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425 - Systemic Pathology > Hepatobiliary > Flashcards

Hepatobiliary Flashcards

1
Q

What is the significance of several biliary cysts in the liver parenchyma?

A

None; they are incidental and insignificant.

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2
Q

In what key way do congenital biliary cysts differ from the cysts in the liver associated with polycystic kidney disease?

A

In number. Congenital biliary cysts are few, whereas those associated with PKD are much more numerous.

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3
Q

What is the significance of fibrous tags or plaques found on the diaphragmatic surface of the liver of horses?

A

None; they are incidental and insignificant.

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4
Q

In which domestic species are fibrous tags or plaques often found on the diaphragmatic surface of the liver?

A

Horses

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5
Q

What is the cause of the fibrous tags or plaques found on the diaphragmatic surface of the liver of horses?

A

No-one knows.

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6
Q

What is tension lipidosis?

A

Areas of pallor in hepatic parenchyma where the liver is suspended by ligaments.

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7
Q

In which domestic species is tension lipidosis most commonly seen?

A

Cattle, and less commonly in horses (i.e., large animals with heavy livers).

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8
Q

What is the pathogenesis of tension lipidosis in cattle?

A

Tension on liver by suspensory ligaments –> impedes blood flow –> localized hypoxia –> localized lipid accumulation –> areas of pallor

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9
Q

What is the significance of tension lipidosis in cattle?

A

None; it’s incidental and insignificant.

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10
Q

In what type of animal is the edge of the liver fimbriated or “frilly”?

A

Camelids (llamas etc.)

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11
Q

What is hepatic telangiectasia? What does it look like grossly?

A

Randomly scattered areas of dilation of hepatic sinusoids by blood where hepatocytes have been lost. Grossly, it appears as dark red “dit-dots” and patches throughout hepatic parenchyma.

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12
Q

In which two domestic species is hepatic telangiectasia most commonly seen?

A

Cats and cattle

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13
Q

You are performing a necropsy examination on a cat and find dozens of dark red foci throughout its liver parenchyma and over the capsular surface of the liver. What are these lesions most likely to be?

A

Hepatic telangiectasia

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14
Q

What is the most common reason for acute passive congestion in the liver?

A

Acute right-sided heart failure (for a variety of reasons)

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15
Q

What is the gross appearance of a liver with acute passive congestion (give 3 gross findings)?

A
  1. Slight hepatomegaly
  2. Enhanced reticular pattern / centrilobular congestion
  3. Oozes blood from cut surfaces
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16
Q

What is the most common reason for chronic passive congestion in the liver?

A

Chronic right-sided heart failure (for a variety of reasons)

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17
Q

What is the gross appearance of a liver with chronic passive congestion (give 3 gross findings)?

A
  1. Hepatomegaly
  2. Rounded edges to liver
  3. Enhanced reticular pattern (“nutmeg liver”)
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18
Q

Describe 3 key histologic findings in a liver with chronic passive congestion

A
  1. Centrilobular congestion
  2. Centrilobular hepatocyte atrophy and/or necrosis
  3. Periportal hepatocyte lipid accumulation.

To summarize: the centres of lobules are dark because of accumulation of “stagnant” blood and loss or compression of hepatocyte plates, while the peripheral areas of lobules are pale because hypoxic hepatocytes have accumulated lipid. This repeating dark-light pattern is called “nutmeg liver.”

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19
Q

Explain the difference between the terms “nutmeg liver,” “enhanced lobular pattern” and “enhanced reticular pattern.”

A

“Enhanced lobular pattern” and “enhanced reticular pattern” mean the same thing and are interchangeable terms. Both refer to any repeating lesion within all hepatic lobules, including (for example) periportal inflammation or cancer, centrilobular necrosis, and midzonal glycogen accumulation (i.e., anything that causes a repeating dark-light pattern at the level of every hepatic lobule). “Nutmeg liver” is a form of enhanced lobular pattern reserved for the chronic passive congestion associated with chronic right sided heart failure.

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20
Q

What histologic changes would you expect in the liver of an anemic animal?

