Hepatic Flashcards
What mutation is associated with copper hepatopathy in Bedlington terriers?
COMMD1, autosomal recessive.
What mutation is associated with copper hepatopathy in Bedlington terriers?
COMMD1, autosomal recessive.
What was the sensitivity of ALT for acute and chronic hepatitis (respectively) in Labradors?
JVIM 2017: 45% for acute, 71% for chronic
What may microRNA panels be used for in liver disease?
JVIM 2018: mi 122 can be used to diagnose liver dz; Sn 77 and Sp 97
JVIM 2016: panel may be used, as associated with various liver diseases; miR 126 - chronic hepatitis, mi 200 - HC carcinoma, mi 21 and 222 - GB mucocoele
Can plasma glutathione concentrations predict levels in the liver?
JVIM 2019 - No
What was the diagnostic agreement of punch, cup and needle biopsies compared to wedge for the liver?
JVIM 2015: Agreement in 60-69% depending on method
JVIM 2018: Compared 3mm to 5mm cup; 67-69%
Biopsy of 2 liver lobes identified the predominant histologic abnormality in what % of cases?
JVIM 2015: 98.6%. only 56% of dogs had 6/6 lobes have the same diagnosis. Samples of several lobes is recommended
What is the interobserver agreement like for liver histology?
JVIM 2017: Fair for fibrosis but poor for necroinflammatory. They recommended 1+ pathologist evaluate sections
What is the association between gall bladder ultrasound findings and the results of bile bacterial culture?
JVIM 2017: Abnormal GB ultrasound was Sn (96%) but not specific (49%) for positive culture in cats. In dogs Sn was 81% and Sp 31% (poorer)
what is perflubutane? what could it be used to differentiate in dogs with liver disease?
JVIM 2017: A second generation ultrasound contrast agent. Phagocytosed by Kupffer cells - the washout ratio of this agent in the hepatic vein was able to predict hepatitis with Sn of 100 and Sp 85% (decreased - perhaps from Kupfer cell impairment)
What is the impact of obesity on the liver biochemically and on ultrasound?
JVIM 2018: Associated with higher ALP and GGT. Obese dogs also had abnormal hepatic spectral wave
What risk factors are associated with urolithiasis in PSS dogs? Is shunt morphology a factor?
JAVMA 2015: Morphology not a factor. Being older, male and having received prior medical therapy were risk factors
What were risk factors identified for a positive bacterial bile culture in dogs?
JAVMA 2015: Dashchunds over represented. Dogs with positive culture were more likely to have biliary sediment or sludge
What biochemical marker was associated with a positive bile culture in a 2016 JVIM study? What had higher yield for microorganisms, cytology or culture?
CPLI. Cytology
What has a higher yield for eggs for Platynosomum; bile or faeces?
JVIM 2016: Bile
Can a patient have a normal serum bilirubin with a ruptured gall bladder?
JAVMA 2015; yes, so GB rupture remains a ddx for acute abdomen even in non-icteric dogs
What is the mortality rate for elective cholecystectomy compared to non-elective?
JAVMA 2018; 2% compared to 20%
What drugs were associated with GB mucocoele formation?
JVIM 2015; thyroxine (treatment for hypoT), Cushings treatment, imidocloprid - the latter particularly in shetland sheepdogs
What is the difference in leptin in dogs with GBM?
JVIM 2017: Increased serum leptin and increased leptin and receptor in the GB
What is the Sn and Sp for ultrasound to detect GB rupture with mucocoele? Does rupture have prognostic significance?
JVIM 2018: Sn 56, Sp 91. Rupture was associated with 2.7 X increased likelihood of death
What improved prognosis in dogs with cholangitis/cholangiohepatitis in a retrospective study?
JVIM 2018: Cholecystectomy
What other congenital disease is gall bladder agenesis associated with?
JVIM 2018: Ductal plate malformation
does the ammonia concentration correlate with the severity of HE?
JAVMA 2015; In this study it did not.
What coagulopathy is associated with high disease severity in dogs with chronic hepatitis?
JVIM 2017: hyperfibrinolysis
What is the most potent mediator of stellate cell proliferation?
