1. The Liver

2. Function: –Metabolism Anatomy/Histology –Right, left lobe –Biliary Tree –Components of Liver: 1. Liver Parenchyma (lobule) 2. Portal area (vessels, bile ducts) 3. Vessels (portal and systemic circulation)

8. Pathology of Liver Primary vs Secondary disease Congenital/Genetic vs Acquired Neoplastic vs non-neoplastic Inflammatory diseases (infection, physical injury, chemical injury, ischemia, immune disease, metabolic disease) Hemodynamic disorder

9. Patterns of Hepatic Injury

10. Ballooning Degeneratin

11. Steatosis (macrovesicular)

12. Steatosis (microvesicular)

13. Feathery Degeneration

14. Iron deposition

15. Copper deposition

16. Interface Hepatitis

17. Protal inflammation

18. Piece-meal necrosis

19. Massive necrosis

20. Regenerative Nodules

21. Ductular Reaction

22. Bridging Fibrosis

23. Cirrhosis

24. Cirrhosis

25. Cirrhosis

26. Clinical Features of Liver Disease Hepatic Failure Cirrhosis Portal Hypertension Cholestasis

27. Clinical Features of Liver Disease Jaundice Hypoalbuminemia Hyperammonemia Plamar Erythema Gynecomastia Coagulopathy Hepatic encephalopathy

28. Clinical Features of Liver Disease History: –Pain, jaundice, Family history, Occupation, contact will jaundice patient, onset of illness –Fever, malaise, anorexia.. Examination: –Jaundice, pallor, Palmar erythema, Flapping tremor, –Ascites, liver enlargement, Spider nevi, Murphy’s sign

29. Investigations of Liver disease

30. Bilirubin Liver Enzymes: ALT, AST, GGT, Alk. Phosphatase Protein: Albumin, Globulin Imaging: ultrasound, CT scan..