A

Centrilobular hepatocyte degeneration and necrosis with dilation and congestion of centrilobular sinusoids by blood. [Note that “enhanced reticular pattern” is a gross, not a histologic change and is not an acceptable answer, sorry.]

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21
Q

Anemia can cause an enhanced lobular pattern grossly and centrilobular hepatocyte degeneration and necrosis microscopically. Explain the pathogenesis of this pattern of injury.

A

Centrilobular hepatocytes receive blood last and so receive the least oxygenated blood in the liver. Therefore, hypoxia caused by anemia hits the centrilobular hepatocytes the hardest –> degeneration or death of centrilobular hepatocytes, while periportal hepatocytes may be spared.

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22
Q

What is the definition of a portosystemic shunt?

A

An abnormal vascular channel that allows portal blood to bypass the liver and enter the systemic circulation.

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23
Q

What is the most common reason for an INTRAhepatic congenital portosystemic shunt?

A

Intrahepatic congenital PSSs are generally due to failure of closure of the ductus venosus at birth. [The ductus venosus is a normal fetal vessel that conducts blood from the umbilical vein to the caudal vena cava.]

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24
Q

In which breeds of dogs (large or small) are INTRAhepatic congenital portosystemic shunts more common?

A

Large breeds

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25
Q

In which breeds of dogs (large or small) are EXTRAhepatic congenital portosystemic shunts more common?

A

Small breeds

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26
Q

What are some of the clinical signs and gross lesions seen in a puppy with a congenital portosystemic shunt?

A
  1. Stunting, relative to littermates
  2. Hepatic encephalopathy (manifesting as mental dullness)
  3. Small liver size.
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27
Q

What are 2 histologic lesions are seen in the liver of a puppy with a congenital portosystemic shunt?

A
  1. Small or absent portal veins in portal areas
  2. “Arteriolar reduplication” in portal areas
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28
Q

What is the most common underlying reason for development of an acquired (not congenital) portosystemic shunt?

A

Portal hypertension. [Portal blood cannot pass through the liver and so creates an escape valve to give itself some way back into the systemic circulation.]

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29
Q

Portal hypertension can be prehepatic, intrahepatic or post-hepatic. Of these, one is more common than the other two. Which one?

A

Intrahepatic causes are most common (the other two are rare).

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30
Q

Portal hypertension caused by intrahepatic disease is far more common that that caused by prehepatic or posthepatic disease. What are two common, underlying mechanisms for intrahepatic portal hypertension?

A
  1. Chronic liver disease with loss of architecture & fibrosis
  2. Hepatic accumulations e.g., amyloid.

[Both cause increased resistance to blood flow through liver.]

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31
Q

Describe the gross appearance of a liver affected by hepatic lipidosis.

A

Enlarged, friable, pale, greasy, may float in formalin

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32
Q

What is the underlying pathogenesis of hepatic lipidosis?

A

The rate of accumulation of triglycerides within hepatocytes exceeds the rate of their removal

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33
Q

What is the characteristic histologic lesion of hepatic lipidosis?

A

Clear cytoplasmic vacuoles within hepatocytes.

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34
Q

Explain how toxic or hypoxic damage to hepatocytes can cause hepatic lipidosis.

A

Hepatocellular injury –> Reduces ability to process, transform & export lipids –> Accumulation within cytoplasm of hepatocytes.

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35
Q

In which phases or periods are cattle most susceptible to developing hepatic lipidosis, and why?

A

Fat cows in late gestation, immediately post partum or in peak lactation. Excessive mobilization of body fat stores to cope with demand overwhelms liver’s ability to process and export it –> accumulation.

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36
Q

What is the characteristic signalment and scenario for a cat that develops hepatic lipidosis?

A

Obese cat –> stressed (disease, change of environment etc.) –> goes off food for several days –> idiopathic accumulation of lipids in hepatocytes.

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37
Q

Which types of equids are prone to development of hepatic lipidosis?

A

Ponies, mini horses & donkeys

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38
Q

In what form is glucose stored in the liver?

