Digestion & Metabolism 2: Liver Response to Injury Flashcards
what 3 things make up the PORTAL TRIAD?
- PORTAL VENULE
- HEPATIC ARTERIOLE
- BILE DUCTULE
SPACE OF DIESSE…
contains WHAT 2 kinds of cells?
can help with ___ ___ function
2 cells?
1. KUPPFER
2. STELLATE
HEPATIC METABOLIC
give each NAME & ZONE
P = PERIPORTAL, ZONE 1
M = MIDZONAL, ZONE 2
C = CENTRILOBULAR, ZONE 3
KUPPFER cells…
= what are they?
what is their function? (2)
= MACROPHAGES within SINUSOIDS & SPACE OF DIESSE
function?
1. PHAGOCYTOSE SENESCENT RBCs & ACCUMULATE IRON
2. PHAGOCYTOSE BACTERIA & ENDOTOXINS
STELLATE CELLS…
aka?
located between ____ and ____ in….
in OLDER CATS… (2)
involved in metabolism of WHAT?
in INJURY… (2)
AKA ITO CELLS or LIPOCYTES
located between HEPATOCYTES and SINUSOIDS in SPACE OF DIESSE
in OLDER CATS…
1. MORE NUMEROUS
2. have MORE VACUOLES
involved in VITAMIN A METABOLISM
in INJURY…
1. can transform into MYOFIBROBLASTS
2. can CONTRIBUTE TO FIBROSIS
PHOTOSENSITIZATION…
what type of reaction is this?
usually occurs after WHAT in HERBIVORES?
TYPE 3 REACTION
usually occurs after CHOLESTASIS or OBSTRUCTION OF BILE FLOW
HEPATOCELLULAR SWELLING
in MOST forms of liver injury….
what usually happens?
2 findings on HISTO?
is this reversible?
can lead to…
this is the FIRST MANIFESTATION
what usually happens?
–> cells ACCUMULATE WATER due to INABILITY TO MAINTAIN IONIC & FLUID HOMEOSTASIS aka HYDROPIC CHANGE
2 findings on HISTO?
1. SEVERE MARKED SWELLING
2. PALE CYTOPLASM
THIS IS REVERSIBLE
can lead to NECROSIS
describe what’s happening in the LIVER
what about the cytoplasm?
HEPATOCELLULAR SWELLING
cytoplasm is PALE
the liver here is FULL OF…
what DZ could this be?
liver is FULL OF GLYCOGEN
could be STEROID HEPATOPATHY
GLYCOGEN accumulation in the liver…
can cause ____ hepatocytes with ____ cytoplasm due to ____ accumulation
usually appears in WHAT zone of HEPATOCYTE?
in NEONATES….
what disease can occur in DOGS ONLY?
reversible?
usually NOT associated with…
SWOLLEN, CLEAR, GLYCOGEN
usually appears MIDZONAL
in NEONATES, can be PHYSIOLOGIC & helps them GROW
can have STEROID HEPATOPATHY in DOGS ONLY
REVERSIBLE
usually NOT associated with NECROSIS
HEPATIC LIPIDOSIS…
aka? (2 different names)
usually the result of ____ imbalance
can be both a DISEASE state & what else?
reversible?
might lead to….
AKA….
1. FATTY CHANGE
2. STEATOSIS
usually the result of ENERGY imbalance
can be both DISEASE state & HISTOLOGIC PATTERN (fat inside hepatocytes)
IS REVERSIBLE
might lead to NECROSIS
how can LIPID accumulate in the HEPATOCYTES/LIVER? (7)
hints: moving fat, diet, blood lipoproteins, oxidation, protein, apoprotein secretion
- INCREASED MOBILIZATION OF FAT STORES with NEGATIVE ENERGY BALANCE
- INCREASED FAT IN DIET
- TOO MUCH MOBILIZATION OF BLOOD LIPOPROTEINS
- DECREASED OXIDATION of FATTY ACIDS and TRIGLYCERIDES due to HEPATIC DYSFUNCTION
- DISORDERS in CHOLESTEROL PRODUCTION
- LACK of PROTEIN to make APOPROTEIN to allow SECRETION OF LDL
- ISSUE WITH HEPATIC MEMBRANE AND APOPROTEIN SECRETION
TENSION lipidosis = definition?
what SPECIES can we see this in?
= TRIANGULAR ligament holding LIVER IN PLACE is PLACED UNDER TENSION BY EXCESS LIPIDS
can see this in HORSES
AMYLOIDOSIS…
usually associated with a ____ or ____ protein
causes ___ material in the…. (2)
causes ____ of HEPATOCYTES and ____ of the SINUSOIDS
associated with WHAT kinds of conditions?
