Hepatobiliary 1 Flashcards
What are your 4 portals of entry into the liver?
Direct extension
Hematogenous spread
Retrograde Biliary Infection-ascending
Retrograde Pancreatic ductular infection-ascending from intestines through pancreatic duct
Sublethal injury and degeneration results in?
autophagy of damaged organelles and accumulation of lipofuscin pigment
Specific areas of degeneration and necrosis that are restricted to a particular portion of the hepatic lobule is considered?
Zonal Necrosis
What kind of necrosis occurs with hypoxic injury?
Centrilobar hepatic necrosis-Zone 3
Other than hypoxic injury, when else can Zone 3 become necrotic
hepatotoxicity
Why is zone 3 most susceptible to hepatotoxicity?
Mixed function oxidases which are present in zone 3. They function in the metabolism of drugs and toxins-Cyt450
If you have hemolytic dz what kind of hyperbilirubinemia would this cause?
Prehepatic
What occurs with obstruction of the extrahepatic bile ducts?
Extrahepatic cholestasis
What occurs with impairment of bile flow within the canaliculi
Intrahepatic cholestasis
What parts of the liver can regenerate?
All
What leads to the progressive loss of function due to loss of normal architecture and less efficient hepatic lobules with fibrosis and altered blood supply?
Chronic injury and regeneration leads to this
What is an increase in the amount of collagen within the liver?
Hepatic fibrosis
What cells produce collagen in the liver?
Stellate cells within the space of Disse
What dz would cause biliary hyperplasia?
biliary inflammation, obstruction, and cholestasis
Also considered to be a non-specific response to a variety of liver insults
What are 4 causes of end stage liver
Chronic hepatoxicity
chronic hepatitis/cholangiohepatitis
chronic biliary obstructive dz
chronic degenerative liver dz
How much of the liver can be removed without significant impairment of function?
75%
What are some consequences of hepatic failure?
Hyperammonemia
Icterus/Jaundice
Metabolic disturbances
Vascular and hemodynamic alterations
Cutaneous Manifestations
Immunologic manifestations
Coagulation abnormalilties
Hypoalbuminemia and ascites
4 congenital abnormalities
Biliary Cysts
Ductal plate malformations
Portosystemic shunts
Port vein hypoplasia
What spp of animals is polycystic dz reported in?
Dog, cat, goat, sheep
What are predisposed breed to polycystic dz?
Persian Cats
Bull terriers
West Highlands
Cairn Terriers
Histologically characterized by diffuse periportal to bridging fibrosis with numerous small, often-irregular bile ducts and reduction in the number of portal vein branches, is what dz?
Ductal plate malformations
What dz is often progressive with portal hypertension leading to ascites, icterus, and end stage liver dz?
What breed is predisposed?
Congenital hepatic fibrosis
YOUNG DOGs—Boxers
What dz results in an embolic pattern which is randomly multifocal
Acute Hepatitis
Acute hepatitis is characterized by?
Inflammation
Hepatocellular necrosis
Apoptosis
What is characterized by fibrosis, mononuclear inflammation cells, hepatocellular loss, nodular regeneration, and structural remodeling of the hepatic lobule and vasculature
Chronic hepatitis
What is characterized by mild mononuclear inflammatory infiltrates in the portal tracts, less commonly around central veins
Nonspecific reactive hepatitis
What is a diffuse process in th eliver that is a response to sytemic inflammation
Nonspecific reactive hepatitis
What is nonspecific reactive hepatitis most commonly stemming from?
GI dz
What values in blood work would you see a mild elevation in, for nonspecific reactive hepatitis?
ALT
ALP
Chronic cholangitis may lead to?
Cholestasis and posthepatic hyperbilirubinemia
What are your two kinds of cholangitis?
Neutrophillic
Lymphocytic
What is a chronic, immune-mediated biliary dz of CATS
Lymphocytic
Inflammation of the biliary ducts and extension of inflammation into the surround liver parenchyma is called?
Cholangiohepatitis
What causes cholangeiohepatitis?
Extension of bacterial cholangitis into the surrounding into periportal hepatic parenchyma
Why would you see a greater elevation of serum ALT in cholangiohepatitis?
There is damage to more hepatocytes
