Clinical Pathology - Hepatobiliary System (Liver)

Question 1

What are the different funtions of the liver? Also name the pneumonic for it

Answer 1

MEDSS
- Metabolic function (produces glucose via hepatic gluconeogenesis; produces lipids such as cholesterol, FA, and TG; it also produces bilirubin)
- Excretory functions
- Detoxification and protective functions
- Synthetic functions (produces proteins, specifically plasma proteins such as albumin, fibrinogen, clotting factors, and globulins)
- Storage functions
-

Question 2

Does the degree of enzyme oincrease correlate with the extent of liver damage?

Answer 2

Degree of enzyme increases does NOT correlate well with the extent of liver damage or the prognosis for the case

Question 3

If you are concerned about liver damage with a patient, what are some physical exam findngs you might expect to see?

Answer 3

• Icterus (mucus membranes, sclera, plasma)
• May see evidence of hepatic encephalopathy with severe/end stage liver disease –> meaning look for head pressing, circling, and dullness

Question 4

What are the main compounds made by the liver?

Answer 4

• Albumin
• clotting factors
• urea
• cholesterol
• glucose

Question 5

Whats hyperbilirubinemia indicative of in bovine?

Answer 5

Its a sensitive indicator of hepatic disease in bovines; most commonly due to hemolytic disease

Question 6

Discuss the different categories of hyperbilirubinemia

Answer 6

1) Pre hepatic –> increased destruction of erythrocytes
2) Hepatic –> Decreased uptake of bilirubin by heoatocytes
3) Post hepatic –> impaired bile flow which can be caused by neoplasia,m inflammation, calculi, and more

Question 7

Discuss what bile acids do and how theyre synthesized

Answer 7

Bile acids have a critical role in fat digestion/absorption
Bile acids are made by hepatocytes: cholesterool –> bile –> intestine

Question 8

What cna cause an increase in bile acids?

Answer 8

1) decreased clearance from portal blood
2) decreased biliary excretion