3 breed dispositions?
how does the liver look GROSSLY?
can cause ___ hepatic DYSFUNCTION that is potentially ____ because of the risk of ____
REACTIVE, SECONDARY
EOSINOPHILIC, in the…
1. SPACE OF DIESSE
2. PORTAL AREAS
ATROPHY, DILATION
associated with INFLAMMATORY conditions
3 breeds?
1. SHAR PEIS
2. ABYSSINIANS
3. SIAMESE
grossly, liver is FRIABLE
can cause DOWNSTREAM dysfunction that is potentially LETHAL because of the risk of RUPTURE of the LIVER
what do we expect on CBC if CELL INJURY/DEATH of HEPATOCYTES?
INCREASED LEAKAGE ENZYMES (ALT/AST)
6 causes of NECROSIS & APOPTOSIS of HEPATOCYTES
- HYPOXIA
- TOXINS
- MICROORGANISMS
- IMMUNOLOGICAL EVENTS
- SEVERE METABOLIC DISTURBANCES
- TRAUMA
in ACUTE/CHRONIC hepatitis we tend to see APOPTOTIC hepatocytes
CHRONIC
if we see LIQUEFACTIVE necrosis occurs in liver, WHAT CAUSED IT?
likely CLOSTRIDIAL
define type of necrosis
what 2 things would be present in the liver?
LIQUEFACTIVE
in the liver…
1. PUS
2. BACTERIA
define type of NECROSIS
COAGULATIVE
define LEFT and RIGHT types of NECROSIS
LEFT = ZONAL
RIGHT = DIFFUSE/MULTIFOCAL RANDOM
define LEFT and RIGHT types of NECROSIS
LEFT = MASSIVE
RIGHT = BRIDGING
what are the ETIOLOGIES of these TYPES of necrosis?
- MULTIFOCAL RANDOM (1, 3 subs)
- MASSIVE (2)
- ZONAL (2)
- MULTIFOCAL RANDOM = INFECTIOUS agents
–> VIRAL
–> PROTOZOAL
–> BACTERIAL - MASSIVE
–> TOXIC
–> NUTRITIONAL - ZONAL
–> TOXIC
–> HYPOXIA
CHOLANGITIS definition?
INFLAMMATION OF THE BILE DUCTS (in LIVER and GALLBLADDER)
CHOLANGIOHEPATITIS definition
inflammation of BILE DUCTS with EXTENSION INTO LIVER PARENCHYMA
CHOLECYSTITIS definition
inflammation of the GALLBLADDER
CHOLEDOCHITIS definition
& describe anatomical location
inflammation of the COMMON BILE DUCTS
anatomy = COMMON BILE DUCT coming OUT of GALLBLADDER and INTO INTESTINE
TIZZER’S DZ
caused by ____ infection of the ____, resulting in ____
caused by CLOSTRIDIAL INFECTION of HEPATOCYTES, resulting in HEPATITIS
what kind of PARASITE likes to LIVE IN THE BILE DUCTS?
what kind of DISEASE PROCESS can they cause?
LIVER FLUKES can live in BILE DUCTS
can cause SUPPURATIVE CHOLANGITIS
IBD tends to affect the ___ ____ in WHAT species?
tends to affect the BILE DUCTS in CATS
TRADITIS definition?
similar to SEVERE ____ ____
can also resemble _____
INFLAMMATION of the…
1. BILE DUCTS
2. INTESTINE
3. PANCREAS
similar to SEVERE LYMPHOCYTIC IBD
can also resemble LYMPHOMA
CHOLESTASIS/BILE STASIS definition
secondary to…
this is INTRA/EXTRA hepatic
what do we see on CBC? (1)
= bile stuck in CANALICULI or BILE DUCTS
secondary to LIVER DAMAGE
this is INTRA-HEPATIC
can see HYPERBILIRUBINEMIA on CBC
DUCTULAR bile stasis is when ____ are filled with ____ due to ____ cause
when DUCTS are filled with BILE due to OBSTRUCTIVE cause
how much of the liver can we resect without causing liver damage?
up to 75%!
CIRRHOSIS…
= definition?
has WHAT 3 histologic components?
= END-STAGE LIVER dz
3 histologic components…
1. SEVER DIFFUSE BRIDGING FIBROSIS
2. NODULAR or COMPLETE REGENERATION
3. BILE DUCT HYPERPLASIA
when performing liver biopsy, WHAT should we be sure to do?
take MANY REPRESENTATIVE SAMPLES
NODULAR REGENERATION vs. NODULAR HYPERPLASIA?
NODULAR REGENERATION = hepatocytes trying to PROLIFERATE to come back to NORMAL HEPATIC CAPACITY/SIZE
NODULAR HYPERPLASIA = usually normal finding for OLD DOG, usually SMALL from SCAR TISSUE/FIBROSIS
