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VMS 2005 > Clinical Pathology of the Liver > Flashcards

Clinical Pathology of the Liver Flashcards

1
Q

Name five functions of the liver

A
  • Protein metabolism
  • Carbohydrate metabolism
  • Lipid Metabolism
  • Storage of glycogen, triglycerides etc.
  • Detoxification
  • Excretory fuction
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2
Q

What part of the liver is most likely to have hypoxic damage?

A

Central lobular cells

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3
Q

What are hepatocellular enzymes?

A

Enzymes released from the cytoplasm of damaged hepatocytes

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4
Q

What is the function of ALP and where is it found?

A

ALP is an enzyme found in the bloodstream, it helps breakdown proteins in the body

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5
Q

What two genes are needed for the production of ALP?

A

I-ALP (Intestinal ALP) and tissue non-specific ALP

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6
Q

What is Cholestasis?

A

Reduced or Stopped Bile Flow

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7
Q

What do hepatocellular enzymes tell us?

A

They tell us that there is a problem in the liver but can also give us some indication of which part of the liver is affected

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8
Q

What would an increase in ALT, AST, GLDH, SDH, or LDH tell us?

A

That there is likely an issue with a hepatocyte

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9
Q

Name the special considerations for each animal when it comes to ALP

A
  • Dogs have a high sensitivity for detecting cholestasis, tends to occur before icterus appears
  • Cats are typically icteric before the increase in ALP so their diagnostic sensitivity is less optimal than with dogs
  • Horses are typically icteric before the increase in ALP
  • Cattle have a moderate sensitivity to detection, cholestasis is uncommon
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10
Q

Name the special considerations for each animal when it comes to GGT

A
  • Horses have a better sensitivity for GGT than they do for ALP for detecting cholestasis
  • In cattle GGT has a better sensitivity than ALP for detecting cholestasis
  • In dogs GGT is parallel with ALP
  • in dogs GGT can be indicative for cholestasis but not always increased
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11
Q

What is an increase in ALP indicative of?

A

Cholestasis

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12
Q

What is liver disease?

A

Damage or a pathological process affecting the liver

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13
Q

What is hepatic insufficiency?

A

The liver being unable to function properly

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14
Q

What are some functional indicators of liver disease?

A
  • Decreased Urea
  • Increased Billirubin
  • Decreased albumin
  • increased/ decreased cholesterol
  • Increased/ Decreased triglycerides
  • Decreased glucose unless cirrhosis
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15
Q

Why may there be increased billirubin in liver disease?

A

If the liver is not functioning properly then the billirubin will not be properly excreted as bile

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16
Q

Why should you not expose billirubin samples to daylight?

A

billirubin is sensitive to light

17
Q

Why is an excess of billirubin indicative of erythrocyte breakdown?

A
  • Once haemoglobin degrades it can be converted to billirubin
18
Q

When does hyperbilirubinaemia occur?

A

Occurs when rate of Bu production exceeds rate of Bu uptake by hepatocytes,
» OR rate of Bc formation in hepatocytes exceeds rate of Bc excretion in the bile

19
Q

What is the difference between conjugated and unconjugated billirubin?

A

Conjugated billirubin can be excreted in urine whereas unconjugated cannot

20
Q

What is functional cholestasis and what is it seen in?

A

When there doesnt appear to be any liver disease or obstruction but there is still an increase in billirubin

  • Reported in E.coli and S. intermedius infections in dogs –
21
Q

Which organ are bile acids released from?

A

They are released from the gall bladder which contracts in response to feeding

22
Q

How do you take a bile acid stimulation test?

A
  • Starve the patient for 12 hours
  • take a baseline blood sample
  • take a second sample 2 hours later
23
Q

Name 5 hepatocellular liver enzymes

A
  • ALT
  • AST
  • GLDH
  • SDH
  • LDH
24
Q

Name two billiary liver enzymes

A
  • ALP
  • GGT- gamma
25
Q

Name six functional indicators of the liver

A
  • Urea
  • Billirubin
  • Albumin
  • Cholesterol
  • Triglycerides
  • Glucose
26
Q

Why is AST not a good indicator of muscle damage in horses?

A
  • Horses already have a high AST baseline
27
Q

What are the two isoforms of tissue non-specific ALP?

A

L- ALP (liver ALP)
* B-ALP (bone ALP)

28
Q

What form of ALP is generally not detected in serum?

A

intestinal ALP

29
Q

What is the link between GGT and cholestasis?

A

increases with cholestasis

30
Q

Why may high liver enzymes not tell us a lot?

A
  • Liver has a high functional reserve- so it can have extremely high liver enzymes and still function adequately
  • or if the liver cirrhoses there may be a loss in the cells that produce liver enzymes (overall loss in liver enzymes)

VMS 2005 (33 decks)

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