Download Pathology of Liver Failure and more Study notes Pathology in PDF only on Docsity!

E-PR

# General^ Info^

alot lives

1. weight^

• 1400 to^1600 gm

   112kg ≈ 

2. (^) Blood (^) supply →^ Postal^

vein =^ GO^ to^ 70%

Hepatic art. =^30 to (^) 40% ◦ Anatomy (^) of diner (^) Lobule model connective tissue bubs (^) ← ¥ÉÉ¥¥¥i¥☒→ central^ mien tnterlobular ruin (^) a ← Egg hepatic win) go o mi :::: ]→*.. """ H¥¥p¥i¥÷:ᵗᵈjE "

Feom (^) portal ruin

I puffer cells

B. duty Hepatocytes unsaid É÷g.p.ve¥¥%E J HA.^ I^ { pace of Disse

endothelial stellate^ I,

uh (^) + , cells space bin^ hepatocyte^

Fat. containing sinusoidal tinning

Celts win^ space

endothelial cells

of Iisse

.sn#!Thiouitk ☒☒☒ ¥i¥÷É¥¥☒*÷w " Y,^ hepatitis^ >^ Canal (^) of cholangiocyte (^) Hering

• Bile^ Flow^ → Bile canaliculi

Duduk ← ⑨ canal^ of Hering ! Hepatocyte cells ↓ Brite ductile ± Tntoelobulwe bite^ duct

☒ EEE^ #☒HUMM^

• E- ¥ # Alky → Iuiured /^ dysfunctional hepatocyte ↓ Res pongee C Reversible^ changed steatosis ←

, → Buttoning of hepatocyte

Cfut deposit)^ lcholestasis

C. Bilirubin It, deposited HALLMARK OF ① (^) Alcohol induced/ Non - alcohol (^) induced ✗ → (^) Irreversible teatohepatitu Lyiwry ↓ Hepatocytes

• die →^

Neurosis

§ → Apoptosis In (^) imbalance in necrosis (^) → AT^ the flaw into hepatocyte ◦ → ↓ This (^) swells (^) - H2O

im ; ↓^

ruptures

↑↑ Intracellular Cat

Burst +

+↑ mitochondrial

dysfunct

Now (^) ; stimuli^ for stellate cell^ activate^ is ① TNF^ -^ a^ - produced by buffer^

cells

macrophages

② Altered interact e-

extracellular matrix^ [^ Eeñ ③ Toxins^ → Reactive

oxygen species^

[Ros]

These activates^ PDUF ,^ Ta^ F- P

& IL- 17 , chemokines Released from keiffer^ cells (^) ,^ other^ monsoons which (^) transmits'"aignd to stellate

• cells which (^) in turn release _uaso active GF factors www.ne/,chemotauhteadinglo-persistence of iuiwy & (^) inflammatory conch

In turn leading to ECM^ deposition ⑨ (^) Spate of Disse^

• toss^ of sinusoidal endothelium I^2 IN^ CA , PILLARIZA^ -110N

Sinusoidal (^) Capili urination is a HALLMARK of

→ NON

• ALCOHOLIC

STEATOHEPATITEE

1 HEPATIC CARCINOMA t, ① toss^ of vascular (^) compromise ② Teansfoun into dense^ fibrous^ Septa This fibrous Hepler encircles surviving hepatocyte & give rise to diffuse

• earring i. (^) e. chief

zedo.fm#yiwy&cwefarmatw is interrupted^ by G- : (^) ① clearance of hepatitis virus ② Cessation^ of alcohol use

stellate cell activate^

_^ stopped &

earring

is

stopped

fibrous septet % (^) broken byMETAuoPRoTEINAS5#

① liver^ transaminases^ are (^) elevated

↓ hepatocyte

smelling

Enlarged him → inflammatory infiltrate

Edema

221 £ (^) II parenchyma dies & (^) liver shrinks ↓

Serum Teams^ aiuiuase

←→

Decrease Elevated^ as^

it ↓ was R^ ↓ :b

sign of ingrown

hepatocyte die

(^) Other (^) main

esfesfatiaws

① Cheek^ stasis^ -^ Bilirubin^ retention due to alteration^ in^ bite formation & (^) flaw. I tending

to

yellows

skin^ → Jaundice sclera →^

icterus

Asterixis is a clinical sign that describes the inability to maintain sustained posture with subsequent brief, shock-like, involuntary movements Grade-> Cerebral edema incidence I- Behariar changes, altered sleep-tale gude farely I-@asterixis, lethargy, disorientation farely Ill - more severe 25-25% IV - CoMa 65-75% ② Hepatic Enchaehalopabhy