JVIM Fibrosis review: Platelet derived growth factor
What was the impact of cyclosporine treatment on dogs with presumed CH?
JVIM 2019: 78% achieved normalisation of ALT. Time to “remission”was 2.5 months. 38% had GI signs and 25% had gingival hyperplasia
What is the evidence for autoimmune hepatitis in Dobermans?
JVIM 2017: Detected increased levels of anti-histone antibodies in 92% of subclinical and 84% of clinical dobermans - suggestive of autoimmune disease and potential screening test
What is the effect of endothelin-1? What may it be increased with?
JVIM 2017: Vasoactive peptide; released from endothelial cells and induces vascular smooth muscle and stellate cell contraction. In this study increased in CH dogs and weakly increased in dogs with increased splenic pulp pressures, so possible association with portal hypertension
What is p21 and what is its potential prognostic impact?
JVIM 2018: Marker of cell senescence, increased expression in liver histology in dogs of this study was associated with reduced survival
What are mi122 and mi29 associated with in labradors?
JVIM 2019: Serum concentrations were associated with grade of hepatitis and stage of fibrosis in chronic hepatitis in this breed.
What time was required to reduce copper in Labrador livers from 710 to 343 with a low copper high Zn diet?
JVIM 2015: 7.1 months
What is the “name” of the copper transporters and where do they reside? Mutations in genes encoding for these transporters have been identified in which breeds?
JVIM 2019: ATP7A (enterocyte; facilitates copper transport into portal circulation), ATP7B (hepatocytes; excretion into the bile ducts). Mutation in the latter is associated with copper overload. Labradors have been identified to have gene mutations, a variant has also been identified in the ATP7B transporter in Dobermans
What drugs were identified as potential treatments for HL in cats based on an organoid study?
JVIM 2019: T863 an inhibitor for DGAT1 (synthesises triacylglycerol), AICAR via decreasing PLIN2 mRNA; a protein which stabilises lipid droplets
What serum vitamin levels have been shown to be lower in dogs with EPI
JVIM 2018: Retinol and alpha-tocopherol
What contrast ultrasonographic changes can be seen in the pancreas and what neighbouring organ during pancreatitis?
JVIM delayed peak perfusion and increased peak intensity and AUC (prolonger hyper echoic enhancement). Duodenal perfusion was also changed (increased peak intensity and AUC)
What changes may be seen on CT in dogs with acute pancreatitis?
JVIM 2015: enlarged and contrast enhancing, with ill defined borders. Enhancement may be homogenous or heterogenous and in this small pilot study the latter was associated with poorer outcome. May see thrombi.
JVIM 2019: CT better identified dogs with more severe disease as heterogenous contrast enhancement was associated with longer hospitalisation, more relapses and more thrombosis
How well does pancreatic ultrasound correlate with Spec cPL for the diagnosis of pancreatitis?
JVIM 2019: Weakly. this study used a clinical assessment as the gold standard for diagnosis of pancreatitis and found that the degree of ultrasound changes affected the Sn/Sp of ultrasound, with enlargement, pancreatic and mesenteric changes all being present, Sn 43 and Sp 92
In a non blinded JSAP study, what was the effect of prednisolone in acute pancreatitis?
JSAP 2019: Faster improvement in CRP, clinical score and reduced mortality
What was a positive prognostic indicator in a large retrospective feline pancreatitis study?
JVIM 2018; antibiotic treatment
Name 4 risk factors for death in pancreatitis.
JVIM 2019; SIRS, coagulation disorders, increased creatinine, hypocalcemia
Name 4 risk factors for death in pancreatitis.
JVIM 2019; SIRS, coagulation disorders, increased creatinine, hypocalcemia
is Beta-HB increased in dogs with acute pancreatitis without DM?
JVIM 2016: yes, median 0.3 (range 0-2.9), which was higher in sick dogs without pancreatitis/DM and fasted dogs
What is the Sn/Sp of FUJI DRI chem lipase for the diagnosis of pancreatitis?
JVIM 2016: Sn 100, Sp 89.5
what was the reported concordance between snap fPL and spec fPL?
JVIM 2019 97% agreement when snap was low, 90% agreement when snap was high
