Alocoholic Liver Pathology and Pathophysiology for USMLE Step 1
21.3 هزار بار بازدید -
10 سال پیش
-
In this video we will
In this video we will be looking at liver pathology and pathophysiology related to alcohol.
Normal histology of Liver: The liver is hexagonal shape. At each corner there is the portal triad and central vein in the middle. It can be divided into three zones. outside is Zone 1 and the inner is Zone 3. Zone 1 has the highest blood flow and so generally viral hepatitis will affect cells in this area the most. Zone 3 has the lowest bloodflow and is affect during times of ischemia. Also it has a high number of CP450 and there acetominaphen affects this area as well as alcohol ingestion.
Serum Markers related to alcohol. AST (Aspartate transaminase) and ALT (Aspartate transaminase). ALT is more specific for the liver and AST is more specific. Viral hepatitis affects the liver and therefore it is ALT is elevated. In alcoholic AST is more elevated.
Steatosis: Initial effect of alcohol and is fairly reversible. Alcohol increases the amount of alcohol dehydrogenase and acetate dehydrogenase. This increases the amount of NADH in the cell and this causes shunting to lipid synthesis and decrease excretion of lipid in liver and decreases peripheral fat metabolism. There small alcohol consumption leads to microvsicles in hepatocytes and large amounts lead to macrovesicles. This pushes nucleus to periphery.
Hepatitis: Develops Mallory Body due to oxidative damage, malnutrition and some inflammation in the Liver.
Mallor bodies are formed due to acetaldehyde causes lipid peroxidation. This will cause damage to cytoskeleton and mallory bodies.
Oxidative damage causes increase Cp450 which increase ROS damage. increase damage if also taking acetominophen. Decrease methionine, decreases glutathione and increase oxidative damage. Malnutrition due to damage to GIT mucosa and formation of pancreatitis which makes it difficult to absorb fat soluble vitamins. Eventually get thiamine deficiency. Inflammation of the gut go to the liver via the portal tract. Accumulation of neutrophils lead to fibrosis.
Complications: Cirrhosis, Portal Hypertension, Hepatocellular Carcinoma, Infection, Hepatic Coma
Normal histology of Liver: The liver is hexagonal shape. At each corner there is the portal triad and central vein in the middle. It can be divided into three zones. outside is Zone 1 and the inner is Zone 3. Zone 1 has the highest blood flow and so generally viral hepatitis will affect cells in this area the most. Zone 3 has the lowest bloodflow and is affect during times of ischemia. Also it has a high number of CP450 and there acetominaphen affects this area as well as alcohol ingestion.
Serum Markers related to alcohol. AST (Aspartate transaminase) and ALT (Aspartate transaminase). ALT is more specific for the liver and AST is more specific. Viral hepatitis affects the liver and therefore it is ALT is elevated. In alcoholic AST is more elevated.
Steatosis: Initial effect of alcohol and is fairly reversible. Alcohol increases the amount of alcohol dehydrogenase and acetate dehydrogenase. This increases the amount of NADH in the cell and this causes shunting to lipid synthesis and decrease excretion of lipid in liver and decreases peripheral fat metabolism. There small alcohol consumption leads to microvsicles in hepatocytes and large amounts lead to macrovesicles. This pushes nucleus to periphery.
Hepatitis: Develops Mallory Body due to oxidative damage, malnutrition and some inflammation in the Liver.
Mallor bodies are formed due to acetaldehyde causes lipid peroxidation. This will cause damage to cytoskeleton and mallory bodies.
Oxidative damage causes increase Cp450 which increase ROS damage. increase damage if also taking acetominophen. Decrease methionine, decreases glutathione and increase oxidative damage. Malnutrition due to damage to GIT mucosa and formation of pancreatitis which makes it difficult to absorb fat soluble vitamins. Eventually get thiamine deficiency. Inflammation of the gut go to the liver via the portal tract. Accumulation of neutrophils lead to fibrosis.
Complications: Cirrhosis, Portal Hypertension, Hepatocellular Carcinoma, Infection, Hepatic Coma
10 سال پیش
در تاریخ 1393/05/04 منتشر شده
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