Hepatobiliary 2 Flashcards
4 Circulatory Disorders?
Passive congestion
Congenital portosystemic shunt
Congenital portal vein hypoplasia
Portal hypertension with acquired vascular shunts
What produces elevated pressure in the caudal vena cava that extends to the hepatic veins and its tributaries
Right sided heart failure
High pressure in the hepatic vein leads to ______ of sinusoids
Centrilobar congestion
Chronic hypoxi injury also leads to??
Steatosis
All of the combined changes of passive congestion results in an accentuated lobular pattern which is termed?
Enhanced reticular pattern
Nutmeg Liver
Passive congestion results in the liver grossly looking like?
Enlarged, with rounded edges
What is an abnormal vascular structure that allows portal blood to bypass the liver and drain directly into the systemic circulation
PSS
What CS do animals have with cPSS
stunted growth
may develop signs of hepatic encephalopathy
Grossly, how does the liver look with CPSS
microhepatica
What crystals do PSS patients have? and why?
Ammonium Biurates
They have abnormal ammonia metabolism
What 6 things might you see with a patient that has a PSS
hyperammonemia
Decreased UN
Increased fasting and postprandial bile acids
Hypocholesterolemia
Hypoalbuminemia
Possible mildly elevated ALT
What are your 2 types of PSS
Intrahepatic
Extrahepatic
What are the differences between intra/extra hepatic shunts?
Intra: failure of closure of the ductus venosus, large breeds
Extra: Portal vein to caudal vena cava anastomosis OR to azygous vein.. Small breeds
Whats another condition where animals typically have microhepatica and ascites and are indistinguisable from PSS?
What breeds has suspected inheritance?
Congenital Portal vein HypOplasia
Small breeds:
Yorkies, Maltese, Cairn terriers, Tibetan spaniels, Shih-tzues, Havanese
small breeds for small veins
Most causes of portal hypertension are?
Intrahepatic: Fibrosis, hepatocellular swelling, regeneration
What can lead to ascites and development of acquired portosystemic shunts?
Portal Hypertension
When does lipidosis occur?
When hepatocyte triglyceride accumulation exceeds the rate of lipoprotein release
When can hepatocellular lipidosis occur? 5
Excessive dietary intake of fats/carbs
Increased mobilization of body fat-DM, Starvation, etc
Hypoxia or mitochondrial damage
Increased glucose and insulin
Impaired secretion of lipoprotein from the liver due to secretory defects produced by hepatotoxins or drugs
What other condition can cause a nutmeg liver?
Fatty Liver
What condition is specific to dogs characterized by hepatocellular glycogen accumulation secondary to excess glucocorticoids?
Canine-steroid induced hepatopathy
What causes the liver, grossly, to look enlarged with rounded edges, firable, and pale?
Hepatic amyloidosis
Where does the amyloid deposit within the liver?
Space of Disse
Portal tracts
w/i and around blood vessels
What chemical leads to the production of reactive oxygen and causes oxidative injury to mitochondria and cellular membranes?
Copper
What spp is this common in? and what exacerbates is?
Sheep
Low dietary molybdenum and sulfur
Chronic copper accumulation in the liver precedes rapid release of copper into blood resulting in????
What can trigger this?
Hemolysis
Stress or illness
Can dogs and cats get copper associated haptopathy, and if they can, what breeds?
Cats-no
Dogs-Yes. Bedlington terriers, Labs.
Hemochromatosis is also called?
Iron storage dz
In what spp is iron storage dz inherited?
Ppl Mynah birds, Toucans Salers cattle Horses
What dye do you use to see iron?
Prussian blue
When will bile acumulate in the liver? What does it cause?
Cholestatic dz
Hepatocellular injury
Lysosomal Storage dz leads to?
What stage of life do you see this in?
Accumulation of substances w/i lysosomes which results in cytoplasmic swelling and vacuolization of hepatocytes, macrophages, neurons, and other cells types
Young animals
