Liver and Biliary Pathology — Flashcards

Flashcard 1: The stain demonstrates reticular fibers of the liver and hence has to be _____ stain.

Answer: reticulin

Flashcard 2: aflatoxicosis is caused by _____

Answer: aspergillus flavus

Extra: 

Flashcard 3: _____ pigment gallstones (color) are radio-opaque and composed of calcium bilirubinate

Answer: Black

Flashcard 4: Strawberry gallbladder is seen in _____ and is associated with cholesterol stones.

Answer: cholesterolosis

Flashcard 5: Hepatocellular carcinoma is CK 7 _____ and CK 20 negative

Answer: negative

Flashcard 6: Risk factors for _____ carcinoma include aflatoxins derived from Aspergillus

Answer: hepatocellular

Flashcard 7: Pyogenic bacteria typically gain access to the liver through either a _____ or portal vein pyemia

Answer: biliary tract infection (ascending cholangitis)

Flashcard 8: _____ syndrome is characterized by micro-vesicular fatty change

Answer: Reye

Flashcard 9: _____ bodies in hepatocytes occur because of aggregation of intermediate filament cytokeratin 8 and 18

Answer: Mallory-denk

Flashcard 10: _____ syndrome is due to a deficiency of bilirubin canalicular transport protein

Answer: Dubin-Johnson

Flashcard 11: CCl3 free radical damage in the liver results in decreased apolipoprotein synthesis with resultant _____ change and centrilobular necrosis

Answer: fatty

Flashcard 12: _____ hepatitis is associated with inflammation that primarily involves the portal tracts

Answer: Chronic

Flashcard 13: Histological studies of hepatic adenoma show the following lack of _____ glands and kupffer cells

Answer: bile duct

Flashcard 14: Hepatic _____ is characterized by macro-vesicular fatty change

Answer: steatosis

Flashcard 15: _____ heart failure is associated with a characteristic 'nutmeg' appearance of the liver

Answer: Right

Flashcard 16: Cholangiocarcinoma may be seen in patients with hepatitis _____ and C

Answer: B

Flashcard 17: The fibrosis seen in cirrhosis is mediated by _____ from stellate (ito) cells

Answer: TGF-

Flashcard 18: Chronic vitamin _____ toxicity may cause hepatic toxicity and enlargement

Answer: A

Flashcard 19: _____ deficiency is characterized by pink/purple colored, PAS-positive globules in hepatocytes

Answer: 1-antitrypsin

Flashcard 20: _____ hepatitis is characterized histologically by mallory bodies, which are intracytoplasmic eosinophilic inclusions of damaged keratin (intermediate) filaments

Answer: Alcoholic

Flashcard 21: _____ autoantibodies are associated with autoimmune hepatitis type 1

Answer: Anti-smooth muscle

Flashcard 22: _____ is a helminth that causes biliary tract inflammation, resulting in pigmented gallstones and ultimately cholangiocarcinoma

Answer: Clonorchis sinensis

Flashcard 23: Bartonella henselae can cause _____, characterized by cystic blood-filled spaces in the hepatic parenchyma

Answer: bacillary peliosis

Flashcard 24: Hepatocyte necrosis is characterized by _____ swelling and cytoplasmic emptying ("ballooning degeneration")

Answer: cellular

Flashcard 25: Hepatic _____ are rare, benign tumors associated with OCP and anabolic steroid use; regress upon cessation of drug

Answer: adenomas

Flashcard 26: Cholangiocarcinoma is CK 7 _____ and CK 20 positive

Answer: positive

Flashcard 27: Cirrhosis is characterized by disruption of normal hepatic parenchyma by bands of _____ and regenerative nodules of hepatocytes

Answer: fibrosis

Flashcard 28: _____ cholangitis causes periductal fibrosis with an 'onion-skin' appearance histologically

Answer: Primary sclerosing

Flashcard 29: _____ is an autoimmune granulomatous destruction of intra-hepatic bile ducts

Answer: Primary biliary cholangitis

Flashcard 30: _____ rise is seen in many liver diseases but more than fourfold rise indicates cholestasis.

Answer: Alkaline phosphatase

Flashcard 31: Schistosoma _____ and japonicum can result in jaundice due to cirrhosis

Answer: mansoni

Flashcard 32: Histological imaging of hepatic adenoma shows cords of _____ containing excessive glycogen and fat

Answer: benign hepatocytes

Flashcard 33: Which two viruses can present with councilman bodies on liver biopsy?_____

Answer: HAV

Flashcard 34: Activation of _____ and inactivation of p53 are the two most common early mutational events in hepatocellular carcinoma

Answer: -catenin

Flashcard 35: Autosomal _____ PKD is associated with congenital hepatic fibrosis which may lead to portal hypertension

Answer: recessive

Flashcard 36: Idiopathic non-cirrhotic portal hypertension (INCPH) is a rare disease characterized by intrahepatic portal hypertension due to peri_____ and perisinusoidal fibrosis

Answer: portal

Flashcard 37: All affected individuals of _____PKD have some degree of congenital hepatic fibrosis.

