Chronic hepatitis, asymptomatic cases, and rarely acute liver failure.
p.69
Drug-Induced Liver Injury (DILI)
What can cause cholestasis with or without hepatocellular injury?
Oral Contraceptives, Anabolic Steroids, Erythromycin.
p.81
Complications of Cirrhosis
What eye symptoms are associated with Wilson Disease?
Kayser-Fleischer rings and 'sunflower' cataract.
What histological evidence is associated with Primary Biliary Cholangitis?
Nonsuppurative destructive cholangitis and destruction of interlobular bile ducts.
p.77
Complications of Cirrhosis
What cardiac issues can arise from hereditary hemochromatosis?
Arrhythmia and cardiomyopathy.
What is the bile duct involvement in PBC?
Intrahepatic small-sized bile ducts.
p.95
Liver Tumors and Cancer
What are tumor markers?
Substances produced by tumor cells in abnormal amounts in the blood, urine, or tissues of some patients with tumors.
p.106
Liver Tumors and Cancer
How is tumor grade defined?
By pathological examination only.
p.140
Inflammation Overview
What type of cells are involved in chronic inflammation?
Mononuclear cells (monocytes, macrophages, lymphocytes, plasma cells).
What nutritional factors are associated with pancreatic carcinoma?
Obesity, high fat diet, and low fiber intake.
What type of infectious agents can cause liver diseases?
Fungi, bacteria, and parasites.
What is pancreatitis?
Inflammation of the pancreas, which can be acute or chronic.
What does 'e' refer to in scientific contexts?
'e' is the base of the natural logarithm, approximately equal to 2.718.
p.95
Liver Tumors and Cancer
Are tumor markers highly sensitive or specific?
No, they are not highly sensitive nor highly specific.
Which demographic is most commonly affected by hereditary hemochromatosis?
Men, with a ratio of 5 to 7:1 compared to women.
p.29
Hepatitis Types and Pathology
What is the equation representing necroinflammatory activity in chronic viral hepatitis?
Cellular damage (hepatocyte) + Inflammatory infiltrate = Necroinflammatory activity.
What is the associated disease found in 70% of PSC patients?
Inflammatory Bowel Disease (IBD), particularly with Ulcerative Colitis (UC).
What type of genetic disorder is Wilson Disease?
Autosomal recessive disorder.
p.112
Liver Tumors and Cancer
What process is referred to as extramedullary hematopoiesis?
Hematopoiesis occurring outside the bone marrow.
p.45
Alcoholic Liver Disease
What can excessive alcohol consumption lead to in terms of liver health?
Cirrhosis and liver damage.
p.85
Complications of Cirrhosis
What liver-related complications can occur in children, adolescents, or adults with Alpha-1 Antitrypsin Deficiency?
Chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC) in 2-3% of cases.
p.93
Liver Tumors and Cancer
What are some risk factors for developing liver tumors?
Chronic hepatitis B or C infection, cirrhosis, and heavy alcohol use.
p.45
Alcoholic Liver Disease
What role does the enzyme aldehyde dehydrogenase (ALDH) play in alcohol metabolism?
It converts acetaldehyde to acetate, a less toxic substance.
p.126
Inflammation Overview
What is the role of fibrosis in chronic inflammation?
Fibrosis is a characteristic feature of chronic inflammation.
p.69
Drug-Induced Liver Injury (DILI)
Which drugs can cause granuloma formation in the liver?
Sulphonamides, Methyldopa, Quinidine, Hydralazine, Allopurinol.
p.72
Drug-Induced Liver Injury (DILI)
What should be considered when taking Paracetamol with alcohol?
The maximal therapeutic dosage should be less.
p.13
Complications of Cirrhosis
What are the swollen veins that can develop in the esophagus and rectum due to cirrhosis?
Varices (esophageal and rectal).
What viral illnesses are particularly associated with Reye's Syndrome when Aspirin is used?
