Hepatobiliary Disease

Question 1

which enzymes are markers of parenchymal disease?

Answer 1

aminotransferases:
alanine aminotransferase (ALT)
aspartate aminotransferase (AST)

Question 2

what is reactive hepatitis like?

Answer 2

mild to moderate portal hepatitis
no necrosis/apoptosis
no spillover into the hepatic parenchyma

Question 3

what gastrointestinal diseases are associated with elevations in ALP?

Answer 3

inflammatory bowel disease
pancreatitis

Question 4

which serum alkaline phosphatases are inducible?

Answer 4

liver
corticosteroid

Question 5

which drugs induce ALP in dogs?

Answer 5

corticosteroids
phenobarbital
penicillamine
pesticides?
supplements: CBD

Question 6

which breeds are predisposed to chronic hepatitis?

Answer 6

bedlington
dalmations
westie
labrado retrievers
doberman pinscher
cocker spaniel
english springer spaniel

Question 7

which breeds are predisposed to idiopathic vacuolar hepatopathies?

Answer 7

scottish terrier
miniature schnauzer

Question 8

what do total serum bile acids measure?

Answer 8

patency of enterohepatic circulation
hepatic function

Question 9

what is benign nodular hyperplasia like on histopathology?

Answer 9

well circumscribed hyperplastic normal hepatocytes that often contain vacuoles and are organized into cord with discernible portal area, lipogranulomas, mild mixed inflammatory infiltrates

Question 10

who is benign nodular hyperplasia common in?

Answer 10

old dogs

Question 11

what is the signalment of gallbladder mucocele?

Answer 11

older dogs
median body weight 15 kg
strong breed predispositions
no sex predilection

Question 12

what signs can dogs with gallbladder mucocele show?

Answer 12

vomiting
anorexia
lethargy
abdominal pain
icterus
fever

Question 13

what can cause an increase in ALP?

Answer 13

benign nodular hyperplasia
gallbladder mucocele
hepatocellular cancer
cholecystitis/cholangitis/cholangiohepatitis
vacuolar hepatopathy

Question 14

what is seen on bloodwork with hepatocellular carcinoma?

Answer 14

increased ALP and ALT
less common AST and GGT

Question 15

what is the etiology of vacuolar hepatopathy?

Answer 15

likely a reactive pattern

Question 16

which breeds are associated with idiopathic vacuolar hepatopathy?

Answer 16

scottie
miniature schnauzer

Question 17

which dog breed is over-represented in cholangitis/cholangiohepatitis/cholecystitis?

Answer 17

doxies

Question 18

what things on ultrasound with the gallbladder are associated with bacterial infection?

Answer 18

immobile bile
thick, mineralized or irregular gallbladder wall/duct

Question 19

what endocrine diseases are associated with elevations in ALP?

Answer 19

hyperadrenocorticism
diabetes mellitus
hypothyroidism- rare
hyperthyroidism: cats

Question 20

which ALPs are inducible?

Answer 20

liver
corticosteroid
not bone

Question 21

what does steroid/vacuolar hepatopathy look like on histopathology?

Answer 21

intracytoplasmic vacuolation
degenerative changes: piecemeal necrosis and ballooning degeneration

Question 22

which breeds are shown to be predisposed to copper heptatitis?

Answer 22

bedlington
dalmation

Question 23

which breeds are thought to be predisposed to immune hepatitis?

Answer 23

labradors
dobermans
cocker spaniels
english springer spaniels

Question 24

what are liver enzymes like in chronic hepatitis?

Answer 24

usually ALT»ALP
until late stage

Question 25

what is likely to be high in congenital portosystemic shunts?

Answer 25

ALT

Question 26

who is predisposed to idiopathic vacuolar hepatopathies?

Answer 26

scottish terrier
miniature schnauzer

Question 27

what can be used to evaluate hepatic function?

Answer 27

bilirubin
albumin
BUN
cholesterol
glucose
total serum bile acids
blood ammonia

Question 28

what do total serum bile acids test?

Answer 28

measure of patency of enterohepatic circulation
hepatic function

Question 29

when are total serum bile acids elevated?

Answer 29

congenital or acquired portosystemic shunting: screen
hepatobiliary pathology: diagnostic

Question 30

is liver size usually normal with benign nodular hyperplasia?

Answer 30

yes

Question 31

what does benign nodular hyperplasia cause in bloodwork?

Answer 31

mild to moderate increase ALP
mild increase ALT, GGT
bilirubin normal
maybe mild increase TSBA

Question 32

what are the risk factors for gallbladder mucocele?

Answer 32

endocrinopathy
hyperlipidemia
biliary infection?
environmental
diet: high fat, gluten

Question 33

what is bloodwork like in a gallbladder mucocele?

Answer 33

normal
abnormal: inflammatory leukogram, elevated liver enzymes ALP»ALT, hyperbilirubinemia
hyperlipidemia

Question 34

what is prognosis like of hepatocellular carcinoma?

Answer 34

resection associated with prolonged survival times with low local recurrence and metastatic rates in dogs

Question 35

what are clinical signs of idiopathic vacuolar hepatopathy?

Answer 35

many have signs compatible with corticosteroid excess

Question 36

what are the consequences of idiopathic vacuolar hepatopathy?

Answer 36

parenchymal loss and fibrosis
neoplastic transformation
gallbladder mucocele
hepatocutaneous syndrome
proteinuria?
hypertension?

Question 37

what is the triad of clinical signs that is very suggestive of cholangitis/cholangiohepatitis/cholecystitis?

Answer 37

icterus
fever
abdominal pain
onlu 20-55% have this