Liver 2 Flashcards
Name the cell type in the liver that deposits collagen in cases of hepatic fibrosis
Ito (hepatic stellate) cell
What is the role of Ito (hepatic stellate) cells in hepatic disease?
To deposit collagen (which can lead to hepatic fibrosis)
What is the alternative name for a hepatic Ito cell?
Hepatic stellate cell
What the alternative name for a hepatic stellate cell?
Ito cell
Ito (hepatic stellate) cells are responsible for collagen deposition in hepatic disease and fibrosis. What is their role in the non-diseased liver?
Storage of vitamin A and fat
Where, precisely, are hepatic Ito (stellate) cells found within the liver?
In the space of Disse
Explain why fibrosis within and around hepatic sinusoids is such a serious change.
The space of Disse becomes reduced or obliterated by collagen deposition. The ability of the liver to carry out its synthetic, catabolic and excretory roles is severely compromised by this reduced exposure of hepatocytes to plasma.
What does the term cirrhosis mean?
Diffuse hepatic fibrosis accompanied by regenerative nodule formation (end-stage liver is a better term than cirrhosis)
What is the term for diffuse hepatic fibrosis accompanied by regenerative nodule formation?
Cirrhosis (or end-stage liver)
Describe the appearance of an end-stage (cirrhotic) liver
The liver is small, firm, and irregular with nodules of regenerative parenchyma separated by tracts of fibrous connective tissue.
Name 3 causes of end-stage liver (cirrhosis). [The answer has 6 causes so if you can name even more than 3 that’s great]
- Chronic toxicity; 2. Chronic cholangitis or obstruction; 3. Chronic congestion (right-sided heart failure); 4. Inherited copper or iron storage disorders; 5. Chronic hepatitis; 6. Idiopathic
Explain why hepatotoxins commonly result in periportal, rather than centrilobular necrosis.
Hepatocytes in Zone 1 of theliver lobule (periportal; closest to portal areas) are the first to receive blood and, therefore, may be the first to be injured by circulating toxins -> PERIPORTAL NECROSIS
Which pattern of hepatic necrosis (centrilobular or periportal) is more likely in cases of hepatotoxicity and why?
Periportal. Hepatocytes in Zone 1 of theliver lobule (periportal; closest to portal areas) are the first to receive blood and, therefore, may be the first to be injured by circulating toxins -> PERIPORTAL NECROSIS
Which pattern of hepatic necrosis (centrilobular or periportal) is more likely in cases of anemia or hypoxia and why?
Centrilobular. Hepatocytes in Zone 3 of the lobule (centrilobular; closest to central veins) are the last to receive blood and, therefore, may be the first to be injured by ischemia -> CENTRILOBULAR NECROSIS
Name 3 routes in which bacteria can reach the liver via the bloodstream.
- The portal vein; 2. The umbilical veins from umbilical infections in newborn animals; 3. The hepatic artery, as part of a generalized bacteremia.
Name 3 NON-vascular routes by which bacteria may reach the liver.
- Ascending infection of the biliary system; 2. Parasitic migration; 3. Direct extension of an inflammatory process from tissues immediately adjacent to the liver, such as the reticulum.
What are the two main syndromes caused by Rhodococcus equi in foals?
Typically enterocolitis and/or bronchopneumonia
Which domestic species, and which specific subgroup in this species, is most commonly affected by disease due to Rhodococcus equi?
Horses; foals most commonly affected
You are performing a necropsy on a foal and find disseminated abscesses throughout the mesenteric lymph nodes, spleen, liver and large intestine. What is the most likely cause?
Rhodococcus equi
How is Rhodococcus equi spread among horses?
It is present in the soil and feces, and farms can be endemically infected. It may be ingested or inhaled to cause infection, but inhalation is believed to be the more common route.
You are performing a necropsy on a feedlot steer and find numerous foci of necrosis and abscess formation throughout the liver. What are the likely (a) cause and (b) pathogenesis?
