Liver Flashcards

1
Q

3 Portals of Entry to the Liver

A
  1. Trauma
  2. Hematogenous
  3. Biliary (retrograde)
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2
Q

Hematogenous entry

A

typically transported from the GI tract from the portal vasculature, but can from systemic or fetal circulation

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3
Q

Two Big Components of Immune System in the Liver

A

Kupffer cells and IgA

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4
Q

Two Big Categories for Patterns of Injury

A
  1. Random
  2. Zonal
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5
Q

random injury appearance and origin

A

scattered, variably sized areas typically from a hematogenous source

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6
Q

Hallmark feature of zonal injury?

A

accentuated reticular pattern

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7
Q

Is zonal injury and acute or chronic process?

A

acute

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8
Q

5 Subtypes of Zonal Injury

A
  1. Centrilobular
  2. Paracentral
  3. Midzonal
  4. Periportal
  5. Bridging
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9
Q

What subtype of zonal injury is the most common?

A

centrilobular

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10
Q

centrilobular injury

A

the lowest oxygen levels, where toxins will activate when they’re broken down - MOST COMMON zonal injury pattern

causes include hypoxia and acetaminophen

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11
Q

periportal injury

A

uncommon, of hematogenous origin, usually due to DIRECT ACTING toxicants (don’t have to be broken down prior to causing injury)

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12
Q

Congenital Portosystemic Shunt

A

singular large caliber anomaly where the portal blood enters the systemic veins because it bypasses the liver

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13
Q

2 Types of Congenital PSS

A
  1. Intrahepatic
  2. Extrahepatic
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14
Q

Intrahepatic PSS

A

less common, ductus venosus, LARGE dogs

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15
Q

Extrahepatic PSS

A

much more common, seen in small breed dogs

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16
Q

labwork abnormalities with congenital PSS

A

high blood ammonia and ammonium biurate crystals in the kidney

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17
Q

Do congenital PSS develop portal hypertension?

A

no, there’s no gradient

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18
Q

Most common cause of impaired venous outflow/chronic passive congestion?

A

heart failure!

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19
Q

Does impaired venous outflow in the liver lead to portal hypertension?

A

duh

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20
Q

NUTMEG LIVER

A

sign of centrilobular/passive congestion (Note the periportal pallor)

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21
Q

How do animals get acquired PSS?

A

high portal pressure, tiny vessels dilate and become tortuous, gradient develops - this is uncommon

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22
Q

Telangiectasis/Peliosis Hepatitis

A

dilated sinusoids and blood filled spaces which is an INCIDENTAL finding in the liver (most common in cattle)

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23
Q

Is stenosis/lipidosis reversible?

A

yes

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24
Q

Pathogenesis of Hepatic lipidosis?

A

triglyceride overload without enough protein for adequate export from the liver (think anorexic fat cats)

25
When might you see hepatic lipidosis in a goat?
late gestation
26
Tension Lipidosis
an INCIDENTAL finding in cattle and horses where tension from fibrous connections collapses the sinusoids so without the blood flow the liver accumulates fat
27
Normal color for a liver?
mahogany
28
Steroid Hepatopathy
hepatocytes fill with glycogen; big brown/tan firm liver on necropsy
29
Can hepatocytes regenerate?
yes, quite quickly actually up to 75% and result in nodules if fibrosis occurs
30
stellate cell function in fibrosis
the stellate cells transform into myofibroblasts
31
cirrhosis
chronic diffuse process from repetitive injury and bridging fibrosis --> nodular regeneration
32
5 Causes of Cirrhosis
1. toxicosis 2. biliary disease 3. chronic passive congestion 4. inherited metal metabolism (copper) 5. chronic hepatitis
33
Manifestations of Liver Failure
high blood ammonia (hepatic encephalopathy), clotting disorders, ascites, hyperbilirubinemia (icterus), cutaneous lesions
34
Clotting Factors affected by Liver Failure
V, VII, IX, X
35
Clinical Sign of Hyperbilirubinemia
icterus/jaundice
36
Main Sign of Acute Hepatitis
hepatocellular necrosis and suppurative exudate - NO fibrosis (obviously, it's acute)
37
2 Etiologies of Chronic Hepatitis
1. Persistence of infectious agent 2. Persistence of antigenic stimulation
38
cholangitis
inflammation of cholangial LUMENS associated with fibrosis and bacterial translocation from the gut
39
cholangiohepatitis
inflammation is centered around cholangioles but also spreads out into hepatocytes
40
What virus can cause "blue eye?"
Canine adenovirus 1 blue eye is corneal edema which occurs during recovery
41
Herpesvirus
typically affects neonates, causes abortion; sudden multifocal necrosis (white dots)
42
Equine Serum Hepatitis (Theiler's Disease) is caused by what?
flavivirus
43
What bacteria causes target lesions on the liver surface in sheep and goats?
Campylobacter fetus
44
Clostridium piliforme
known as Tyzzer's disease, causes necrosis and stacks of intracellular filamentous bacteria!
45
Is tularemia zoonotic?
oh yeah, close er up
46
Clostridium haemolyticum
spores reside in cattle liver and then the Fascioloides flukes cause liver damage and hemoglobinuria
47
Is Mycobacterium bovis zoonotic?
also yes - causes large multifocal granulomatous hepatitis
48
Fusobacterium necrophorum
grain overload causes rumen acidosis and then it spreads to liver, abscesses form, animals die from pulmonary hemorrhage
49
milk spots
seen in pig livers and are caused by chronic ascarid larval migration with fibrosis
50
Where do mature Fascioloides hepatica live?
in the bile ducts!
51
Eimeria steidae
coccidia parasite in RABBITS which causes biliary hyperplasia
52
Results of chronic pyrrolizidine alkaloid toxicosis in cattle?
biliary hyperplasia, fibrosis, hepatomegalocytosis, photosensitization
53
What causes chronic aflatoxicosis?
moldy corn (Aspergillus)
54
Copper and Bedlington Terriers
a mutation COMMD1 causes excessive copper accumulation
55
Sheep and Copper
the sheep get into cattle feed, it accumulates, causes intravascular hemolysis and hemoglobinuric nephrosis
56
Appearance of hepatocellular carcinoma in dogs?
single mass in the left lateral liver lobe; multilobulated, gross margins
57
Most common liver neoplasm in cats?
cholangiocarncinoma
58
Most common liver metastatic neoplasm in dogs?
hemangiosarcoma