Hepatobiliary and Pancreatic Flashcards
Amino acid changes in PSS?
Increased aromatic: tyrosine, phenylalanine
Decreased branched chain: leucine, isoleucine, valine
MicroRNAs in hepatic disease?
Chronic hepatitis - miR-126/122/29a. 122 corr with fibrosis. Increase ET1 too
miR-200 hepatocell carc
mrR21/122 mucocoele
mrR122 gen hepatic dz (
Dermatological presentation of hepatic disease?
Superficial necrolytic dermatitis
Compounds associated with hepatic encephalopathy?
Increased: ammonia, aromatic AAs, endogenous benzodiazepines, gamma-aminobutyric acid (GABA), glutamine, phenol. short chain FAs, tryptophan, false NTs
Decreased: alpha-ketoglutarate
What is the half life of ALT, ALP and AST in dogs and cats?
ALT: 48-60/6
AST: 22h/77m (nb 20 % in mitochondria)
ALP: 70/6
What links ALP to cell membranes? Why is it released in cholestasis?
Glucosyl phosphatidyl inositol linkage
Cholestasis - bile acids detergent, increased glucosylphosphatidylinositol phospholipase activity
When is GGT increased?
Zone 1 peri portal disease
When do steroids start increasing ALP?
mRNA 24-48h, expression gene 10d
Mechanism of RBC changes in hepatobiliary disease?
Microcytosis - impaired iron transport
Target cells/poikilocytes - altered RBC cell membrane lipoprotein content/deformability
Anaemia - chronic dz, haemorrhage
Thrombocytopenia - sequestration, decreased thrombopoietin
Why do dogs have bilirubin in urine?
Can conjugate it renal - have enzymes - esp males, plus low renal threshold
Mechanism of ammonium biurate stones?
No uric acid conversion to allantoin (uricase)
Low USG?
Loss medullary hypertonicity, decreased cortisol metabolism, psychogenic
Glucose?
Decrease when 75 % liver gone - decreased glycogen stores, gluconeogenesis, insulin clearance and glucagon response
Increase in globulin?
Decreased filtration and clearance of toxins and bacteria
How is ammonia incorporated into the urea cycle?
Carbamoyl phosphate synthesise 1 (helped with nacetylglutamate)
What is more sens/spec - single BA, fasting NH3, pre and post BA PSS?
Sens - pre + post BA then ammonia then single BA
Spec - ammonia > BA
Urine versus serum BAs?
Increased specificity lower sens HEPATOBILIARY
Equivalent serum in cats
Lower sens PSS
Values of ammonia for PSS?
> 45 - 98/89 % sens/spec
Don’t do tolerance test if > 150 basal
What clotting factor does the liver not produce?
vonWB subtype of VII
Protein C?
Binds protein S to degrade V and VIII clotting factors
Decreased in PSS vs PVH
What is used to conjugate bile acids?
Glycine/taurine
Bile salt hepatocyte export and import?
Bile salt export pump (multi drug resistance associated protein 2)
Sodium dependent taurochlorate cotransporter
Ileum - apical sodium bile acid cotransporter
What transports bilirubin and bile acids in blood?
Organic ion transporting polypeptide
Top end normal CBD cat/dog?
< 4 <3