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Pathology II > Lecture 14: Liver pathology I > Flashcards

Lecture 14: Liver pathology I Flashcards

1
Q

Normal liver is ___% of BW

A

2-3%

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2
Q

liver receives ___% of cardiac output

A

25%

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3
Q

The liver is very susceptible to what type of injury

A

hypoxic injury

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4
Q

what is the most important liver function

A

synthesis of plasma proteins- albumins, globulins, clotting factors

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5
Q

what makes up the portal triad

A
  1. Portal vein
  2. Hepatic artery
  3. Bile duct
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6
Q

what is the function of hepatocytes

A
  1. Synthesize and secrete plasma proteins- clotting factors, acute phase proteins, and bile acids
  2. Detoxification
  3. Store nutrients
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7
Q

what tissue is this, identify 1-4

A
  1. Hepatocytes
  2. Portal vein
  3. Bile duct
    4, hepatic artery
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8
Q

what structure indicated by asterisks

A

Centrilobular vein

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9
Q

what vessel drains the 02 poor, nutrient rich blood from intestines, stomach, pancreas and spleen

A

portal vein

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10
Q

what vessel provides 75% of oxygen to liver

A

hepatic artery

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11
Q

what zone is more susceptible to direct acting toxins

A

zone 1 or peri portal because gets most blood

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12
Q

what zone is more suspcetible to hypoxia injury

A

zone 3 or centrilobular-gets less blood

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13
Q

what cell serves as first line of defense of liver

A

kupffer cells-hepatic macrophages

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14
Q

Is cell swelling a reversible or irreversible response to injury

A

reversible

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15
Q

what does chronic active injury in liver lead to

A

fibrosis, bile duct proliferation—> cirrhosis

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16
Q

what liver dysfunction leads to icterus

A

hyperbilirubinemia due to pre-hepatic, hepatic, or post-hepatic dysfunction

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17
Q

what can cause pre-hepatic dysfunction leading to icterus

A

hemolysis

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18
Q

what can cause hepatic dysfunction leading to icterus

A

Decreased conjugation and secretion of bilirubin

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19
Q

what can cause post-hepatic dysfunction leading to icterus

A

reduction of bile outflow- cholestasis

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20
Q

What is pathogenesis of hemorrhage in liver

A

hepatocyte damage—> decreased clotting factors produced

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21
Q

horses with acute liver injury can get __, unknown cause

A

intravascular hemolysis

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22
Q

what does copper toxicity cause and why

A

hemolysis due to oxidative injury

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23
Q

what are the two mechanisms of ascites from liver injury

A
  1. Fibrosis—> portal hypertension—> edema—> ascites
  2. Decreased albumin—> decreased oncotic pressure—>ascites
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24
Q

what wrong and what pathogenesis n

A

Photosensitivity
Severe liver disease—> can’t remove phylloerythrin—> accumulates in serum and skin—> UV light activates phylloerythrin in non-pigmented areas of skin—> necrosis of epithelial cells/epidermis

25
Q

what is hepatic encephalopathy associated with and due to what

A

ammonia not being cleared due to damage or shunting

26
Q

what are some clinical signs of hepatic encephalopathy

A

ataxia, depression, head pressing, behavioral change, convulsions

27
Q

what is hepatic encephalopathy most commonly associated with

A

PSS

28
Q

what wrong and what cause

A

ammonium urate uroliths due to increased urine acid and ammonium excretion

Associated with PSS

29
Q

what is the best way to biopsy a liver

A

wedge, collect from 3 lobes and save some for culture and copper

30
Q

what wrong

A

bile accumulation- cholestasis
Note brown material in sinusoids

31
Q

what wrong and what are some causes

A

Glycogen accumulation
Causes:
1. Hyperadrenocorticism (most common)
2. DM

32
Q

what is pathogenesis of hepatic lipidosis

A

primary disease causing negative energy balance—> increased fat mobilization from fat stores—> lipid accumulation in liver

33
Q

what are some potential causes of hepatic lipidosis in ruminants

A

late pregnancy, acute anorexia

34
Q

what are some causes of feline hepatic lipidosis

A

DM and DKA, anorexia

35
Q

What wrong

A

Hepatic lipidosis

36
Q

What wrong and what cause

A

amyloidosis due to overproduction of amyloid A protein

37
Q

what is a PSS

A

vascular channel that connects portal vein to systemic circulation (bypasses liver)

38
Q

intrahepatic shunts are common in who

A

large breed dogs

39
Q

extrahepatic shunts common in who

A

small breed dogs and cats

40
Q

what are some signs of PSS

A

poor, shunted growth, behavioral change, collapse, convulsions

41
Q

what wrong

A

extrahepatic PSS

42
Q

what wrong and what zone of liver is affected

A

Passive congestion due to right sided heart failure

Centrilobular zone most affected because hypoxia injury

43
Q

when does portal hypertension occur

A

blood flow in/put of liver gets slowed down

44
Q

what is most common cause of portal hypertension

A

hepatic fibrosis

45
Q

Acquired PSS can develop as a result of __

A

portal hypertension

46
Q

what is the likely cause of centrilobular (zone 3) necrosis

A

hypoxia and toxicity

47
Q

what is the likely cause of multifocal random hepatic necrosis

A

infection

48
Q

what is the likely cause of massive necrosis of majority of liver

A

toxic

49
Q

Hepatocellular toxins cause __ and lead to __

A

lipidosis, centrilobular necrosis

50
Q

what drugs are hepatocellular toxins

A

acetominophen, phenobarbital, xylitol

51
Q

what minerals are hepatocellular toxins

A

copper, iron

52
Q

what are some causes of cooper toxicity in sheep

A
  1. Increased intake
  2. Increased availability due to low molybdenum
  3. Hepatocelllular damage from other toxins
53
Q

what is the consequence of too much copper

A

oxidative damage and hepatocellular necrosis

54
Q

what are some signs of cooper toxicity

A

icterus, swollen and pale liver, hemoglobinuria

55
Q

copper storage hepatopathy is common in what breed

A

bedlington terrier

56
Q

what causes copper storage hepatopathy

A

inadequate excretion of bile possibly due to dietary excessive copper in commercial dog food

57
Q

what causes theiler’s disease (aka equine serum hepatitis)

A

parvovirus

58
Q

horse liver- what likely dx and cause

A

dx: theilers disease
Cause: parvovirus

Pathology II (15 decks)

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