A

As glycogen

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39
Q

What accumulates in the cytoplasm of hepatocytes in so-called “steroid hepatopathy”?

A

Glycogen (NOT steroids!)

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40
Q

What is the underlying cause of excessive glycogen accumulation in the liver?

A

Excessive glucocorticoids [either exogenous (iatrogenic) or endogenous (hyperadrenocorticism)]

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41
Q

Excessive administration of glucocorticoids by veterinarians can cause what substance to accumulate in the liver? What is the term for this condition?

A

Glycogen. “Steroid hepatopathy”

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42
Q

What is the characteristic histologic lesion of hepatic lipidosis?

A

Clear cytoplasmic vacuoles within hepatocytes.

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43
Q

You are performing a necropsy on a bird euthanized for chronic foot infections and notice that the liver is swollen, pale, waxy and friable. What is the most likely cause of the liver lesion?

A

Hepatic amyloid accumulation (amyloidosis)

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44
Q

Where, precisely, in the liver is amyloid deposited in cases of amyloidosis?

A

The spaces of Disse

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45
Q

Name the cell type in the liver that deposits collagen in cases of hepatic fibrosis

A

Ito (hepatic stellate) cell

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46
Q

What is the role of Ito (hepatic stellate) cells in hepatic disease?

A

To deposit collagen (which can lead to hepatic fibrosis)

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47
Q

What is the alternative name for a hepatic Ito cell?

A

Hepatic stellate cell

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48
Q

What the alternative name for a hepatic stellate cell?

A

Ito cell

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49
Q

Ito (hepatic stellate) cells are responsible for collagen deposition in hepatic disease and fibrosis. What is their role in the non-diseased liver?

A

Storage of vitamin A and fat

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50
Q

Where, precisely, are hepatic Ito (stellate) cells found within the liver?

A

In the space of Disse

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51
Q

Explain why fibrosis within and around hepatic sinusoids is such a serious change.

A

The space of Disse becomes reduced or obliterated by collagen deposition. The ability of the liver to carry out its synthetic, catabolic and excretory roles is severely compromised by this reduced exposure of hepatocytes to plasma.

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52
Q

What does the term cirrhosis mean?

A

Diffuse hepatic fibrosis accompanied by regenerative nodule formation (end-stage liver is a better term than cirrhosis)

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53
Q

What is the term for diffuse hepatic fibrosis accompanied by regenerative nodule formation?

A

Cirrhosis (or end-stage liver)

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54
Q

Describe the appearance of an end-stage (cirrhotic) liver

A

The liver is small, firm, and irregular with nodules of regenerative parenchyma separated by tracts of fibrous connective tissue.

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55
Q

Name 3 causes of end-stage liver (cirrhosis). [The answer has 6 causes so if you can name even more than 3 that’s great]

A
  1. Chronic toxicity
  2. Chronic cholangitis or obstruction
  3. Chronic congestion (right-sided heart failure)
  4. Inherited copper or iron storage disorders
  5. Chronic hepatitis
  6. Idiopathic
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56
Q

Explain why hepatotoxins commonly result in periportal, rather than centrilobular necrosis.

A

Hepatocytes in Zone 1 of theliver lobule (periportal; closest to portal areas) are the first to receive blood and, therefore, may be the first to be injured by circulating toxins -> PERIPORTAL NECROSIS

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57
Q

Which pattern of hepatic necrosis (centrilobular or periportal) is more likely in cases of hepatotoxicity and why?

A

Periportal. Hepatocytes in Zone 1 of theliver lobule (periportal; closest to portal areas) are the first to receive blood and, therefore, may be the first to be injured by circulating toxins -> PERIPORTAL NECROSIS

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58
Q

Which pattern of hepatic necrosis (centrilobular or periportal) is more likely in cases of anemia or hypoxia and why?

A

Centrilobular. Hepatocytes in Zone 3 of the lobule (centrilobular; closest to central veins) are the last to receive blood and, therefore, may be the first to be injured by ischemia -> CENTRILOBULAR NECROSIS

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59
Q

Name 3 routes in which bacteria can reach the liver via the bloodstream.

