What is the blood supply of the liver? - ANSWER *dual blood supply* from hepatic artery
and portal vein
What is the common reaction pattern that occurs when the biliary system undergoes
dysfunction for any reason, causing buildup of bile and bile pigments? - ANSWER
cholestasis
What are some mechanisms that can cause cholestasis? - ANSWER decreased or
defective bile secretion
obstruction of bile channels, either intrahepatic or extrahepatic
What are symptoms of cholestasis? - ANSWER jaundice
pruritis
malabsorption (particularly fat soluble vitamins)
What is the pathogenesis of cholestasis? - ANSWER canaliculi expand with accumulate
bile--> excess bile/bile pigments will collect within and expand hepatocytes-->
hepatocytes undergo apoptosis
Microscopically, cholestasis will be evident early on as what? - ANSWER
green-brown-gold plugs of bile within bile canalicular, hepatocytes, and Kupffer cells
Longer standing cholestasis can develop what as bile accumulates and this will cause
the ductal cells to do what? - ANSWER develop bile plugs that will incite ductal cells to
undergo *hyperplasia* and create more of itself
What is the term for large stones/lithiases in the large extra hepatic bile ducts? -
ANSWER choledocholithiasis
, What can be a malignant obstruction of the common bile duct? - ANSWER
cholangiocarcinoma of the large extra hepatic ducts OR
pancreatic adenocarcinoma (MOST COMMON)
What is the term for the autoimmune large duct obstructive process? - ANSWER primary
slcerosing cholangitis
How does ascending cholangitis occur? - ANSWER when bacterial overgrowth
complicates the obstruction, with the somewhat stopped luminal fluid allowing for
abundant bacterial growth
What can ascending cholangitis evolve further into? - ANSWER suppurative cholangitis
(extensive pus)--> liver abscess or small bile induced necrosis
What becomes a big problem once suppuration from ascending cholangitis occurs? -
ANSWER SEPSIS
What can happen with chronic bile duct obstruction? - ANSWER on-going upstream
inflammation--> bile duct hyperplasia and ductal luminal expansion--> biliary induced
cirrhosis
What is the most common cause of neonatal jaundice and cholestasis? - ANSWER Biliary
atresia
What is biliary atresia? - ANSWER when there is partial or complete biliary obstruction
at any level or location of the biliary tree
How can biliary atresia occur? - ANSWER if biliary tree didn't develop correctly in-utero
OR
normal biliary tree for some unknown reason undergoes destruction during infancy
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