Brainscape's Knowledge GenomeTM

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


See full index

VET433: Gastroenterology > Liver > Flashcards

Liver Flashcards

1
Q

hepatic acinus

A

functional unit of the liver

extends from the hepatic triad to the central vein

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

central vein

A

vein located in the center of each liver lobule that receives nutrient rich blood after it passes through the sinusoids and carries it to the hepatic vein

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

sinusoids

A

fenestrated sinuses between each hepatocyte that allows for exchange of nutrients and absorption and secretion of products

hepatocytes detoxify blood as it passes through the sinusoids

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

portal triad

A

portal vein + hepatic artery + bile duct

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

portal vein

A

provides 80% of the blood and 50% of oxygen to the liver

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

hepatic artery

A

provides 20% of blood supply and 50% of oxygen to the liver

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

bile duct

A

collects bile from the bile canaliculi as it’s produced by hepatocytes

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

zone 1

A

periportal (closest to hepatic triad)

receives the most oxygen + nutrient rich blood

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

zone 3

A

centrilobular (closest to the central vein)

receives the least oxygen + nutrients

site of CYP450 metabolism
most susceptible to hypoxic injury

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

what are the clinical signs of liver disease

A
  1. subclinical
  2. non-specific - anorexia, weight loss, vomiting, weakness, lethargy
  3. specific - icterus, ascites, PU/PD, neuro signs, pigmenturia, fever, melena, acholic feces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the 5 liver function parameters

A
  • albumin
  • BUN
  • cholesterol
  • glucose
  • bilirubin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are two highly specific liver tests

A
  • bile acids
  • blood ammonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

bile acids test

A

detects liver dysfunction even if albumin, BUN, cholesterol, glucose, and bilirubin are normal

ELEVATED with portosystemic shunts or hepatobiliary disease

sample 1: fasted
sample 2: 2 hours post meal

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

when should a bile acids test NOT be used

A

hyperbilirubinemia

redundant, BA will be high (exception: prehepatic hyperbilirubinemia - bile acids will be normal)

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

blood ammonia

A

ELEVATED with portosystemic shunts

1 fasted sample

better in dogs than cats

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

liver enzymes

A

evaluates the degree of liver damage/leakage and cholestasis NOT function

ALT
AST
ALP
GGT

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

ALT (alanine aminotransferase)

A

hepatocellular leakage

located in cytosol - increases with minimal damage

liver ONLY
if >2x upper limit –> ALWAYS significant

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

AST (aspartate aminotransferase)

A

hepatocellular leakage

located in mitochondria - increases with severe damage

liver & skeletal muscle
- always evaluate alongside CK

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

ALP (alkaline phosphatase)

A

cholestatic enzyme
- indicates impaired bile flow

liver, bone, corticosteroid
- corticosteroid ONLY in dogs

comes from hepatocytes near bile canaliculi

20
Q

GGT (gamma glutamyl transferase)

A

cholestatic enzyme
- indicates impaired bile flow

liver only

comes from hepatocytes near the bile duct

21
Q

hepatocellular hepatopathies

A

elevated ALT, AST

22
Q

cholestatic hepatopathies

A

elevated ALP, GGT

23
Q

mixed hepatopathies

A

elevated ALT (+/- AST), ALP, GGT

24
Q

what liver parameters are always relevant in cats

A

bilirubinuria
elevated ALP (no corticosteroid induced)

25
Q

why does triaditis only occur in cats

A

common bile duct + pancreatic duct converges prior to entering the duodenum

26
Q

primary vs secondary hepatopathies

A

primary - liver disease causing a hepatopathy

secondary - reactive hepatopathies

27
Q

what is the most common cause of reactive hepatopathy

A

GI disease

others: dental disease, diabetes, hypoxemia, hyperlipidemia, hyperthyroidism, pancreatitis, R-CHF

28
Q

non-specific reactive hepatitis

A

commonly occurs with GI diisease due to liver receiving splanchnic blood flow (from abdominal viscera) containing inflammatory cytokines, GI endotoxins, etc leading to hepatic inflammation WITHOUT hepatocyte death

29
Q

what are the common feline hepatic diseases

A
  1. hepatic lipidosis
  2. cholangitis
  3. neoplasia
  4. reactive hepatopathy
  5. vascular, toxic, FIP
30
Q

how should caloric requirements be calculated for refeeding a hepatic lipidosis cat

A

resting energy requirements (RER)

tube feed in increments of 20% RER daily

(day 1 = 20% RER, day 2 = 40% RER, etc)

31
Q

resting energy requirement equation

A

linear: RER = (BW x 30) + 70
- only in patients >2kg and <40kg
log: RER = 70 x BW^0.75

32
Q

what are the three forms of feline cholangitis

A
  1. neutrophilic (most common)
  2. lymphocytic
  3. liver flukes
33
Q

can you differentiate between neutrophilic and lymphocytic cholangitis on imaging or labwork

A

no - requires histopathology

34
Q

what are the common canine hepatic diseases

A
  1. reactive hepatopathy
  2. immune mediated chronic hepatitis
  3. copper associated chronic hepatitis
  4. portosystemic shunts & portal venous hypoplasia (PVH)
  5. hepatic neoplasia
  6. superficial necrolytic dermatitis
35
Q

hepatic encephalopathy

A

accumulation of ammonia due to decreased liver function

liver unable to convert ammonia into urea for excretion –> excess ammonia causes damage to astrocytes

36
Q

treatment of hepatic encephalopathy

A
  1. antibiotics (amoxicillin) - goal is to decrease urease producing bactera
  2. lactulose - changes colon pH to acidify NH3 to NH4, provides alternate nutrient source for urease producing bacteria, and causes osmotic diuresis by pulling water into colon and promoting rapid passage through colon
  3. restrict dietary protein - decreases ammonia production
37
Q

what is ursodeoxycholic acid

A

ursodiol

increases bile flow (choleretic)

anti-inflammatory, immunomodulatory, and antifibrotic

38
Q

what is denamarin

A

SAMe + silybin

antioxidants - protects from oxidative damage

39
Q

how to biopsy a liver if suspected chronic hepatitis

A
  1. rule out lymphoma via FNA
  2. perform coagulation panel
  3. obtain 5+ liver biopsies from 2+ liver lobes
    (3 for histo, 1 for culture, 1 for copper quantification)
40
Q

what is chronic hepatitis

A

non-specific inflammation of the liver due to an underlying etiology

  • immune mediated
  • copper accumulation
  • infectious
  • drug induced (tetracyclines, phenobarbital)
41
Q

what histopathologic features are seen with immune mediated chronic hepatitis

A

normal chronic hepatitis features plus:
- interface hepatitis
- hepatocyte death at limiting plate

42
Q

interface hepatitis

A

inflammation extending past the limiting plate into the parenchyma

limiting plate: separates the triad from the hepatic parenchyma

43
Q

what histopathologic features are seen with copper associated chronic hepatitis

A

normal chronic hepatitis features plus:
- rhodanine staining of copper accumulations in centrilobular regions
(accumulates in zone 3 but progresses periportal)
- pigment granulomas
- NO interface hepatitis

44
Q

pigment granulomas

A

aggregates of macrophages with copper granules

45
Q

congenital portosystemic shunts

A

SINGLE shunts
intra or extrahepatic

small breeds: single extrahepatic

large breeds: single intrahepatic

46
Q

acquired portosystemic shunts

A

MULTIPLE shunts
intra or extrahepatic

VET433: Gastroenterology (16 decks)

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