A
  1. The portal vein
  2. The umbilical veins from umbilical infections in newborn animals
  3. The hepatic artery, as part of a generalized bacteremia.
60
Q

Name 3 NON-vascular routes by which bacteria may reach the liver.

A
  1. Ascending infection of the biliary system
  2. Parasitic migration
  3. Direct extension of an inflammatory process from tissues immediately adjacent to the liver, such as the reticulum.
61
Q

What are the two main syndromes caused by Rhodococcus equi in foals?

A

Typically enterocolitis and/or bronchopneumonia

62
Q

Which domestic species, and which specific subgroup in this species, is most commonly affected by disease due to Rhodococcus equi?

A

Horses; foals most commonly affected

63
Q

You are performing a necropsy on a foal and find disseminated abscesses throughout the mesenteric lymph nodes, spleen, liver and large intestine. What is the most likely cause?

A

Rhodococcus equi

64
Q

How is Rhodococcus equi spread among horses?

A

It is present in the soil and feces, and farms can be endemically infected. It may be ingested or inhaled to cause infection, but inhalation is believed to be the more common route.

65
Q

You are performing a necropsy on a feedlot steer and find numerous foci of necrosis and abscess formation throughout the liver. What are the likely (a) cause and (b) pathogenesis?

A

(a) Fusobacterium necrophorum; (b) Damage to ruminal mucosa (rumenitis) -> bacteria enter portal circulation -> shower liver -> hepatic abscesses -> poor production

66
Q

Explain why feedlot cattle with rumenitis may develop hepatic and even pulmonary abscesses.

A

Damage to ruminal mucosa (rumenitis) -> bacteria enter portal circulation -> shower liver -> hepatic (and possibly pulmonary) abscesses

67
Q

Name the organism that causes Tyzzer’s disease.

A

Clostridium piliforme

68
Q

Which hepatic disease is caused by Clostridium piliforme?

A

Tyzzer’s disease

69
Q

Which animal types are most commonly affected by Tyzzer’s disease?

A
  1. Laboratory rodents
  2. Horses (foals and stressed weanlings)
70
Q

How is Clostridium piliforme, the organism responsible for Tyzzer’s disease, spread among animals?

A

Fecal-oral transmission

71
Q

What is the characteristic gross lesion of Tyzzer’s disease?

A

Numerous liver “dit-dots.” In an exam write: disseminated gray-white 1 to 3 mm diameter foci of necrosis surrounded by suppurative inflammation.

72
Q

We think of leptospirosis primarily affecting the kidney. How, then, does it cause icterus? What is the pathogenesis?

A

Leptospirosis -> hemolysis -> ischemic injury to centrilobular hepatocytes -> centrilobular necrosis -> icterus

73
Q

Each species has its own abortigenic herpesvirus strain. What strain causes abortion in: (a) horses; (b) cattle; (c) dogs; (d) cats?

A

(a) EHV-1; (b) BHV-1; (c) CHV-1; (d) FHV-1

74
Q

Herpesviruses may cause abortion in adult animals. What fetal lesions are characteristic in a fetus aborted because of herpesviral infection?

A

Multifocal random pinpoint necrosis in multiple organs: liver, kidneys, lungs and spleen most commonly affected. These show up as randomly distributed white “dit-dots.”

75
Q

You are examining the carcass of an aborted foal and notice randomly distributed white “dit-dots” through the liver, kidneys, lungs and spleen. What is the most likely cause of these?

A

Abortion due to infection with equine herpesvirus type 1 (EHV-1)

76
Q

You are examining the carcass of an aborted calf and notice randomly distributed white “dit-dots” through the liver, kidneys, lungs and spleen. What is the most likely cause of these?

A

Abortion due to infection with bovine herpesvirus type 1 (BHV-1)

77
Q

You are examining the carcass of a newborn puppy that failed to thrive and then died. You notice randomly distributed white “dit-dots” through the liver, kidneys, lungs and spleen. What is the most likely cause of these?