Answer: AR

Flashcard 38: In growth factor phase of hepatocyte regeneration, _____ and TGF- act on primed hepatocytes to stimulate cell metabolism and entry into the cell cycle

Answer: HGF

Flashcard 39: _____ is associated with anti-mitochondrial antibody

Answer: Primary biliary cirrhosis (PBC)

Flashcard 40: _____ is a calcified gallbladder that results from chronic cholecystitis

Answer: Porcelain gallbladder

Flashcard 41: Alcoholic _____ is characterized by swelling of hepatocytes with necrosis and neutrophilic infiltration

Answer: hepatitis

Flashcard 42: Copper-associated proteins (eg: ceruloplasmin) are stained by _____ stain.

Answer: orcein

Flashcard 43: An incomplete septum that separates the hyperplastic from the normal layer of the gall bladder is seen in a condition called as _____

Answer: cholecystitis glandularis proliferans/adenomyomatosis

Flashcard 44: Cystic fibrosis with pancreatic insufficiency is associated with the development of _____ gallstones

Answer: pigmented

Flashcard 45: In the priming phase of hepatocyte regeneration, cytokines like IL - 6 are produced by the _____ cells and act on hepatocytes to make them sensitive to growth factor signals

Answer: Kupffer

Flashcard 46: Which form of cholangiocarcinoma is the most common?_____

Answer: Sclerosing

Flashcard 47: What is the primary mechanism of liver regeneration after hepatectomy?_____

Answer: Proliferation of residual hepatocytes

Flashcard 48: _____ is the commonest benign lesion found in the liver.

Answer: Hemangioma

Flashcard 49: Bacterial infections of the gallbladder causing acalculous cholecystitis include:_____

Answer: Leptospira, Streptococcus, Salmonella, Vibrio cholerae (4)

Flashcard 50: Rupture of RokitanskyAschoff sinuses leads to _____ cholecystitis

Answer: xanthogranulomatous

Flashcard 51: Budd-chiari syndrome will lead to _____nodular cirrhosis

Answer: micro

Flashcard 52: Low tumor stage in hepatoblastoma is associated with a _____ prognosis

Answer: good

Flashcard 53: Portal fibrosis is more prominent in _____

Answer: non-alcoholic steatohepatitis (ALD/NASH)

Flashcard 54: Bile duct proliferation is seen in _____ on liver biospy

Answer: EHBA (neonatal hepatitis/EHBA)

Flashcard 55: Which form of cholangiocarcinoma is associated with favourable outcomes?_____

Answer: Papillary

Flashcard 56: Rhabdoid features in hepatoblastoma is associated with a _____ prognosis

Answer: poor

Flashcard 57: A patient of Alagille syndrome will show _____ number of interlobular bile ducts on liver biopsy

Answer: reduced

Flashcard 58: Interface hepatitis and ductular reaction are a feature of _____ hepatitis

Answer: chronic (acute/chronic)

Flashcard 59: Fibrolamellar variant of hepatocellular carcinoma (HCC) is likely to be associated with elevated levels of _____

Answer: neurotensin

Flashcard 60: Inflammation is more prominent, with neutrophils in _____

Answer: alcoholic liver disease (ALD/NASH)

Flashcard 61: _____ is the most common malignant mesenchymal tumor of the liver.

Answer: Angiosarcoma

Flashcard 62: _____ variant of hepatocellular carcinoma is well circumscribed

Answer: Fibrolamellar (Classical/Fibrolamellar)

Flashcard 63: Ballooning degeneration is a feature of _____ hepatitis

Answer: acute (acute/chronic)

Flashcard 64: The most common site for cholangiocarcinoma is _____

Answer: confluence of the right and left hepatic ducts

Flashcard 65: Viral hepatitis will lead to _____nodular cirrhosis

Answer: macro

Flashcard 66: Primary biliary cirrhosis presents with _____ bodies

Answer: mallory-denk

Flashcard 67: _____ pattern is seen on trichrome staining of liver biopsy specimen in alcoholic hepatitis

Answer: Chicken-wire fence

Flashcard 68: "Ground glass hepatocytes" are a feature of chronic hepatitis _____

