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Small Animal Medicine and Surgery > Hepatobiliary Disease > Flashcards

Hepatobiliary Disease Flashcards

1
Q

which enzymes are markers of parenchymal disease?

A

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

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2
Q

what is reactive hepatitis like?

A

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

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3
Q

what gastrointestinal diseases are associated with elevations in ALP?

A

inflammatory bowel disease
pancreatitis

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4
Q

which serum alkaline phosphatases are inducible?

A

liver
corticosteroid

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5
Q

which drugs induce ALP in dogs?

A

corticosteroids
phenobarbital
penicillamine
pesticides?
supplements: CBD

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6
Q

which breeds are predisposed to chronic hepatitis?

A

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

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7
Q

which breeds are predisposed to idiopathic vacuolar hepatopathies?

A

scottish terrier
miniature schnauzer

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8
Q

what do total serum bile acids measure?

A

patency of enterohepatic circulation
hepatic function

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9
Q

what is benign nodular hyperplasia like on histopathology?

A

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

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10
Q

who is benign nodular hyperplasia common in?

A

old dogs

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11
Q

what is the signalment of gallbladder mucocele?

A

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

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12
Q

what signs can dogs with gallbladder mucocele show?

A

vomiting
anorexia
lethargy
abdominal pain
icterus
fever

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13
Q

what can cause an increase in ALP?

A

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

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14
Q

what is seen on bloodwork with hepatocellular carcinoma?

A

increased ALP and ALT
less common AST and GGT

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15
Q

what is the etiology of vacuolar hepatopathy?

A

likely a reactive pattern

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16
Q

which breeds are associated with idiopathic vacuolar hepatopathy?

A

scottie
miniature schnauzer

17
Q

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

A

doxies

18
Q

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

A

immobile bile
thick, mineralized or irregular gallbladder wall/duct

19
Q

what endocrine diseases are associated with elevations in ALP?

A

hyperadrenocorticism
diabetes mellitus
hypothyroidism- rare
hyperthyroidism: cats

20
Q

which ALPs are inducible?

A

liver
corticosteroid
not bone

21
Q

what does steroid/vacuolar hepatopathy look like on histopathology?

A

intracytoplasmic vacuolation
degenerative changes: piecemeal necrosis and ballooning degeneration

22
Q

which breeds are shown to be predisposed to copper heptatitis?

A

bedlington
dalmation

23
Q

which breeds are thought to be predisposed to immune hepatitis?

A

labradors
dobermans
cocker spaniels
english springer spaniels

24
Q

what are liver enzymes like in chronic hepatitis?

A

usually ALT»ALP
until late stage

25
Q

what is likely to be high in congenital portosystemic shunts?

A

ALT

26
Q

who is predisposed to idiopathic vacuolar hepatopathies?

A

scottish terrier
miniature schnauzer

27
Q

what can be used to evaluate hepatic function?

A

bilirubin
albumin
BUN
cholesterol
glucose
total serum bile acids
blood ammonia

28
Q

what do total serum bile acids test?

A

measure of patency of enterohepatic circulation
hepatic function

29
Q

when are total serum bile acids elevated?

A

congenital or acquired portosystemic shunting: screen
hepatobiliary pathology: diagnostic

30
Q

is liver size usually normal with benign nodular hyperplasia?

A

yes

31
Q

what does benign nodular hyperplasia cause in bloodwork?

A

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

32
Q

what are the risk factors for gallbladder mucocele?

A

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

33
Q

what is bloodwork like in a gallbladder mucocele?

A

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

34
Q

what is prognosis like of hepatocellular carcinoma?

A

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

35
Q

what are clinical signs of idiopathic vacuolar hepatopathy?

A

many have signs compatible with corticosteroid excess

36
Q

what are the consequences of idiopathic vacuolar hepatopathy?

A

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

37
Q

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

A

icterus
fever
abdominal pain
onlu 20-55% have this

Small Animal Medicine and Surgery (71 decks)

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