A

Infection with canine herpesvirus type 1 (CHV-1)

78
Q

Herpesviruses may cause severe disease and death in fetal and neonatal animals. Give 4 possible routes of infection of a fetus/neonate with herpesviruses.

A

(1) Transplacental in utero
(2) During birth from birth canal
(3) After birth from infected littermates’ oronasal secretions
(4) After birth from dam’s oronasal secretions.

79
Q

Dogs, especially in warmer climates, may develop “deep” (systemic) fungal infections that cause granulomatous inflammation in the lung and liver. Name one genus of fungus that is commonly involved.

A

(1) Histoplasma spp.
(2) Blastomyces spp.
(3) Coccidioides spp.

80
Q

What is the cause of “milk spots” in the liver of pigs?

A

Migration of the nematode worm Ascaris suum through the liver

81
Q

What gross lesion is characteristically seen in pigs infected with Ascaris suum?

A

Fibrous scars in the liver called “milk spots”

82
Q

What organism causes heartworm disease in dogs?

A

The nematode worm Dirofilaria immitis

83
Q

What organism causes vena caval (postcaval) syndrome in dogs?

A

The nematode worm Dirofilaria immitis

84
Q

Explain the pathogenesis of vena caval (postcaval) syndrome in dogs.

A

The nematode worm Dirofilaria immitis (the cause of heartworm disease) normally lives in the pulmonary arteries. Heavy infestation can lead to worms also occupying the right heart and caudal vena cava –> acute hepatic failure -> rapid death

85
Q

What lifecycle stage of the harmless Taenia tapeworms found in wild and domestic canids is found in intermediate hosts, and where in the intermediate host are these found??

A

The encysted intermediate stages of Taenia tapeworms are called Cysticercus. They are found in solid organs (often liver) of the intermediate hosts: horses, ruminants, pigs, rabbits, rodents etc.

86
Q

You are examining the liver of a cow and find several encysted parasitic cysts, later identified as Cysticercus species. How was this cow infected? What is the lifecycle of this parasite?

A

From grazing on pasture contaminated by the feces of a canid infected with the tapeworm species Taenia. The lifecycle is completed when the canid eats the cyst in the intermediate host (i.e., the cow).

87
Q

What organism causes hydatid cysts in sheep and aberrantly infected humans?

A

Echinococcus spp. These are tapeworms in canids that, when ingested in feces, cause formation of large cysts in the solid organs of the intermediate host. These cysts can be fatal in humans.

88
Q

Why are humans so concerned about infection of pet dogs and wild canids (e.g., coyotes) with the relatively harmless tapeworms in the genus Echinococcus?

A

Echinococcus spp. are tapeworms in canids that, when ingested in feces, cause formation of large cysts in the solid organs of the intermediate host. These cysts can be fatal in humans.

89
Q

What species of fluke infests the biliary ducts of ruminants?

A

Fasciola hepatica (and Fascioloides magna in wild ruminants)

90
Q

You are examining the liver of a cow and find numerous linear and branching dark black tracts throughout the parenchyma that appear to follow vessels. What is the most likely cause?

A

These are migration tracts of liver flukes (Fasciola hepatica), which live in and migrate along biliary ductules

91
Q

What is a serious sequela to hepatic fluke infestation in ruminants, and what is the pathogenesis?

A

Migrating flukes leave hemorrhagic and necrotic tracts in the liver before reaching the biliary ducts. These can cause hepatic disease by themselves but, more seriously, spores of Clostridium species can proliferate in necrotic hepatic tissue [C. haemolyticum –> bacillary hemoglobinuria (red water disease); C. novyi –> infectious necrotic hepatitis (black disease)]

92
Q

Name two clostridial species that may proliferate in the necrotic debris left by migrating hepatic flukes in ruminants.

A

C. haemolyticum –> bacillary hemoglobinuria (red water disease)
C. novyi –> infectious necrotic hepatitis (black disease)

93
Q

Two clostridial species may proliferate in the necrotic debris left by migrating hepatic flukes in ruminants. Name them, and the disease caused by each.

