Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pathology > Hepatobiliary & Muscle I > Flashcards

Hepatobiliary & Muscle I Flashcards

Dr. Parsely

1
Q

What are categories of liver disease?

A
  1. hepatocellular injury
  2. cholestasis
  3. decreased hepatic functional mass

+/-: alterations in portal blood flow (related to #3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the types of hepatic primary enzymes?

A

leakage enzymes
inducible enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe leakage enzymes

A

cytoplasmic and/or mitochondrial

hepatocellular injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe inducible enzymes

A

membrane-bound

cholestasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Based on this chart, which animal is getting better?

A

A (need less enzymes so getting better = don’t need)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens in hepatocellular injury?

A

enzymes leak from cytoplasm

elevated in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the biomarkers for hepatocellular injury?

A

ALT
AST
SDH
GLDH
LDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is ALT (alanine aminotransferase)?

A

tissue sources - cytoplasmic

the preferred hepatocellular injury marker in dogs and cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is not a useful marker for horses, ruminants, and pigs?

A

ALT - lack significant hepatocellular ALT

LA: muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can increased ALT mean?

A
  • hepatocellular injury
  • muscle injury
  • drug therapy in dogs (glucocorticoids, anticonvulsants)
  • hyperadrenocorticism in dogs
  • feline hyperthyroidism - typically mild
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is AST (aspartate transaminase)?

A

tissue sources - cytoplasmic, mitochondrial

liver and muscle > other tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can increased AST mean?

A
  • hepatocellular injury
  • muscle injury
  • hyperadrenocrticism
  • drug induction in dogs (glucocorticoids, anticonvulsants)
  • hemolysis (artifactual)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What else should you interpret with AST?

A

CK
ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What liver marker is good to use for indication of active/recent injury?

A

AST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is SDH (sorbitol dehydrogenase)?

A

tissue sources - cytoplasmic

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can increased SDH mean?

A

hepatocellular injury - large animal and small animal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the caveats to SDH?

A

not always available due to instability of enzyme

small animals not commonly used due to ALT being good enough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Talk about large animals and SDH

A

it is the hepatocellular enzyme of choice for large animals!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is GLDH (glutamate dehydrogenase)?

A

tissue sources - mitochondrial

liver&raquo_space;» other tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What can increased GLDH mean?

A

hepatocellular injury - large and small animals
- sensitive and specific

not commonly used in the US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is LDH (lactate dehydrogenase)?

A

tissue sources - cytoplasmic

liver, muscle, red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can increased LDH mean?

A
  • hepatocellular injury
  • muscle injury
  • hemolysis (even very mild)

not very specific due to it being located in multiple tissue sources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

LDH generally gives the same information as _______

A

AST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

List the common chemistry panels in small animals - hepatocellular injury

A

ALT
AST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

List the common chemistry panels in large animals - hepatocellular injury

A

AST
+/- SDH
+/- GLDH
+/- LDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Look at chart for hepatocellular injury

A
27
Q

Look at chart for hepatocellular injury - list 3 keyed drugs/therapy

A

carprofen
glucocorticoids
phenobarbital

28
Q

Look at chart for hepatocellular injury - key 6 toxicities to know

A

amanita mushroom
blue-green algae
copper toxicosis
sago palm
xylitol
pyrrolozidine alkaloids

29
Q

What is the magnitude of increase of hepatocellular injury - mild?

A

2-3x URL

30
Q

What is the magnitude of increase of hepatocellular injury - moderate?

A

4-10x URL

31
Q

What is the magnitude of increase of hepatocellular injury - marked?

A

> 10x URL

32
Q

What is cholestasis?

A

interruption or obstruction of bile flow

33
Q

What are the types of cholestasis?

A

obstructive cholestasis
functional cholestasis

34
Q

What are the types of obstructive cholestasis?

A

intra-hepatic - bile canaliculi, bile ductules

extra-hepatic (post-hepatic) - bile duct, gallbladder

35
Q

What is happening with functional cholestasis?

A

some cellular process isn’t working to move it out/process is not as good

  • sepsis
36
Q

What does cholestasis induce?