Answer: B

Flashcard 69: Steatosis of liver is NOT seen in Hepatitis _____ infection

Answer: B

Flashcard 70: Which precursor lesion of HCC is rarely associated with cirrhosis?_____

Answer: Hepatocellular adenoma

Flashcard 71: Piecemeal necrosis is a feature of _____ hepatitis

Answer: chronic (acute/chronic)

Flashcard 72: What is the common cause of death in epitheloid hemangioendothelioma?_____

Answer: Liver failure

Flashcard 73: _____ hepatic adenomas are associated with non-alcoholic fatty liver disease

Answer: Inflammatory

Flashcard 74: Loss of liver architecture is seen in _____ on liver biospy

Answer: neonatal hepatitis (neonatal hepatitis/EHBA)

Flashcard 75: _____ is derived from fetal or embryonic hepatocytic progenitors, and mesenchymal elements are often present

Answer: Hepatoblastoma (Liver tumor)

Flashcard 76: Hepatitis C genotype 3 is reported to cause periportal _____, most probably due to its association with metabolic syndrome and non-alcoholic fatty liver disease

Answer: steatosis

Flashcard 77: Confluent necrosis and "spotty necrosis" are a feature of _____ hepatitis

Answer: acute (acute/chronic)

Flashcard 78: Which precursor lesion of HCC is commonly associated with glycogen storage diseases?_____

Answer: Hepatocellular adenoma

Flashcard 79: Primary biliary cirrhosis presents with _____ which are lymphoplasmacytic infiltrate with/ without granulomas centred around bile duct.

Answer: Florid duct lesion

Flashcard 80: _____ is the most important risk factor for carcinoma gallbladder.

Answer: Cholelithiasis

Flashcard 81: Hepatocellular carcinoma (HCC) has a tendency to invade the _____.

Answer: portal vein (vessel)

Flashcard 82: Which form of cholangiocarcinoma is the usually intrahepatic?_____

Answer: Nodular

Flashcard 83: Cytokeratin _____ is an IHC commonly expressed in tumors of bile duct origin

Answer: 7

Flashcard 84: Perivenular and perisinusoidal fibrosis is more prominent in _____

Answer: alcoholic liver disease (ALD/NASH)

Flashcard 85: Proliferation of hepatocytes in regeneration starts with the _____ stage

Answer: priming

Flashcard 86: Laennec cirrhosis is the classic micronodular cirrhosis seen in end-stage _____

Answer: alcoholic liver disease

Flashcard 87: _____ variant of hepatocellular carcinoma is associated with low serum AFP levels

Answer: Fibrolamellar (Classical/Fibrolamellar)

Flashcard 88: Upto _____% of the hepatic adenomas may undergo malignant transformation to hepatocellular carcinoma.

Answer: 10

Flashcard 89: What is the primary mechanism of liver regeneration in liver injury or inflammation?_____

Answer: Proliferation of oval cells

Flashcard 90: Hereditary hemorrhagic telangectasia will lead to _____nodular cirrhosis

Answer: macro

Flashcard 91: _____ is the tumor marker of fibrolamellar variant of hepatocellular carcinoma (HCC).

Answer: Neurotensin

Flashcard 92: Small cell undifferentiated histology in hepatoblastoma is associated with a _____ prognosis

Answer: poor

Flashcard 93: In liver, pathologic steatosis is defined as involving more than _____% of hepatocytes

Answer: 5

Flashcard 94: Dilated sinusoids lined by atypical endothelial cells are classic findings observed on biopsy of _____ of liver

Answer: angiosarcoma

Flashcard 95: Which hepatic adenomas are associated with upregulation of CRP and SAA?_____

Answer: Inflammatory adenoma

Flashcard 96: Cirrhosis is more commonly seen in 90% of _____ HCCs

Answer: classical (fibrolamellar/classical)

Flashcard 97: _____vesicular fatty liver (steatosis) is seen in obesity

Answer: Macro

Flashcard 98: Tuberculous focus in the liver is also known as _____ focus

Answer: Simmond's

Flashcard 99: The gold standard for diagnosis of Wilson's disease is _____

Answer: liver biopsy

Flashcard 100: The stain demonstrates reticular fibers of the liver and hence has to be _____ stain.

Answer: reticulin

Flashcard 101: _____ hepatitis presents with positive ANA and increased serum IgG.

Answer: Autoimmune

Flashcard 102: Ground glass hepatocytes are characteristically seen in _____.

Answer: Hepatitis B

Flashcard 103: Liver biopsy in Reye's syndrome will show marked _____.

Answer: microvesicular steatosis

Flashcard 104: The best prognostic indicator in chronic hepatitis C infection is the _____.

Answer: liver biopsy