A

C. haemolyticum –> bacillary hemoglobinuria (red water disease); C. novyi –> infectious necrotic hepatitis (black disease)

94
Q

What predisposes cattle to development of infectious necrotic hepatitis, and what causes this disease?

A

Clostridium novyi causes infectious necrotic hepatitis (black disease). Migrating liver flukes (Fasciola hepatica) predispose to this disease by leaving hemorrhagic and necrotic tracts in the liver before reaching the biliary ducts. These can cause hepatic disease by themselves but, more seriously, spores of Clostridium species can proliferate in necrotic hepatic tissue.

95
Q

What organism causes bacillary hemoglobinuria (red water disease) in ruminants?

A

Clostridium haemolyticum causes bacillary hemoglobinuria (red water disease). Migrating liver flukes (Fasciola hepatica) predispose to this disease by leaving hemorrhagic and necrotic tracts in the liver before reaching the biliary ducts. These can cause hepatic disease by themselves but, more seriously, spores of Clostridium species can proliferate in necrotic hepatic tissue.

96
Q

On ultrasound examination you detect a smoothly-domed well-demarcated parenchymal mass in the liver of a dog. Assuming that it is not malignant, what are two likely diagnoses for this mass?

A

(1) Nodular hyperplasia; (2) Hepatocellular adenoma

97
Q

In which type of domestic animal is hepatic nodular hyperplasia seen, and in which age group?

A

Dogs (middle-aged & older)

98
Q

Compare and contrast the appearance and causes of (1) nodular hyperplasia and (b) nodular regeneration in the liver of dogs

A

(1) Nodular hyperplasia: usually solitary, well demarcated, smoothly domed and NOT associated with hepatic disease (neither causing nor resulting from it); (2) Nodular regeneration: the liver is small, firm and irregular with nodules of regenerative parenchyma separated by tracts of fibrous connective tissue. This disease is the result of prolonged insult to the liver, such as that caused by chronic anticonvulsant administration.

99
Q

Describe the typical gross appearance of a liver with severe nodular regeneration (end-stage liver).

A

The liver is small, firm and irregular with nodules of regenerative parenchyma separated by tracts of fibrous connective tissue.

100
Q

What is the name and appearance of a benign liver mass derived from hepatocytes?

A

Hepatocellular adenoma; Discrete, well circumscribed mass that may compress but does not invade adjacent liver parenchyma

101
Q

What is the name and appearance of a malignant liver mass derived from hepatocytes?

A

Hepatocellular carcinoma; Poorly demarcated and multilobular mass that invades adjacent liver parenchyma. The centres of neoplastic lobules are frequently necrotic

102
Q

What is the name and appearance of a benign liver mass derived from the cells that line biliary ductules?

A

Cholangiocellular adenoma (“biliary adenoma”). Variably sized cystic cavities in the liver lined by flattened biliary epithelium. These are difficult to distinguish from congenital biliary cysts.

103
Q

In which domestic species is cholangicellular adenoma (“biliary adenoma”) most common?

A

Cats; rare in other species.

104
Q

What is the name and appearance of a malignant liver mass derived from the cells that line biliary ductules?

A

Cholangiocellular carcinoma; Multiple, randomly distributed firm hepatic nodules, many with umbilicated centers

105
Q

Many types of metastatic neoplasm can end up in the liver, where they usually appear as nodules with a characteristic “showering” distribution. One very common neoplasm doesn’t follow this rule, however, and can cause diffuse hepatic enlargement and an enhanced lobular pattern that can mimic various other hepatic diseases. What neoplasm is this?

A

Lymphoma

106
Q

What is one characteristic (and “non-lumpy”) appearance of a liver with infiltrative / metastatic lymphoma? How does this appearance arise?

A

Diffuse hepatic enlargement, pale liver and an enhanced lobular pattern that can mimic various other hepatic diseases. The reason for this is that neoplastic lymphocytes typically aggregate in portal areas of each lobule, rather than forming discrete nodules (although the latter is possible and even common; lymphoma does not follow rules and should always be considered in a differential list).

107
Q

What is another name for equine serum hepatitis?

