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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
what are some types of extrahepatic cholestasis
cholangitis cholelithiasis cholecystitis pancreatitis
26
which type of cholestatic disease occurs with impairment of bile flow within canaliculi
intrahepatic cholestasis
27
what commonly causes intrahepatic cholestasis
chronic hepatitis neoplasia hepatocellular swelling
28
what is the outcome of repeated injury/ regeneration cycles
formation of fibrosis and nodular regeneration
29
what is the result of chronic and severe repeated injury/ regeneration cycles
end-stage liver (cirrhosis)
30
true or false: chronic injury and regeneration leads to progressive loss of function
true
31
what is an increase in the amount of collagen within the liver
hepatic fibrosis
32
which cells within the liver are responsible for producing the collagen needed to form fibrotic tissue
stellate cells
33
what is the proliferation of newly formed biliary ducts within the portal tracts and periportal regions
biliary hyperplasia
34
with what diseases is biliary hyperplasia commonly associated with
biliary inflammation obstruction cholestasis
35
true or false: biliary hyperplasia indicated long-standing (chronic) hepatic injury
true
36
true or false: biliary hyperplasia can be non-specific
true
37
what is the diffuse process in the liver characterized by severe fibrosis and replacement of normal hepatic lobules with nodular regeneration and abnormal vasculature
end stage liver (Chirrhosis)
38
true or false: up to 75% of hepatic parenchyma can be removed without significant impairment of function
true
39
what are some clinical manifestations of hepatic failure
hyperammonemia hyperbilirubinema/ icterus/ jaundice immunologic manifestations coagulation abnormalities hypoalbuminemia and ascites
40
what are some hepatic congenital abnormalities
biliary cysts ductal plate malformations portosystemic shunts portal vein hypoplasia
41
what disease is commonly caused by congenital biliary cysts in cairn terries, westies, bull terriers and persian cats
congenital polycystic disease
42
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
ductal plate malformation
43
what hepatic congenital disorder is common in Boxers and young dogs
congenital hepatic fibrosis
44
what liver disorder is characterized by inflammation, hepatocellular necrosis and apoptosis
acute hepatitis
45
what can cause acute hepatitis
systemic infections or portal circulation of disease
46
what is the pattern associated with acute hepatitis
embolic pattern
47
what liver disorder is characterized by fibrosis, mononuclear inflammatory cells, hepatocelluar loss, nodular regeneration and structural remodeling of the hepatic lobule and vasculature
chronic hepatitis
48
what can cause chronic hepatitis
chronic persistent antigenic stimulus
49
what type of reactive hepatitis is the diffuse process in the liver that is response to systemic inflammation commonly stemming from GI disease
nonspecific reactive hepatitis
50
true or false: nonspecific reactive hepatitis may cause mild elevation of serum ALT and ALP
true
51
what is inflammation of the biliary ducts
cholangitis
52
what can chronic cholangitis lead to
cholestasis elevated serum ALP hyperbilirubinemia
53
which type of cholangitis is due to infection
neutrophilic cholangitis
54
what can cause neutrophilic cholangitis
ascending bacterial infection of E. coli, Enterococcus, bacteroides, streptococcus, or clostridium
55
which type of cholangitis is immune mediated
lymphocytic cholangitis
56
in which species is lymphocytic cholangitis most common
cats
57
what is inflammation of biliary ducts and extension of inflammation into the surrounding liver parenchyma
cholangiohepatitis
58
what causes cholangiohepatitis
an extension of bacterial cholangitis into the surrounding periportal hepatic parenchyma
59
what is the clinical manifestation on a CBC of cholangiohepatitis
greater elevation of serum ALT
60
what are the 4 most common circulatory diseases of the liver
passive congestion congenital portosystemic shunt congenital portal vein hypoplasia portal hypertension with acquired vascular shunts
61
what circulatory disease occurs as a consequence of reduced hepatic outflow due to cardiac dysfunction
passive congestion
62
what pre-existing disorder often leads to passive congestion of the liver
right sided heart failure
63
what can be a result of the chronic hypoxic injury caused by passive congestion in the liver
steatosis
64
what is the classic characteristic of a liver with passive congestion
nutmeg liver enlarged with rounded edges
65
what circulatory disorder is an abnormal vascular structure that allows portal blood to bypass the liver and drain directly into the systemic circulation
congenital portosystemic shunt
66
what type of animals are characteristic of having congenital portosystemic shunts
stunted growth hepatic encephalopathy due to hyperammonemia microheptica presence of ammonium biurate crystalluria
67
what is expected to be seen on a chemistry of an animal with PSS
hyperammonemia decreased BUN increased fasting and postprandial bile acids hypocholesterolemia hypoalbuminemia possible mild elevated ALT
68
which type of congenital portosystemic shunt is commonly formed due to failure of closure of the ductus venosus
intrahepatic shunts
69
in which type of dogs are intrahepatic shunts more common
large breed dogs
70
which type of congenital PSS is formed due to anastomosis of portal vein to caudal vena cava or portal vein to azygos vein
extrahepatic shunts
71
in which type of dogs and cats are extrahepatic shunts more commonly seen
small breeds
72
what is a congenital vascular anomaly in dogs and occasionally cats characterized by abnormally small portal veins
hepatic microvascular dysplasia
73
what are the results of a typical animal with hepatic microvascular dysplasia
microhepatica ascites
74
what can occur with thrombosis or other types of occulsion within that portal vein or hepatic outflow
portal hypertension
75
true or false: most causes of portal hypertension are intrahepatic
true
76
what can persistent portal hypertension lead to
ascites acquired portosystemic shunts
77
what occurs when hepatocyte triglyceride accumulation exceeds the rate of lipoprotein release
hepatic lipidosis
78
what can cause hepatocellular lipidosis
excessive dietary intake increased mobilization of body fat hypoxia / mitochondrial damage diabetes mellitus secretory defects
79
what does hepatic lipidosis look like
diffusely swollen yellow greasy texture "nut meg" liver
80
in what type of cows does bovine fatty liver disease occur in
dairy cows in late gestation or peak lactation
81
true or false: feline hepatic lipidosis is an emergency situation in cats
true
82
what liver disease is the result of glycogenosis with metabolic disturbances that affect glucose regulation
hepatocellular glycogen accumulation
83
what is a condition specific to dogs characterized by hepatocellular glycogen accumulation secondary to excess glucocorticoids
canine steroid-induced hepatopathy
84
what is most commonly a result of secondary reactive amyloidosis as a consequence of prolonged systemic inflammation
hepatic amyloidosis
85
what does a hepatic amyloidotic liver look like
rounded edges friable pale
86
true or false: copper accumulation leads to the production of reactive oxygen species that cause oxidative injury
true
87
which species is highly susceptible to copper toxicosis
sheep
88
what type of dietary complications exacerbate copper toxicosis
low dietary molybdenum and sulfur
89
what is the hemolytic result of copper accumulation
hemolysis
90
which breeds of dogs are predisposed to disorders of copper metabolism
bedlington terriers labrador retrievers
91
what is the dog specific copper accumulation
canine copper-associated hepatopathy
92
what iron storge disease
hemochromatosis
93
what is hemochromatosis
abnormally increased amount of iron storage within the liver
94
what causes hemochromatosis
excessive intake of dietary iron (inherited)

Pathology (18 decks)

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