What are examples of pathologies of the liver?
Intrahepatic bile duct obstruction
What is pathology of the gallbladder usually?
What is pathology of the extrahepatic bile ducts normally?
What 2 broad categories is liver failure a complication of?
Acute liver injury
Chronic liver disease (such as cirrhosis)
What are examples of acute liver injury?
Bile duct obstruction
What can cause hepatitis which causes acute liver injury?
Viruses such as hep A, B, C, E, other viruses
What is the pathology of virus hepatitis?
Inflammation of the liver
Liver cell damage and death of the individual liver cells
What are the possible outcomes of acute liver injury?
Resolution (liver function returns to normal)
Liver failure (if severe damage to the liver)
Progression to chronic hepatitis and cirrhosis
What hepatitis viruses can cause acute liver injury but then lead to resolution?
Hepatitis A and E
What hepatitis can cause acute liver injury and lead to liver failuer?
Hepatitis A, B and E
What hepatitis can cause acute liver injury and lead to chronic hepatitis?
Hepatitis B and C
What is alcohol liver disease?
Result of consuming too much alcohol, leading to build up of inflammation, fat and scar tissue
What is the pathology of alcoholic hepatitis?
Liver cell death
Progress to cirrhosis
What is alcoholic hepatitis?
Inflammation of the liver caused by drinking to much alcohol
What is jaundice caused by?
Increased circulating bilirubin due to altered metabolism of bilirubin
What are the 3 broad areas of the body involved in bilirubin metabolism?
Explain the pathway of bilirubin metabolism?
1) Breakdown of haemoglibin in spleen to form haem and globin (prehepatic)
2) Haem converted to bilirubin (prehepatic)
3) Release of bilirubin into circulation (prehepatic)
4) Uptake of bilirubin by hepatocytes (hepatic)
5) Conjugation of bilirubin in hepatocytes (hepatic)
6) Excretion of conjugated bilirubin into biliary system (hepatic)
7) Transport of conjugated bilirubin in biliary system (posthepatic)
8) Breakdown of bilirubin conjugate in intestine (posthepatic)
9) Reabsorption of bilirubin (posthepatic)
What are the 3 broad categories of causes of jaundice?
What are pre-hepatic causes of jaundice?
Increased release of haemoglobin from red cells (haemolysis)
What is the rupture or destruction of red blood cells called?
What are some causes of cholestasis?
Drugs (therpeutical, recreation, can be predictable so dose related or unpredictable so not dose related)
What are some
What are hepatic causes of jaundice?
Intra-hepatic bile duct obstruction
What is cholestasis?
Accumulation of bile within hepatocytes or bile canaliculi
What are causes of intra-hepatic bile duct obstruction?
Primary biliary cholangitis
Primary sclerosing cholangitis
Tumours of the liver
What kind of condition is primary biliary cholangitis?
How does the incidence of primary biliary cholangitis change between males and females?
Affects males to females 1:9 ratio
What is the pathology of primary biliary cholangitis?
Granulomatous inflammation involving bile ducts
Loss of intra-hepatic bile ducts
Progression to cirrhosis
What does PBC (primary biliary cholangitis) change in the blood?
Raises serum alkaline phosphatase
What does PBC stand for?
Primary biliary cholangitis