32 Questions
What is the normal range for hemoglobin concentration?
70-110 g/dL
Which type of necrosis involves a zonal loss of contiguous hepatocytes which begins in zone 3 near the central vein?
Confluent necrosis
What is the morphological feature of apoptosis characterized by hepatocyte shrinkage and nuclear chromatin condensation?
Pyknosis
Which cells are involved in laying down of collagen in the liver?
Stellate cells
What is the end point where fibrous septa encircle regenerative hepatocytes and give rise to diffuse scarring?
Cirrhosis
Which parameter reflects bile duct injury?
Alkaline phosphatase (ALP)
What is the hallmark of cholestasis?
Accumulation of green-brown plugs of bile pigment in hepatocytes
Which type of liver injury involves cell swelling, cytoplasmic clearing, and clumping of intermediate filaments?
Ballooning degeneration
What is the AST:ALT ratio in alcoholic liver disease?
Greater than 2:1
What is the parameter for hepatocellular pattern of injury?
ALT
What is the main learning objective related to histology of the liver?
Describing the microscopic structure and organization of the liver
Which aspect is included in the learning objectives related to liver injury and repair?
Recognizing major morphologic patterns seen in response to liver injury and repair
What is the primary function of aminotransferases like AST and ALT in liver function tests?
To evaluate hepatocyte integrity or injury
What is the significance of the AST:ALT ratio in liver function tests?
It can provide diagnostic indications, with high ratios suggesting alcoholic liver disease
What is the primary function of bilirubin metabolism in liver function tests?
The breakdown product of heme, with conjugated and unconjugated fractions indicating liver function and disease
What is the primary role of liver function tests in diagnosing liver diseases?
To detect liver diseases, distinguish between different types, gauge the extent of damage, and follow treatment response
What is the primary function of the hepatic acinus in the liver's structure?
Defines three zones based on blood flow
What is the primary function of the hepatic lobule in the liver's structure?
Is hexagonal, with the terminal hepatic vein at the center and the portal tracts at the periphery
What is the primary function of liver's histology?
Includes hepatic parenchyma with anastomosing sheets of hepatocytes, bile canaliculi, vascular sinusoids, Kupffer cells, and the perisinusoidal space containing stellate cells
What is the primary function of liver's dual blood supply?
Portal vein supplies 60 to 70% and hepatic artery supplies 30 to 40% of the blood flow to the liver
What is the primary function of liver's resistance to infarction?
Due to its dual blood supply
What is the primary function of liver's metabolic activities?
Include glucose and lipid metabolism
Which zone in the hepatic acinar model is closest to the blood supply?
Zone 1
What is the primary function of aminotransferases like AST and ALT?
Evaluate hepatocyte integrity or injury
Which blood vessel supplies 60-70% of the blood flow to the liver?
Portal vein
What does a high AST:ALT ratio suggest?
Alcoholic liver disease
Which component of liver histology contains stellate cells?
Perisinusoidal space
What is the primary function of liver function tests?
Detect liver diseases
Which parameter is used to evaluate ammonia detoxification in the liver?
Serum ammonia levels
Which zone in the hepatic acinar model is affected in yellow fever?
Zone 2
What is the primary function of the hepatic artery in liver blood supply?
Supplies 30-40% of the blood flow to the liver
What is the primary function of bilirubin metabolism in the liver?
Indicate liver function and disease
Study Notes
Liver Microscopic Structure and Function
- The normal adult liver weighs 1400-1600gm and has a dual blood supply, with the portal vein supplying 60 to 70% and the hepatic artery supplying 30 to 40% of the blood flow to the liver.
- The liver is structured into the classical hepatic lobule and the hepatic acinus. The lobular model is hexagonal, with the terminal hepatic vein at the center and the portal tracts at the periphery, while the acinar model defines three zones based on blood flow.
- The liver is resistant to infarction due to its dual blood supply, and in the acinar model, Zone 1 is closest to the blood supply, Zone 3 is farthest, and Zone 2 is affected in yellow fever.
- The liver's histology includes hepatic parenchyma with anastomosing sheets of hepatocytes, bile canaliculi, vascular sinusoids, Kupffer cells, and the perisinusoidal space containing stellate cells.
- Liver functions include metabolic (glucose and lipid metabolism), synthetic (albumin, coagulation proteins), storage (glycogen, triglycerides, vitamins), catabolic (ammonia detoxification), and excretory (bile excretion).
- Liver function tests, including biochemical, radiologic, and pathologic tests, are used to detect liver diseases, distinguish between different types, gauge the extent of damage, and follow treatment response.
- Basic liver function test parameters include total and conjugated bilirubin levels, AST/SGOT, ALT/SGPT, ALP, GGT, total albumin, glucose, PT, and serum ammonia levels.
- Aminotransferases, such as AST and ALT, are used to evaluate hepatocyte integrity or injury, with significant elevations indicating disorders like viral hepatitis, ischemic liver injury, or drug-mediated liver injury.
- The pattern of aminotransferase elevation, particularly the AST:ALT ratio, can provide diagnostic indications, with high ratios suggesting alcoholic liver disease.
- Bilirubin metabolism involves the breakdown product of heme, with conjugated and unconjugated fractions indicating liver function and disease, and bilirubinuria may be present in chronic hepatocellular disorders.
- The evaluation of liver function is crucial in diagnosing and managing liver diseases, and liver function tests are essential for assessing liver health and disease.
Test your knowledge of liver microscopic structure and function with this quiz! Explore the dual blood supply, hepatic lobular and acinar models, histological components, and the various functions of the liver. Learn about liver function tests and their significance in diagnosing liver diseases.
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