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Pathology > Hepatobiliary Diseases 1 > Flashcards

Hepatobiliary Diseases 1 Flashcards

1
Q

what is the functional subunit of the liver parenchyma

A

hepatic lobule

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2
Q

what does the center of the hepatic lobule contain

A

central vein

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3
Q

what resides on the peripherals of the hepatic lobules

A

portal tracts

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4
Q

what are the one-cell thick layers of hepatocytes that extend radially from the central vein and are separated by blood-filled hepatic sinusoids

A

hepatic plates

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5
Q

what are the one-cell thick layers of hepatocytes that extend radially from the central vein and are separated by blood-filled hepatic sinusoids

A

hepatic plates

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6
Q

what is the perisinusoidal space between sinusoid and hepatic plate

A

space of Disse

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7
Q

within the space of Disse, what cells are important for the storage of Vitamin A and responds to hepatic injury

A

hepatic stellate cells

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8
Q

what cells of the liver function to remove infectious agents, endotoxins, immune complexes and others

A

kupffer cells

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9
Q

what drains the digestive tract and provides 60-70% of the total blood

A

portal vein

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10
Q

true or false:
hepatocytes surrounding central veins have the least oxygenated blood

A

true

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11
Q

what cells are the most susceptible to hypoxia in the liver

A

hepatocytes surround the central veins

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12
Q

what type of infection ascends bacterial or parasitic from the intestine and can gain access to the pancreas through the pancreatic duct

A

retrograde pancreatic ductuar infection

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13
Q

what results from sublethal injury and degeneration

A

autophagy of damaged organelles
accumulation of lipofuscin pigment

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14
Q

what are the 2 patterns of hepatocellular degeneration

A

random
zonal

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15
Q

what is the main descriptive characteristic of a random pattern of hepatocellular degeneration

A

embolic pattern

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16
Q

what types of injuries cause embolic patterns in the liver

A

blood-borne infectious agents
virus
bacteria
protozoa

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17
Q

what types of injuries cause zonal necrosis patterns in the liver

A

hypoxic injury
zonal hepatitis
hepatotoxicities

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18
Q

what part of the liver is mostly affected by zonal hepatic necrosis

A

centrilobular (zone 3)

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19
Q

what causes centrilobular hepatic necrosis

A

hypoxic injury
hepatotoxicity

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20
Q

what are the 3 causes of hyperbilirubinemia

A

hemolytic disease
liver failure
cholestatic disease

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21
Q

which prehepatic hyperbilirubinemia disease leads to the accumulation of bilirubin in the blood

A

hemolytic disease

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22
Q

which hepatic hyperbilirubinemia disease leads to failure of hepatocytes to uptake bilirubin from the blood

A

liver disease

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23
Q

what are the 2 types of cholestatic disease

A

extrahepatic cholestasis
intrahepatic cholestasis

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24
Q

which type of cholestatic disease occurs with obstruction of the extrahepatic bile ducts

A

extraheptic cholestasis

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25
Q

what are some types of extrahepatic cholestasis

A

cholangitis
cholelithiasis
cholecystitis
pancreatitis

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26
Q

which type of cholestatic disease occurs with impairment of bile flow within canaliculi

A

intrahepatic cholestasis

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27
Q

what commonly causes intrahepatic cholestasis

A

chronic hepatitis
neoplasia
hepatocellular swelling

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28
Q

what is the outcome of repeated injury/ regeneration cycles

A

formation of fibrosis and nodular regeneration

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29
Q

what is the result of chronic and severe repeated injury/ regeneration cycles

A

end-stage liver (cirrhosis)

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30
Q

true or false:
chronic injury and regeneration leads to progressive loss of function

A

true

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31
Q

what is an increase in the amount of collagen within the liver

A

hepatic fibrosis

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32
Q

which cells within the liver are responsible for producing the collagen needed to form fibrotic tissue

A

stellate cells

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33
Q

what is the proliferation of newly formed biliary ducts within the portal tracts and periportal regions

A

biliary hyperplasia

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34
Q

with what diseases is biliary hyperplasia commonly associated with

A

biliary inflammation
obstruction
cholestasis

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35
Q

true or false:
biliary hyperplasia indicated long-standing (chronic) hepatic injury

A

true

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36
Q

true or false:
biliary hyperplasia can be non-specific

A

true

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37
Q

what is the diffuse process in the liver characterized by severe fibrosis and replacement of normal hepatic lobules with nodular regeneration and abnormal vasculature

A

end stage liver (Chirrhosis)

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38
Q

true or false:
up to 75% of hepatic parenchyma can be removed without significant impairment of function

A

true

39
Q

what are some clinical manifestations of hepatic failure

A

hyperammonemia
hyperbilirubinema/ icterus/ jaundice
immunologic manifestations
coagulation abnormalities
hypoalbuminemia and ascites

40
Q

what are some hepatic congenital abnormalities

A

biliary cysts
ductal plate malformations
portosystemic shunts
portal vein hypoplasia

41
Q

what disease is commonly caused by congenital biliary cysts in cairn terries, westies, bull terriers and persian cats

A

congenital polycystic disease

42
Q

what congenital abnormality is characterized by diffuse periportal to bridging fibrosis with numerous small, often irregular bile ducts and reduction in the number of portal vein branches in the ductal plate

A

ductal plate malformation

43
Q

what hepatic congenital disorder is common in Boxers and young dogs

A

congenital hepatic fibrosis

44
Q

what liver disorder is characterized by inflammation, hepatocellular necrosis and apoptosis

A

acute hepatitis

45
Q

what can cause acute hepatitis

A

systemic infections or portal circulation of disease

46
Q

what is the pattern associated with acute hepatitis

A

embolic pattern

47
Q

what liver disorder is characterized by fibrosis, mononuclear inflammatory cells, hepatocelluar loss, nodular regeneration and structural remodeling of the hepatic lobule and vasculature

