Hepatic Disease Flashcards
Which type of PSS is more commonly seen in cats?
EHPSS
Why does clinical icterus take 2 weeks to resolve?
It binds irreversibly to albumin and can be deposited in tissues
At what level of bilirubin does clinical jaundice become noticeable?
>50umol/L
How might protein content of ascitic fluid due to portal hypertension help in refining differential diagnoses?
Typical anything gpost-sinosoidal (e.g. hepatic/post-hepatic) has a higher protein content (>25g/dL).
Accumulation of which amino acid is implicated in ammonia’s effect on neuronal cells?
Glutamine (as NH3 can be combined with glutamate) GLutamin acts as an osmotic agent.
ALT half life
- Dog
- Cat
48-60h in the dog
6h in the cat
ALP half life
- Dog
- Cat
- 70h
- 6 hours
How is ALP bonded to the cell membrane?
Via glucose phosphatidyllinositol bonds - these can be degraded in there presence of bile acids.
Other than the liver, what alternative sources for ALP are there?
Intestine, renal cortex, placenta, liver, bone
AST half life and alternative sources
22h dog, 6 minutes cat
Red blood cells and muscle.
What does it mean if ALP is increased by GGT is not in a cat?
This can be indicative of hepatic lipidosis.
Why is GGT more useful than some other liver enzymes in cats?
It has a longer half life than ALP
What part of the liver do GLDH and LDH give information about?
Both are indicative of hepatocellular injury
GLDH is more specific to the liver and LDH is less so.
Which liver enzymes should be interpreted alongside CK?
Mostly AST but also ALT as this is found in muscle to some degree too.
What is the normal function of CK?
It releases ADP from phosphocreatine, creating ATP.
At what degree of elevation might CK elevation make you suspicious for muscle disease?
>5x elevations repeatedly.
What can happen to ALP concentrations with improvement of chronic hepatitis and why?
It can increase due to induction from the regenerative response.
How much functional hepatic loss must there be, generally, before significant hypoalbuminaemia may develop?
70%
Which globulins are produced in the liver?
Alpha and beta. Gamma are produced by B and plasma cells.
Which of the following is most correct about the sensitivity and specificitty of serum bile acids for the diagnosis of PSS?
a) neither is improved by addition of the fasting sample
b) the post-prandial sample improves sensitivity
c) the post-prandial improves specificity
c)
Although both sensitivity and specificity is improved.
Ammonia is more [sensitive than it is specific/specific than it is sensitive] for PSS
Ammonia is more sensitive than specific.