Jordan's study guide- liver and pancreas Flashcards

Normal liver
Liver functions (7)
- bile production and excretion
- excretion of bilirubin, cholesterol, hormones, drugs
- Metabolisim of fats, proteins, and carbs
- Enzyme activation
- storage of glycogen, vit, and minerals
- synthesis of plasma proteins and clotting factors
- blood detox and purification
Purpose of acinus
bile secreting unit
Where are the acinus located
zones 1,2, and 3
Purpose of lobule
Blood filtering unit
Where are the lobules located
periportal, mid-zonal, centralobular
What zone has the lowest oxygen content
Zone 3
What area is affected by hypoxia first
Centralobular hepatocytes in zone 3
some signs of liver disease
Anorexia
vomiting
diarrhea
weight loss
fever
Hyperbilirubinemia
Increased production
Hemolysis
Congenital defect in bilirubin conjugation
Hyperbilirubinemia-decreased production
Hepatic dysfucntion
cholestasis
3 causes of extrahepatic cholestasis
- cystic mucosal hyperlasia of the gal bladder
- mucocele of gal bladder
- cysts
What is an incidental finding of extrahepatic cholestasis
Cystic mucosal hyperplasia of the gal bladder
Cause of extrahepatic cholestasis
Expand and replace normal tissue
Lined by epithelial cells
PKD1 mutation

Biliary cystic adenoma
This is caused by chronic passive congestion
-nutmeg liver

Hepatic fibrosis
What causes heptic fibrosis
Anything that causes blood to back up into the liver
- right sided heart failure
- vena cava blockage by pheochromocytoma

This occurs when both hepatic and portal veins are blocked

Infarction
Why is infarction rare
Liver has a dual blood supply
What are the two types of portosystemic shunts
Intrahepatic
Extrahepatic
A large dog comes in with depression, anorexia, vomiting, CNS signs, decreased BUN, and elevated ammonia.

Intrahepatic portosystemic shunt
Characteristics of extrahepatic shunt
- small dog
- portal vein to azygous
- portal vein to vena cava
- gastric vein to vena cava (cats)
- Atresia of the portal vein
Characteristics of portosystemic shunts
- Chronic hepatic injury with diffuse fibrosis
- causes portal hypertension
- blood bypasses the liver
- ascites
Ascites
Increased hydrostatic pressure
Amyloidosis

- caused by chronic inflammation
- sinuses fill with amyloid
- liver becomes weak
Causes of microhepatica
Portosystemic shunts
Chronic hepatitis
congenital
Causes of hepatomegly
acute hepatits
amyloidosis
cancer
Blood filled cysts
incidental finding

Telangiectaia
Common finding from steroid administration
mid-zonal accumulation of glycogen
Does not cause liver disease

Steroid hepatopathy
Disease common in ruminates and pigs
Usually insignificant

Capsular fibrosis
Physiologic cause of lipidosis
Late pregnancy
Lactation
Pathologic causes of lipidosis

Increased synthesis, lipolysis, or uptake of FFAs
Decrease FA oxidation, apoprotien synthesis or excretion
How do you know if a liver is fatty

Put it in water
an obease (or anorexic) icteric cat with hepatic failure/encephalopathy with a history of other disease

Feline fatty liver syndrome
fibrosis and nodular regernation of the liver

Cirrhosis
Causes of cirrhosis
Copper toxicosis, PA toxins, aflotoxins, anti-convulsants, chronic pasive congestion
an incidental hepatopthy
tesnion from diaphram
common in ruminates

Tension lipidosis
not pathologic
Incidental finding

Gas pockets formed by bacteria
post-mortem decomposition
hepatic infection from the gut

Cholaniohepatitis
What causes this

hepatic abscesses secondary to rumen ulceration
What causes this

ascending infection from umbilical chord
What causes this hepatic infection

leptospirosis
What causes this infection in cats

Feline infectious peritonitis
What causes this hepatic infection that infects the endothelial cells causing vasculitis in dogs

Canine infectous hepatitis/adenovirus type 1
Benign cancer of hepatocytes

Hepatic adenoma
hepatoma
Benign hepatic cancer of bile ducts
Biliary adenoma
Benign hepatic cancer of endothelia cells
hemangioma
Malignant cancer of hepatocytes

Hepatocellular carcinoma
woodchucks have a virus that causes this
Malignant cancer of bile ducts

Biliary carcinoma
cholangiocarcinoma
Malignant cancer of endothelial cells

Hemangiosarcoma
How do you tell the difference between hemangioscarc and melanoma met
Blot on paper
Red=hemangiosarc
Black= melanoma met
Difference between sarcomas and carcinomas
Sarcomas spread through a tissue
Carcinomas met everywhere
Intrinsic toxins
Produce consisten hepatotoxicity
What are examples of intrinsic toxins
Pyrrolizidine alkaloids
Aflotoxins
Idiosyncratic toxins
Produce sporadic toxicisty
What are examples of idiosyncratic toxins
NSAID
anesthetics
anticonvulsants
Causes biilary hyperplasia and portal fibrosis
Pyrrolizidine alkaloid toxicity
a bedlington terrier come in with this liver

Cholestasis secondary to biliary hyperplasia and fibrosis
Very little exocrine pancrease tissue

Exocrine pancreatic insufficiency
Pancreatic enzymes break down the pancrease and release into the abdomen

Acute pancreatitis
Benign pancreatic neoplasia

Pancreatic adenoma
Malignant neoplasia that loves to metastasize to nearby tissues

Pancreatic adenocarcinoma
Incidental finding in older animals in the pancreas

Nodular hyperplasia of the pancreas