(a) Fusobacterium necrophorum; (b) Damage to ruminal mucosa (rumenitis) -> bacteria enter portal circulation -> shower liver -> hepatic abscesses -> poor production
Explain why feedlot cattle with rumenitis may develop hepatic and even pulmonary abscesses.
Damage to ruminal mucosa (rumenitis) -> bacteria enter portal circulation -> shower liver -> hepatic (and possibly pulmonary) abscesses
Name the organism that causes Tyzzer’s disease.
Clostridium piliforme
Which hepatic disease is caused by Clostridium piliforme?
Tyzzer’s disease
Which animal types are most commonly affected by Tyzzer’s disease?
- Laboratory rodents; 2. Horses (foals and stressed weanlings)
How is Clostridium piliforme, the organism responsible for Tyzzer’s disease, spread among animals?
Fecal-oral transmission
What is the characteristic gross lesion of Tyzzer’s disease?
Numerous liver “dit-dots.” In an exam write: disseminated gray-white 1 to 3 mm diameter foci of necrosis surrounded by suppurative inflammation.
We think of leptospirosis primarily affecting the kidney. How, then, does it cause icterus? What is the pathogenesis?
Leptospirosis -> hemolysis -> ischemic injury to centrilobular hepatocytes -> centrilobular necrosis -> icterus
Each species has its own abortigenic herpesvirus strain. What strain causes abortion in: (a) horses; (b) cattle; (c) dogs; (d) cats?
(a) EHV-1; (b) BHV-1; (c) CHV-1; (d) FHV-1
Herpesviruses may cause abortion in adult animals. What fetal lesions are characteristic in a fetus aborted because of herpesviral infection?
Multifocal random pinpoint necrosis in multiple organs: liver, kidneys, lungs and spleen most commonly affected. These show up as randomly distributed white “dit-dots.”
You are examining the carcass of an aborted foal and notice randomly distributed white “dit-dots” through the liver, kidneys, lungs and spleen. What is the most likely cause of these?
Abortion due to infection with equine herpesvirus type 1 (EHV-1)
You are examining the carcass of an aborted calf and notice randomly distributed white “dit-dots” through the liver, kidneys, lungs and spleen. What is the most likely cause of these?
Abortion due to infection with bovine herpesvirus type 1 (BHV-1)
You are examining the carcass of a newborn puppy that failed to thrive and then died. You notice randomly distributed white “dit-dots” through the liver, kidneys, lungs and spleen. What is the most likely cause of these?
Infection with canine herpesvirus type 1 (CHV-1)
Herpesviruses may cause severe disease and death in fetal and neonatal animals. Give 4 possible routes of infection of a fetus/neonate with herpesviruses.
(1) Transplacental in utero; (2) During birth from birth canal; (3) After birth from infected littermates’ oronasal secretions; (4) After birth from dam’s oronasal secretions.
Dogs, especially in warmer climates, may develop “deep” (systemic) fungal infections that cause granulomatous inflammation in the lung and liver. Name one genus of fungus that is commonly involved.
(1) Histoplasma spp. ; (2) Blastomyces spp. (3) Coccidioides spp.
What is the cause of “milk spots” in the liver of pigs?
Migration of the nematode worm Ascaris suum through the liver
What gross lesion is characteristically seen in pigs infected with Ascaris suum?
Fibrous scars in the liver called “milk spots”
What organism causes heartworm disease in dogs?
The nematode worm Dirofilaria immitis
What organism causes vena caval (postcaval) syndrome in dogs?
The nematode worm Dirofilaria immitis
Explain the pathogenesis of vena caval (postcaval) syndrome in dogs.
The nematode worm Dirofilaria immitis (the cause of heartworm disease) normally lives in the pulmonary arteries. Heavy infestation can lead to worms also occupying the right heart and caudal vena cava –> acute hepatic failure -> rapid death
What lifecycle stage of the harmless Taenia tapeworms found in wild and domestic canids is found in intermediate hosts, and where in the intermediate host are these found??
The encysted intermediate stages of Taenia tapeworms are called Cysticercus. They are found in solid organs (often liver) of the intermediate hosts: horses, ruminants, pigs, rabbits, rodents etc.