A

Theiler’s disease

108
Q

What is another name for Theiler’s disease in horses?

A

Equine serum hepatitis

109
Q

What is the pathogenesis of Theiler’s disease in horses?

A

Horse receives an injection of a biologic that contains equine serum (e.g., tetanus antitoxin) –> After some time horse develops hepatic failure –> hepatic encephalopathy & icterus –> death. Cause / mechanism unknown

110
Q

You are examining the liver of a horse that died of hepatic failure. The liver is small, flabby and limp (“dishrag” appearance). What is the most likely disease, and what aspect of this horse’s history should be investigated?

A

Theiler’s disease. You should investigate whether this horse has had a recent injection of a biologic that contains equine serum (e.g., tetanus antitoxin)

111
Q

Theiler’s disease in horses results from (a) Clostridium piliforme infection or (b) recent injection of a biologic that contains equine serum (e.g., tetanus antitoxin). [Choose one answer]

A

(b) Recent injection of a biologic that contains equine serum (e.g., tetanus antitoxin)

112
Q

Tyzzer’s disease in horses results from (a) Clostridium piliforme infection or (b) recent injection of a biologic that contains equine serum (e.g., tetanus antitoxin). [Choose one answer]

A

(a) Clostridium piliforme infection

113
Q

Chronic copper toxicity occurs most often in sheep. What is its pathogenesis and how does it cause liver damage?

A

Dietary copper excess or molybdenum deficient soil -> Copper accumulates in liver -> [at later time] Animal ingests hepatotoxin (plant or mycotoxin) -> Hepatocyte injury -> Sudden release of copper -> Acute intravascular hemolysis -> Hepatocellular necrosis because of anemia. Note that the copper itself is not directly toxic to the liver

114
Q

You are examining the liver of a young, rapidly growing pig that died of hepatic failure. The liver is swollen, necrotic and covered in fibrin. What disease should you be thinking of, and what is its cause?

A

Hepatosis dietetica. The cause is unknown, but it is vitamin E / selenium responsive and so may be due to a deficiency of these.

115
Q

Which mineral must be supplemented in young, indoor-housed pet pigs?

A

Iron

116
Q

Iron deficiency is a risk in which particular population of pigs?

A

Young, indoor-housed pet pigs

117
Q

How does lack of iron supplementation result in liver disease in young, indoor-housed pet pigs?

A

Iron deficiency -> anemia -> ischemic injury to centrilobular hepatocytes -> centrilobular necrosis -> icterus

118
Q

One cause of chronic hepatitis in dogs is copper accumulation. In one breed in particular there is a well-recognized genetic mutation that prevents copper excretion by hepatocytes. Name this breed.

A

Bedlington terrier

119
Q

One cause of chronic hepatitis in dogs is copper accumulation in certain predisposed breeds. In the Bedlington terrier there is a well-recognized genetic mutation that prevents copper excretion by hepatocytes. In other breeds, however, it’s less clear whether copper accumulation is a cause for, or a result of the disease. Name one of these predisposed breeds.

A

Cocker spaniels; Doberman pinschers; Skye terriers; Standard poodles; West Highland white terriers

120
Q

What agent causes infectious canine hepatitis?

A

Canine adenovirus type 1 (CAV-1)

121
Q

True or false: infection with canine adenovirus-1 generally causes fulminant infection which is often fatal.

A

False; most infections are asymptomatic

122
Q

Canine adenovirus type 1 (CAV-1), the cause of infectious canine hepatitis, has a tropism for which types of cells? Name three.

A

(1) Hepatocytes; (2) Endothelial cells; (3) Mesothelial cells, such as those lining the peritoneal, pleural and pericardial cavities

123
Q

A thickened edematous gall bladder in a dog that died of systemic disease is characteristic of which disease, and what is the cause of this disease?

A

Infectious canine hepatitis, caused by canine adenovirus type 1 (CAV-1)

124
Q

Canine adenovirus type 1 (CAV-1), the cause of infectious canine hepatitis, has a tropism for (1) hepatocytes; (2) endothelial cells; (3) mesothelial cells, such as those lining the peritoneal, pleural and pericardial cavities. Given this, what gross lesions would you expect, in addition to liver necrosis?

