Liver Abscess: Anatomy, Physiology, and Biliary Circulation Quiz and Flashcards

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Questions and Answers

What is the unique feature of the circulation of blood through the intestines and liver in human anatomy?

Blood from the liver flows directly into the intestines

Blood from the hepatic capillary system flows into the intestinal capillary system

Blood from the heart flows directly into the liver

Blood from the intestinal capillary system flows into the hepatic capillary system (correct)

Which of the following is NOT a function of the liver?

Synthesis of albumin

Catabolism of hormones

Production of bile acids (correct)

Storage of glycogen

What is the term for the reabsorption of hormones and other serum proteins by the liver?

Enterohepatic circulation

Gluconeogenesis

Glycogenolysis

Catabolism (correct)

Which of the following is a common consequence of liver disease?

Toxic accumulations of metabolic waste Signup and view all the answers

What is the final endpoint of many liver diseases?

Cirrhosis Signup and view all the answers

Which of the following is a common complication of cirrhosis?

Portal hypertension Signup and view all the answers

What is the term for the inflammation of the liver?

Hepatitis Signup and view all the answers

Which of the following is a characteristic of steatohepatitis?

Fibrosis and inflammation Signup and view all the answers

What is the term for the degeneration of liver cells, characterized by swelling and fatty infiltration?

Ballooning degeneration Signup and view all the answers

Which of the following is a common metabolic consequence of liver disease?

Edema due to albumin deficiency Signup and view all the answers

What is the most common type of viral hepatitis in the world?

HAV Signup and view all the answers

What is the primary mode of transmission of HAV?

Fecal-oral transmission Signup and view all the answers

What is the most common cause of chronic liver disease?

HCV Signup and view all the answers

What is the approximate number of new cases of HCV per year in the US?

40,000 Signup and view all the answers

What is the main reason for the difficulty in developing a vaccine for HCV?

Mutating RNA virus Signup and view all the answers

What is the primary mode of transmission of HDV?

Co-infection with HBV Signup and view all the answers

What is the characteristic of autoimmune hepatitis?

High titers of autoantibodies Signup and view all the answers

What is the most common cause of liver abscess in industrialized nations?

Bacteria Signup and view all the answers

What is the approximate percentage of HBV patients who develop chronic viral hepatitis?

10% Signup and view all the answers

What is the characteristic of fulminant hepatitis or hepatic failure?

Extensive necrosis Signup and view all the answers

What is the primary function of albumin in maintaining body fluid balance?

Preventing edema by maintaining oncotic pressure Signup and view all the answers

Which of the following liver function tests is most specific to liver damage?

Alanine aminotransferase (ALT) Signup and view all the answers

What is the characteristic feature of cirrhosis?

Patterned fibrosis with interconnecting bands of scar tissue Signup and view all the answers

Which of the following viruses is associated with acute and mild hepatitis?

HAV Signup and view all the answers

What is the consequence of obstruction of the extrahepatic bile ducts?

Cholestasis and jaundice Signup and view all the answers

What is the primary cause of ascites in liver disease?

Portal hypertension Signup and view all the answers

What is the characteristic laboratory finding in hepatic failure?

All of the above Signup and view all the answers

What is the significance of gamma-glutamyl transferase (GGT) in liver function tests?

Indicates bile duct obstruction Signup and view all the answers

What is the consequence of repeated episodes of liver cell necrosis and regeneration?

Cirrhosis Signup and view all the answers

What is the primary mechanism of liver damage in autoimmune hepatitis?

Autoimmune antibodies Signup and view all the answers

What is the minimum amount of daily alcohol consumption required to produce cirrhosis in approximately 10-16 years?

200gms Signup and view all the answers

What is the term for the accumulation of fat in liver cells, often seen as the first sign of alcohol liver injury?

Steatosis Signup and view all the answers

What is the primary mechanism of hemochromatosis?

Abnormal absorption of iron from the intestine Signup and view all the answers

What is the term for the autoimmune disease characterized by inflammatory destruction of intrahepatic bile ducts?

Primary biliary cirrhosis Signup and view all the answers

What is the most common neoplasm in the liver?

Metastatic carcinoma Signup and view all the answers

What is the term for the obstruction of the hepatic vein as it flows out of the liver?

