内容教案讲稿digestive d

2023/1/1012023/1/10Pathology-DH22023/1/10342023/1/10Pathology-DH2023/1/1052023/1/10Pathology-DH62023/1/1072023/1/1089EsophagitisGastritisPepticulcerTumorsofdigestivetractViralhepatitisCirrhosisHepatocellularcarcinomaPathology-DH2023/1/1010EsophagitisGastritisPepticulcerTumorsofdigestivetractViralhepatitisCirrhosisHepatocellularcarcinomaPathology-DH2023/1/10Pathology-DH11Inflammationofthelivercausedby“hepatitisviruses”HepatitisA,hepatitisB,hepatitisC,hepatitisD,hepatitisE,hepatitisGAlterativeinflammationViralhepatitis2023/1/10GeneralresponsestohepaticinjuryDegenerationandintracellularaccumulationNecrosisandapoptosisInflammationRegenerationFibrosisballooningdegenerationfeatherydegenerationsteatosisfocalorspottynecrosispiecemealnecrosisbridgingnecrosissubmassive/massivenecrosisabscessesPathology-DH122023/1/10Pathology-DH132023/1/1014Pathology-DH2023/1/10Pathology-DH152023/1/10Pathology-DH162023/1/10Pathology-DH172023/1/10HAVHBVHCVHDVHEVHGVAgentUnenvelopedssRNA27nmEnvelopeddsRNA42nmEnvelopedssRNA30～60nmenvelopedssRNA35nmunenvelopedssRNA32～34nmenvelopedssRNATransmissionFecal-oralBloodborne/closecontactBloodborne/closecontactBloodborne/closecontactFecal-oralBloodborneIncubationperiod

2～6

weeks4～26

weeks2～26

weeks4～7

weeks2～8

weeksunknownEtiologyandpathogenesisPathology-DH182023/1/10HAVHBVHCVHDVHEVHGVCarrierstatenoneyesyesDrugaddictsandhemophiliacsunknownbloodtransfusionsordialysisChronichepatitisnone5%～10%>50%<5%coinfection>80%superinfectionNoneNoneFulminant

hepatitis0.1%～0.4%<1%rare3%～4%incoinfection0.3%～3%;20%inpregnantwomennoneHepatocellularcarcinomaNoYesYesNoincreaseaboveHBVNoNoEtiologyandpathogenesisPathology-DH192023/1/10ClinicalsyndromesandpathologicalchangesCarrierstateAsymptomaticinfectionAcutehepatitisFulminanthepatitisChronichepatitisPathology-DH202023/1/103.AcutehepatitisFourphases:AnincubationperiodAsymptomaticpreictericphaseAsymptomaticphasewithjaundiceandscleralicterusConvalescencePathology-DH212023/1/103.AcutehepatitisMorphologicfeatures:Enlarged,reddenedliver,greenishifcholestaticCellswellingApoptosisandnecrosisInflammationKupffercellshypertrophyandhyperplasiaCholestaticPathology-DH222023/1/10Pathology-DH232023/1/104.FulminanthepatitisMorphologicfeatures:Shrink,muddyred,blotchybilestainingSubacute----bridgingnecrosisAcute----submassive/massivenecrosisPathology-DH242023/1/1025Pathology-DH2023/1/10Pathology-DH262023/1/10Pathology-DH272023/1/10Pathology-DH282023/1/105.ChronichepatitisGPortal/periportalinflammationLobularinflammationSFibrosis0nonenone0none1PortalinflammationDegeneration/focalnecrosis1Portaldeposition2MildPNDegeneration/focalnecrosis/apoptosis2Portalandperiportaldeposition3ModeratePNSeverdegeneration/necrosis/BN3Formationofbridgingfibroussepta4SeverePNSevereBN/submassivenecrosis4CirrhosisPN:piecemealnecrosis;BN:bridgingnecrosisPathology-DH292023/1/102023/1/1030Pathology-DH2023/1/1031Pathology-DHPathology-DH322023/1/10AutoimmunehepatitisCharacters:FemalepredominanceTheabsenceofserologicmarkersofaviraletiologyElevatedserumIgGlevelsHightitersofautoantibodiesAnincreasedfrequencyofHLA-A1,B8,DR3,DR4ResponsetoimmunosuppressivetherapyPathology-DH332023/1/10AutoimmunehepatitisMorphology:interfacehepatitiscelldegeneration--------cirrhosisPathology-DH342023/1/10Pathology-DH352023/1/10Toxicanddrug-inducedliverdiseasesPathologicalchangesHepatocellulardamageCholestasisVasculardisordersGranulomaformationPathology-DH362023/1/10AlcoholicliverdiseasesFattyliverAlcoholichepatitisHepatocyteswellingandnecrosisMallorybodiesNeutrophilicreactionFibrosisAlcoholiccirrhosisPathology-DH372023/1/10Pathology-DH382023/1/10Metabolicdiseasesα1-antitrypsindeficiency

characteristicredcytoplasmicgranulesHepatolenticulardegeneration,Wilson’sdisease

fattychange----hepatitis----cirrhosisHemochromatosisdepositionofhemosiderin----cirrhosisPathology-DH392023/1/1040EsophagitisGastritisPepticulcerTumorsofdigestivetractViralhepatitisCirrhosisHepatocellularcarcinomaPathology-DH2023/1/10CirrhosisDisruptionofthearchitectureoftheentireliverFibrosisthroughouttheliverParenchymalnodulescreatedbyregenerationofencircledhepatocyte--------pseudolobulePathology-DH412023/1/10Pathology-DH422023/1/10PathogenesisHepatocellulardeathRegenerationProgressivefibrosis

432023/1/10Pathology-DHEtiologicAlcoholicliverdiseaseViralhepatitisBiliarydiseasesMetabolicdiseases……MorphologicMicronodularMacronodularMixedtypeClassification

442023/1/10Pathology-DHAlcoholiccirrhosisGrossly:micronodularcirrhosisMicroscopy:finenodules;bridgingfibrousseptaPostnecroticcirrhosisMorphology:mixedtypePathology-DH452023/1/10Pathology-DH462023/1/10BiliarycirrhosisPrimarybiliarycirrhosisSecondarybiliarycirrhosisPigmentcirrhosisPathology-DH472023/1/10ClinicalfeaturesPortalhypertensionAscitesPortosystemicshuntsSplenomegalyGastro-intestinalcongestionPathology-DH482023/1/10HepaticfailurejaundicebleedingtendencylackofestrogeninactivationhypoalbuminemiahepaticencephalopathyhepatorenalsyndromePathology-DH492023/1/1050EsophagitisGastritisPepticulcerTumorsofdigestivetractViralhepatitisCirrhosisHepatocellularcarcinomaPathology-DH2023/1/10