Influenza and varicella (chickenpox).
p.66
Drug-Induced Liver Injury (DILI)
Which types of medications are commonly associated with DILI?
Antibiotics, anticonvulsants, and non-steroidal anti-inflammatory drugs (NSAIDs).
p.29
Hepatitis Types and Pathology
What type of cellular damage is associated with chronic viral hepatitis?
Apoptosis and spotty necrosis.
p.106
Liver Tumors and Cancer
What characterizes Grade 2 tumors?
Moderately-differentiated.
p.29
Hepatitis Types and Pathology
What is a characteristic feature of the inflammatory response in chronic viral hepatitis?
Portal chronic inflammatory infiltrate.
What is a potential complication of chronic pancreatitis?
Pancreatic insufficiency.
p.109
Liver Tumors and Cancer
What is the purpose of the CUPI system?
To provide prognostic information for HCC.
What is a key laboratory finding in Primary Biliary Cholangitis?
Elevated serum ALP (alkaline phosphatase).
p.40
Alcoholic Liver Disease
What does a 'Yes' response to 2 CAGE questions suggest?
Suggestive of alcohol dependence.
p.72
Drug-Induced Liver Injury (DILI)
What is the recommended dosage of Paracetamol for children?
60 - 90 mg/kg/day or 10 - 15 mg/kg Q4H.
p.97
Liver Tumors and Cancer
What is a significant association with Hepatocellular Adenoma?
Oral contraceptive pill (85-90%).
p.97
Liver Tumors and Cancer
What is the typical symptomatology of Hemangioma?
Asymptomatic and essentially complication-free.
p.100
Liver Tumors and Cancer
What is the risk increase for hepatocellular carcinoma associated with viral hepatitis C?
Significant, though specific multiplier not provided.
p.66
Drug-Induced Liver Injury (DILI)
What is the management strategy for DILI?
Discontinuation of the offending drug and supportive care.
p.52
Non-Alcoholic Fatty Liver Disease (NAFLD)
What is the prevalence of NAFLD in males compared to females?
Male: 36.8% vs. Female: 22.7%.
What does the ATP7B gene encode?
Hepatocyte canalicular membrane transmembrane copper-transporting ATPase.
What type of liver disease is Primary Biliary Cholangitis?
Chronic cholestatic liver disease.
What does '10' signify?
It represents the quantity ten.
p.29
Hepatitis Types and Pathology
What is the significance of ground-glass hepatocytes?
They are indicative of HBsAg cytoplasmic inclusion.
p.40
Alcoholic Liver Disease
What does a 'Yes' response to 3 CAGE questions confirm?
Confirms alcohol dependence.
p.94
Liver Tumors and Cancer
What is Focal Nodular Hyperplasia (FNH)?
A benign liver lesion characterized by a hyperplastic nodule.
p.94
Liver Tumors and Cancer
What is the significance of secondary liver tumors?
They are metastases from other primary cancers.
What types of fibrosis can occur in Wilson's Disease?
Portal/periportal, pericellular, bridging, leading to cirrhosis.
What types of liver diseases can contribute to hemochromatosis?
Chronic viral hepatitis, alcoholic liver disease, non-alcoholic steatohepatitis, Wilson disease, and porphyria cutanea tarda.
Which gene is associated with hereditary hemochromatosis?
HFE gene located on 6p22.2.
What are glycogenated nuclei?
Nuclei in periportal hepatocytes that contain glycogen.
p.95
Liver Tumors and Cancer
Can tumor markers be normal despite a large tumor?
Yes, they may not be elevated despite a huge tumor.
p.93
Liver Tumors and Cancer
What are common treatment options for liver tumors?
Surgery, liver transplantation, ablation therapies, and chemotherapy.
p.77
Complications of Cirrhosis
What are some common presentations of hereditary hemochromatosis?
Hepatomegaly, cirrhosis, HCC, bronze pigmentation, diabetes mellitus, arrhythmia, cardiomyopathy, and arthritis.
p.94
Liver Tumors and Cancer
What type of liver tumor is Cholangiocarcinoma (CC)?
