Hepatic Clinical Pathology

Question 1

what are some normal hepatic FNA findings?

Answer 1

blood contamination
clusters of hepatocytes
uncommon: small clumps biliary epithelium

Question 2

what is lipofuscin?

Answer 2

residues of lysosomal digestion

Question 3

what can hepatocyte copper granules be associated with?

Answer 3

concurrent hepatitis

Question 4

how is copper hepatopathy best diagnosed?

Answer 4

liver biopsy

Question 5

what is hepatic vacuolar change from?

Answer 5

lipid accumulation
glycogen accumulation

Question 6

why can glucocorticoids cause glycogen vacuolation?

Answer 6

disturb balance between glycogen synthesis and glycogenolysis

Question 7

when do clinical alterations in hepatic function tests occur?

Answer 7

more than 70-80% of hepatic functional mass lost

Question 8

what does functional mass depend on?

Answer 8

number of hepatocytes
viability of hepatocytes

Question 9

are hepatic enzyme or hepatic function tests more sensitive for hepatic disease?

Answer 9

hepatic enzyme tests more sensitive

Question 10

what predominantly produces bilirubin?

Answer 10

macrophages

Question 11

what is delta bilirubin or biliprotein?

Answer 11

conjugated bilirubin bound to serum proteins

Question 12

will bilirubin in urine precede hyperbilirubinnemia?

Answer 12

usually

Question 13

what do bile acids do?

Answer 13

act as biologic detergents to solubilize lipids in the intestine

Question 14

when might you see increased bile acid levels?

Answer 14

reduced hepatic functional mass
cholestasis
portosystemic shunting
combination

Question 15

what is ammonia produced from?

Answer 15

protein/amino acid catabolism

Question 16

what are some causes of hyperammonemia?

Answer 16

portosystemic shunting
decreased hepatic uptake
urea or ammonia toxicosis
congenital urea cycle enzyme deficiency

Question 17

when might ammonium biurate crystals be seen in urine?

Answer 17

hyperammonia
increased urates
hyperuricosuria

Question 18

what are the induced/cholestatic enzymes?

Answer 18

ALP: alkaline phosphatase
GGT: gamma-glutamyl transferase

Question 19

when might decreased levels of the cytoplasmic enzymes occur?

Answer 19

hepatic atrophy or cirrhosis

Question 20

how specific to the liver is ALT (alanine aminotransferase) for dogs and cats?

Answer 20

pretty specific
mild increases may occur with muscle necrosis

Question 21

what does hepatocellular injury and swelling often result in?

Answer 21

intrahepatic cholestasis