& (^) pectaumofdistwrbunuocc-i.ir

1. Consciousness μ fiction behavioral abnormality bᵈ% D (^) iinfusim a) ii. coma I

5) Death

Symptoms can oceans^

① Rigidity

Hyperrefused

a

Asterisms

t.

No☒^ -

rhythmic ,^ eapidenteusth

flexion movement of head + extremities ;^ when arm is^ -^ extended^ + dorsi flexd wrists

COAGULOPATHY ÷

2+5--7 ; 9.10.^

21h

All

are defiant " . Leading to ① (^) Easy bruiseability

② Intracranial^

bleeding

(^) Portal

hypertension

• More^ commonly

in (^) chronic Intra (^) hep §tic^

obstruction

tower failure

I can lead^ to^ Ascites

(^) tlepulo

renal (^) syndrome - Renal failure^ occurring in (^) pt

. (^) with

liver failure

c- No

fun ctl (^) cause (^) of kidney (^) dysfuutn _

Splanchnic circulation is composed of gastric,small intestine,colonic,pancreatic, hepatic splenic circulation arranged in parallel with one another symptoms ÷^ ① 4 Urine output

② ↑ Urea + Creatinine

③ Farted^ hypertension

⑥ with * vasodilators^ 6% by endothelial^ cells in ←splanchnic^ vasculature ↓ Thus 4 Renal^ output ↓ Renal

perfusion

• +^ UFR tending to Renal^ failure

(^) Pts (^) develops heputo

renal (^) syndrome

also have portal hypertext due^

to ←

Shure Metastatic

§ Cirrhosis^

Alcoholic Tumor

scarring (^) of him Hepatitis

tissues

i. e.^ Fibrosis^ of^ lines tissue

Regenerative →

Nodules

Microscopically

• Mousson trichome stain ↓ To stain^ thick fibrous bands of collagen around cirrhotic nochilli

40% individuals^ →^ Asymptomatic for & times^ chieosis lien. Symptoms ① Anorexia

② Weight

loss ③ Weakness causes (^) of Death ① Haepatio encephalopathy ② Bleeding from esophageal^ varies ③ Bacterial (^) infections ⑨ tlaepato

cellular carcinoma

⑤Jon

dice +

encephalopathy

• co^

• agile

path✓

acute liver^ failure

of (^) xp

(^) CAUSE

of Resistance (^) El (^) sinusoids ① (^) Contract of

muscular smooth muscles

② & cursing

• Formation^ of nodule in

liver

parenchyma ③ (^) It, No C^ Nitric^ oxide] + ↑↑ Endothelin I

Auyiotousiogent Eicosanoids ↑ ↑

Release ↑^ A^ Naso^ constriction

⑥ sinusoidal^ remodelling

anastomoses ↑ ↑^ portal hypertension ⑤

✗☒ Portal^ venous blood

flaws ioduelo hyperdynamic circulation

Due to^ **^ splanchnic arterial^ blood^ flow

leading

to increase^ venous^ efflux

☒ ☒^ No = vasodilation

170*1#

¥q☒e

#$#☒ F

1. (^) Hepatic (^) encephalopathy
2. Ascites
3. Format^ of^ porto

systemic venous

shunt

Congestive splenomegaly

¥ #SEE

#& - Ibid accumulation

3. Peritoneal^ cavity 88 %^ caused^ by chi (^) irons

Fluid accumulate^ >^ so◦^ ml -^ detectable If It's serous (^) fluid

• <3 gmldl protein denim : as #to^

1. I^ gmldl Alb.

• (^) Mesothelial cells^ +^ Mononuclear leukocytes

Neutrophil presence suggests (^) infection ◦ RBC presence intra abdominal cancer