A primary malignant tumor of the bile ducts.
What treatments are available for immune-mediated liver diseases?
Corticosteroids and immunosuppressive medications.
p.109
Liver Tumors and Cancer
What is the BCLC system used for?
Staging hepatocellular carcinoma (HCC).
p.100
Liver Tumors and Cancer
What is Aflatoxin B1 and how does it affect hepatocellular carcinoma risk?
A dietary toxin from Aspergillus flavus that increases risk 200 times when combined with HBV.
p.140
Inflammation Overview
What is hyperemia in the context of acute inflammation?
Increased blood flow, also referred to as congestion.
p.72
Drug-Induced Liver Injury (DILI)
What is Paracetamol commonly known as?
Acetaminophen, Panadol, or Tylenol.
What is mixed steatosis?
A condition characterized by the accumulation of fat in the liver, involving both macrovesicular and microvesicular steatosis.
What antibody is commonly positive in Primary Biliary Cholangitis?
Anti-mitochondrial antibody (AMA).
p.29
Hepatitis Types and Pathology
What does the presence of sanded nuclei indicate?
HBcAg intranuclear inclusion.
p.72
Drug-Induced Liver Injury (DILI)
What is a common reason for Paracetamol overdose?
Intentional or accidental overdose.
p.13
Complications of Cirrhosis
What serious infection can occur in patients with ascites?
Spontaneous bacterial peritonitis (SBP).
p.140
Inflammation Overview
What is a key feature of chronic inflammation regarding fibrosis?
Yes, fibrosis is present.
p.45
Alcoholic Liver Disease
How does alcohol affect the metabolism of other substances?
It can inhibit the metabolism of drugs and nutrients.
p.111
Liver Tumors and Cancer
What are the histological components of hepatoblastoma?
Epithelial component (fetal, embryonal, or mixed), ± mesenchymal component (including osteoid), ± teratoid component (e.g. skeletal muscle, cartilage), ± extramedullary hematopoiesis.
p.100
Liver Tumors and Cancer
How does alcohol consumption relate to hepatocellular carcinoma?
It is a contributing factor.
What are Mallory-Denk bodies?
Abnormal protein aggregates found in hepatocytes, often associated with liver disease.
How many of the key features must be present for a diagnosis of Primary Biliary Cholangitis?
Two out of the three features.
p.72
Drug-Induced Liver Injury (DILI)
What type of medical emergency can Paracetamol intoxication cause?
Irreversible fulminant hepatic failure.
p.94
Liver Tumors and Cancer
What is an Inflammatory Pseudotumor?
A non-neoplastic lesion that can mimic a tumor.
What is the mutation in hereditary hemochromatosis that leads to excessive iron absorption?
C282Y homozygote (0.4%) and H63D homozygote (2%) in North Europeans.
p.93
Liver Tumors and Cancer
What symptoms may indicate the presence of a liver tumor?
Unexplained weight loss, loss of appetite, abdominal pain, and jaundice.
p.81
Complications of Cirrhosis
What neurological symptoms can occur in Wilson Disease?
Parkinsonism, mild behavioral change, and frank psychosis.
p.94
Liver Tumors and Cancer
What is the primary malignant liver tumor in adults?
Hepatocellular Carcinoma (HCC).
What is the bile duct involvement in PSC?
Extrahepatic large-sized and intrahepatic large to small-sized bile ducts.
p.13
Complications of Cirrhosis
What type of cancer is associated with cirrhosis?
Hepatocellular carcinoma (HCC).
What does the hepatic iron index measure?
Liver iron concentration in umol divided by patient’s age.
p.94
Liver Tumors and Cancer
Name a benign liver lesion that is an epithelial tumor.
Hepatocellular Adenoma (HCA).
What is the mean age at onset for PSC?
Approximately 39 years (from childhood to elderly).
What is the ERCP/MRCP finding in PSC?
Irregularity, stricture, or 'beads on string'.