Hepatic vein thrombosis Signup and view all the answers

What is the term for the presence of gallstones in the gallbladder or biliary tree?

Cholelithiasis Signup and view all the answers

What is the most common major complication of gallstones?

Cholecystitis Signup and view all the answers

What is the term for the type of gallstones that are composed of bilirubin and calcium salts?

Pigment gallstones Signup and view all the answers

What is the term for the autoimmune disease characterized by the accumulation of copper in the brain and liver?

Wilson disease Signup and view all the answers

Study Notes

Liver Anatomy and Function

Unique circulation of blood through the intestines and liver (enterohepatic circulation)
Liver has a functional reserve that must suffer a large loss before becoming symptomatic
Liver function tests (LFTs) measure enzymes (e.g., LDH, AST, ALT, ALKP, bilirubin) to assess liver function

Liver Diseases

Chronic liver disease can lead to toxic accumulations of metabolic waste (e.g., ammonia, bilirubin), bleeding, edema, and failure to absorb intestinal fat
Viral hepatitis (HAV, HBV, HCV, HDV, HEV) can cause acute and chronic hepatitis, cirrhosis, and liver cancer
Autoimmune hepatitis is a chronic liver disease not associated with viral infection
Liver abscess is a focal collection of necrotic tissue, inflammatory debris, and fluid

Hepatitis A (HAV)

Primarily fecal-oral transmission
Benign and self-limiting
Incubation period is about 2-6 weeks
Most common type of hepatitis worldwide
Fatalities are rare
No carrier state
Vaccine is available

Hepatitis B (HBV)

Detector by presence of HBsAg
Viremia may last for many weeks
1st antibody to appear is anti-HBc
Beginning of recovery marked by appearance of anti-HBs, which confers immunity
Transmitted through blood, saliva, semen, and vertically from mother to child
Vaccine is available

Hepatitis C (HCV)

Major cause of chronic liver disease
Incubation period varies from a few weeks to 6 months
About 40,000 new cases per year
About 2% have antibodies indicating previous infection
Transmission is primarily through IV drug abuse, sexual contact, and infected healthcare workers
Mutating RNA virus, making vaccine development difficult

Hepatitis D (HDV)

Co-infects with HBV
Mostly in IV drug abusers and hemophiliacs
Delta virus

Hepatitis E (HEV)

Rare in the US but most common form of epidemic hepatitis in India
Transmitted like HAV
Mild and self-limiting

Pathology of Hepatitis

Carrier state: liver biopsy normal, usually
Acute hepatitis: hydropic degeneration, chronic inflammation, necrosis of individual cells
Fulminant hepatitis or hepatic failure: extensive necrosis
Chronic hepatitis: more severe damage, disorganized, intense inflammatory reaction, more extensive necrosis, scar tissue

Cirrhosis

Final, common endstage for various chronic liver diseases
Patterned fibrosis characterized by interconnecting bands of scar tissue, dividing the liver into small nodules separated by dense fibrous tissue
Progressive, irreversible, and incurable, usually due to alcoholic liver disease, chronic viral hepatitis, or chronic disease of the biliary tree

Alcoholic Liver Disease

Amount necessary to produce cirrhosis: about 200gms/day for 10-16 years
Sequence of damage: fatty liver, alcoholic hepatitis, cirrhosis, and steatohepatitis/alcoholic hepatitis
Severe damage if: abnormal clotting tests, low albumin, signs of hepatic failure

Other Liver Diseases

Hemochromatosis: toxic accumulation of iron in cells, especially the liver, heart, and pancreas
Wilson disease: autosomal recessive disorder, toxic accumulation of copper mainly in the brain and liver
Primary biliary cirrhosis: autoimmune disease, inflammatory destruction of intrahepatic bile ducts
Hepatocellular carcinoma: usually related to HBV and HCV, high levels of alpha-fetoprotein, grim prognosis
Metastatic carcinoma: most common neoplasm in the liver, usually from colon, lung, or breast

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Description

Test your knowledge on the liver and biliary tract, including the unique circulation of blood through the intestines and liver, and the liver's functions in glucose homeostasis, hormone catabolism, and protein reabsorption. This quiz covers key concepts in liver physiology and pathology.

Diseases of the Liver and Biliary Tract: Enterohepatic Circulation

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