A

chronic hepatitis

48
Q

what can cause chronic hepatitis

A

chronic persistent antigenic stimulus

49
Q

what type of reactive hepatitis is the diffuse process in the liver that is response to systemic inflammation commonly stemming from GI disease

A

nonspecific reactive hepatitis

50
Q

true or false:
nonspecific reactive hepatitis may cause mild elevation of serum ALT and ALP

A

true

51
Q

what is inflammation of the biliary ducts

A

cholangitis

52
Q

what can chronic cholangitis lead to

A

cholestasis
elevated serum ALP
hyperbilirubinemia

53
Q

which type of cholangitis is due to infection

A

neutrophilic cholangitis

54
Q

what can cause neutrophilic cholangitis

A

ascending bacterial infection of E. coli, Enterococcus, bacteroides, streptococcus, or clostridium

55
Q

which type of cholangitis is immune mediated

A

lymphocytic cholangitis

56
Q

in which species is lymphocytic cholangitis most common

A

cats

57
Q

what is inflammation of biliary ducts and extension of inflammation into the surrounding liver parenchyma

A

cholangiohepatitis

58
Q

what causes cholangiohepatitis

A

an extension of bacterial cholangitis into the surrounding periportal hepatic parenchyma

59
Q

what is the clinical manifestation on a CBC of cholangiohepatitis

A

greater elevation of serum ALT

60
Q

what are the 4 most common circulatory diseases of the liver

A

passive congestion
congenital portosystemic shunt
congenital portal vein hypoplasia
portal hypertension with acquired vascular shunts

61
Q

what circulatory disease occurs as a consequence of reduced hepatic outflow due to cardiac dysfunction

A

passive congestion

62
Q

what pre-existing disorder often leads to passive congestion of the liver

A

right sided heart failure

63
Q

what can be a result of the chronic hypoxic injury caused by passive congestion in the liver

A

steatosis

64
Q

what is the classic characteristic of a liver with passive congestion

A

nutmeg liver
enlarged with rounded edges

65
Q

what circulatory disorder is an abnormal vascular structure that allows portal blood to bypass the liver and drain directly into the systemic circulation

A

congenital portosystemic shunt

66
Q

what type of animals are characteristic of having congenital portosystemic shunts

A

stunted growth
hepatic encephalopathy due to hyperammonemia
microheptica
presence of ammonium biurate crystalluria

67
Q

what is expected to be seen on a chemistry of an animal with PSS

A

hyperammonemia
decreased BUN
increased fasting and postprandial bile acids
hypocholesterolemia
hypoalbuminemia
possible mild elevated ALT

68
Q

which type of congenital portosystemic shunt is commonly formed due to failure of closure of the ductus venosus

A

intrahepatic shunts

69
Q

in which type of dogs are intrahepatic shunts more common

A

large breed dogs

70
Q

which type of congenital PSS is formed due to anastomosis of portal vein to caudal vena cava or portal vein to azygos vein

A

extrahepatic shunts

71
Q

in which type of dogs and cats are extrahepatic shunts more commonly seen

A

small breeds

72
Q

what is a congenital vascular anomaly in dogs and occasionally cats characterized by abnormally small portal veins

A

hepatic microvascular dysplasia

73
Q

what are the results of a typical animal with hepatic microvascular dysplasia

A

microhepatica
ascites

74
Q

what can occur with thrombosis or other types of occulsion within that portal vein or hepatic outflow

A

portal hypertension

75
Q

true or false:
most causes of portal hypertension are intrahepatic

A

true

76
Q

what can persistent portal hypertension lead to

A

ascites
acquired portosystemic shunts

77
Q

what occurs when hepatocyte triglyceride accumulation exceeds the rate of lipoprotein release

A

hepatic lipidosis

78
Q

what can cause hepatocellular lipidosis

A

excessive dietary intake
increased mobilization of body fat
hypoxia / mitochondrial damage
diabetes mellitus
secretory defects

79
Q

what does hepatic lipidosis look like

A

diffusely swollen
yellow
greasy texture
“nut meg” liver

80
Q

in what type of cows does bovine fatty liver disease occur in

A

dairy cows in late gestation or peak lactation

81
Q

true or false:
feline hepatic lipidosis is an emergency situation in cats

A

true

82
Q

what liver disease is the result of glycogenosis with metabolic disturbances that affect glucose regulation

A

hepatocellular glycogen accumulation

83
Q

what is a condition specific to dogs characterized by hepatocellular glycogen accumulation secondary to excess glucocorticoids

A

canine steroid-induced hepatopathy

84
Q

what is most commonly a result of secondary reactive amyloidosis as a consequence of prolonged systemic inflammation

A

hepatic amyloidosis

85
Q

what does a hepatic amyloidotic liver look like

A

rounded edges
friable
pale

86
Q

true or false:
copper accumulation leads to the production of reactive oxygen species that cause oxidative injury

A

true

87
Q

which species is highly susceptible to copper toxicosis

A

sheep

88
Q

what type of dietary complications exacerbate copper toxicosis

A

low dietary molybdenum and sulfur

89
Q

what is the hemolytic result of copper accumulation

A

hemolysis

90
Q

which breeds of dogs are predisposed to disorders of copper metabolism

A

bedlington terriers
labrador retrievers

91
Q

what is the dog specific copper accumulation

A

canine copper-associated hepatopathy

92
Q

what iron storge disease

A

hemochromatosis

93
Q

what is hemochromatosis

A

abnormally increased amount of iron storage within the liver

94
Q

what causes hemochromatosis

A

excessive intake of dietary iron (inherited)

Pathology (18 decks)

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