A

induction and release of membrane-bound enzymes (“induced enzymes”)

  • ALP, GGT
37
Q

Release of enzymes from cholestasis occurs with [functional/obstructive] cholestasis

A

obstructive

38
Q

What are additional indicators of cholestasis?

A
  • hyperbilirubinemia
  • hypercholesterolemia
39
Q

What are intra-hepatic examples - obstructive cholestasis?

A
  • hepatocyte swelling or necrosis
  • inflammation
  • neoplasia
40
Q

What are extra-hepatic examples - obstructive cholestasis?

A
  • gallbladder mucocele
  • pancreatitis
  • neoplasia
  • cholelithiasis / choledocholithiasis
41
Q

What is ALP (alkaline phosphatase)?

A

sources and isoforms

42
Q

What are isoforms of ALP in serum?

A
  • L-ALP: liver (hepatocytes and biliary epithelium)
  • B-ALP: bone (osteoblasts)
  • C-ALP: DOGS only, corticosteroid (hepatocytes)
43
Q

Dogs are the only one to have the isoform ______

A

C-ALP

44
Q

What are causes of increased ALP?

A
  • cholestasis: L-ALP
  • bone: B-ALP
  • drugs: C-ALP (glucocorticoids)
  • endocrine/metabolic
45
Q

What is GGT (gamma glutamyl transferase)?

A

sourced form the liver (hepatocytes and biliary epithelium)

renal tubular epithelium
mammary epithelium
- these 2 DO NOT contribute to serum GGT (enters urine/milk, respectively)

46
Q

What are causes of increased GGT?

A
  • cholestasis
  • billiary hyperplasia
  • drug therapy (glucocorticoids, anticonvulsants)
  • colostrum ingestion (NOT foals)
47
Q

Is ALP or GGT more sensitive regarding cholestasis in dogs?

A

dogs: ALP

48
Q

Is ALP or GGT more sensitive regarding cholestasis in cats?

A

GGT

49
Q

Is ALP or GGT more sensitive regarding cholestasis in large animals?

A

GGT

50
Q

Hepatic lipidosis in ____ has a characteristic pattern. Explain

A

Cats

hepatic lipidosis —> often increased in ALP > GGT

51
Q

What is “mixed hepatopathy”?

A

we often see cholestasis and hepatocellular injury together

52
Q

Hepatocellular injury or cholestasis?

A

hepatocellular injury

ALP is elevated but not as severe

53
Q

What is the definition of muscle injury?

A

disruption of myofiber cell membranes to allow leakage of cytoplasmic/mitochondrial enzymes

54
Q

T/F: Muscle injury with degeneration, necrosis, and inflammation is the same as atrophy

A

FALSE

55
Q

What are some causes of muscle injury?

A
56
Q

What enzymes would you expect to see elevation in regarding muscle injury?

A

CK
AST - muscle or liver
ALT - large animal = muscle; small animal = liver, possibly muscle

57
Q

What is creatine kinase (CK)?

A

multiple isoenzymes (skeletal muscle, cardiac muscle, brain)

most is skeletal muscle isoenzyme

58
Q

What does high CK indicate?

A

recent or ongoing injury

has a short half-life

59
Q

If we have any species with elevated CK, elevated AST, and normal ALT, what is our most likely interpretation?

A

recent or ongoing muscle injury

60
Q

If we have a small animal with normal CK, elevated AST, and elevated ALT, what is our most likely interpretation?

A

hepatocellular injury

61
Q

If we have a large animal with normal CK, elevated AST, and elevated ALT, what is our most likely interpretation?

A

previous or resolving muscle injury (because CK normal)

62
Q

If we have a small animal with normal CK, elevated AST, and normal ALT, what is our most likely interpretation?

A
63
Q

If we have a large animal with normal CK, elevated AST, and normal ALT, what is our most likely interpretation?

A

previous or resolving muscle injury or hepatocellular injury - can’t tell

64
Q

What would help you determine if there is hepatocellular injury in a large animal?

A

SDH or GLDH

Clinical Pathology (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions