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Hepatitis B

•Parenteral, sexual and vertical transmission

•Acidophil (Councilman) body

•Ground glass hepatocytes

•Apoptosis

•Hepatocellular carcinoma

•ALT > AST

Hepatitis A

•Fecal-oral transmission

•Direct hyperbilirubinemia

•Incubation: 14 - 21 days

•ALT > AST

Hepatitis C

•Blood transfusion

•Proliferative glomerulonephritis

Reye’s Syndrome

•Young children

•Encephalopathy and coma

•Flu-like illness;

•Chicken pox and Influenza

•Aspirin ingestion

•Fatty Liver

Primary Billiary Cirrhosis

•Autoimmune

•Middle-aged women

•Antimitochondrial antibody

•Severe obstructive jaundice

Chronic Passive Congestion

•Right heart failure

•Nutmeg liver

Hepatic Adenoma

•Subcapsular and intraperitoneal hemorrhage

•Oral contraceptives

Hepatocellular Carcinoma

•Most common primary malignancy

•Hepatitis B, cirrhosis

•Aflatoxin B

•Alpha-fetoprotein marker

•Alcoholism

•Low serum albumin

•Increased PT, Ascites

•Wilson disease

Angiosarcoma

•Vinyl chloride

•Thorotrast

•Arsenic

Alcoholic Cirrhosis

•Mallory’s hyaline—cytokeratin filament

•Fatty liver changes

•Focal necrosis

Wilson’s Disease

•Autosomal recessive

•Kayser-Fleischer rings, cornea

•Hepatolenticular degeneration

•Copper accumulation, liver

•Low ceruloplasmin

•Chromosome 13, band q14.3

Hemochromatosis

•Iron absorption defect

•Cirrhosis

•Bronze diabetes

•Steatorrhea

•Skin pigmentation

α-1 Antitrypsin Deficiency

•Barrel-shaped chest

•RT ventricular hypertrophy

•Obstructive pattern

•Panacinar emphysema-lower lobe

•Cirrhosis

Chronic Pancreatitis

•40+ men

•Alcoholism

•Steatorrhea

•Epigastric pain

•High serum amylase and lipase

•Cystic fibrosis

Acute Pancreatitis

•Male

•Alcoholism

•Mid epigastric pain

•Increased Amylase, SGOT, LDH

•Hypocalcemia

•Gall stones

Cholangiocarcinoma

•Intrahepatic biliary epithelium

•Clonorchis sinensis

Diabetes Mellitus

•Type I=IDDM; Juvenile, weight loss, no insulin synthesis

•Type II=NIDDM, Adult, weight gain, insulin resistance

•Glycosylation of hemoglobin protein

•Kimmelstiel-Wilson nodule in kidney glomerulus

Pancreatic Adenocarcinoma

•Trousseau’s sign

•Painless jaundice

•Palpable gall bladder

•Hyper-coagulopathy

•Pruritus

•Increased bilirubin, dark urine

•Increased alkaline phosphatase

•Diabetes, and chronic pancreatitis

•Ki-ras oncogen

Gastrinoma

•Hypergastrinemia

•Zollinger-Ellison Syndrome