A

Widespread petechial hemorrhages because of the endothelial damage

125
Q

How is canine adenovirus type 1 (CAV-1), the cause of infectious canine hepatitis, transmitted among dogs?

A

Urine-oral infection

126
Q

Which canine disease is associated with development of “blue-eye”, in which the cornea becomes edematous and opaque?

A

Infectious canine hepatitis, caused by canine adenovirus type 1 (CAV-1). Infection or vaccination with CAV-1 can result in immune complex uveitis, a type III hypersensitivity reaction

127
Q

Dogs recovering from or vaccinated against infectious canine hepatitis may develop ocular lesions. What are these ocular lesions and what is their pathogenesis?

A

Infectious canine hepatitis, caused by canine adenovirus type 1 (CAV-1) is associated with development of “blue-eye”, in which the cornea becomes edematous and opaque. Infection or vaccination with CAV-1 can result in immune complex uveitis, a type III hypersensitivity reaction

128
Q

Lymphocytic cholangitis is a slowly progressive disease affecting which domestic species most commonly?

A

Cats

129
Q

Lymphocytic cholangitis, a slowly progressive disease of cats, affects which age group?

A

Young to middle-aged cats

130
Q

Lymphocytic cholangitis, a slowly progressive disease of cats, is caused by what?

A

No-one knows. It is presumed to be immune-mediated, but no definitive cause has been found

131
Q

Gallstones are relatively uncommon in domestic animals. However, they are seen not infrequently in one species of domestic animal. Which one?

A

Cattle

132
Q

What is the term for inflammation of the gall bladder?

A

Cholecystitis

133
Q

What is the term for the condition of gallstones?

A

Cholelithiasis

134
Q

Cholecystitis (gall bladder inflammation) is seen most commonly in dogs with which infectious disease?

A

Infectious canine hepatitis, caused by canine adenovirus type 1 (CAV-1)

135
Q

Cholecystitis (gall bladder inflammation) is seen most commonly in calves with which infectious disease?

A

Enteric salmonellosis

136
Q

Mucocele of the gall bladder is seen most frequently in which domestic species?

A

Dogs

137
Q

Mucocele of the gall bladder does not cause clinical signs. True or false?

A

False. Mucocele of the gall bladder is often associated with signs of biliary obstruction and can occasionally lead to gallbladder rupture.

138
Q

You perform a necropsy on a dog with biliary obstruction and note that the gall bladder is distended by mucus. What is this condition?

A

Gall bladder mucocele

139
Q

You perform a necropsy on a dog with no clinical signs and note that the gall bladder has a “sponge-like” consistency. What is this condition?

A

Cystic mucinous hyperplasia

140
Q

Describe the gross lesions of cystic mucinous hyperplasia of the gall bladder in dogs.

A

Sponge-like mucosal surface of the gall bladder caused by numerous 1-3 mm diameter cysts filled with mucus.

141
Q

Both gall bladder mucocele and cystic mucinous hyperplasia of the gall bladder in dogs are associated with mucous distension of the gall bladder or its mucosa. However, one is typically associated with clinical signs, and sometimes even biliary obstruction or gall bladder rupture. Which one?

A

Gall bladder mucocele

142
Q

What is the term for inflammation of the biliary ducts?

A

Cholangitis

143
Q

What does the term cholangitis mean?

A

Inflammation of the biliary ducts

144
Q

What is the most common reason for neutrophilic cholangitis?

A

Ascending bacterial infection from the intestine via the bile duct

145
Q

In which domestic species is lymphocytic cholangitis most commonly seen?

A

Cats

146
Q

What is the term for inflammation affecting both the biliary ducts and hepatic parenchyma?

A

Cholangiohepatitis

147
Q

What does the term cholangiohepatitis mean?

A

Inflammation affecting both the biliary ducts and hepatic parenchyma

425 - Systemic Pathology (7 decks)

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