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SAM 2 > Liver 2 > Flashcards

Liver 2 Flashcards

1
Q

What is hepatopathy?

A

An abnormal or diseased state of the liver

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2
Q

What is icterus or jaundice?

A

Increased bilirubin in the blood steam and extracellular fluid causing yellow pigment of skin, sclera, and other mucous membranes

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3
Q

What is hepatitis?

A

Inflammation affecting of the hepatocytes

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4
Q

What is cholangitis?

A

Inflammation affecting the bile ducts?

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5
Q

What is cholangiohepatitis?

A

Inflammation affecting the bile ducts and hepatocytes

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6
Q

What is cirrhosis?

A

Scarring of the liver

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7
Q

What conditions can lead to an acute hepatopathy?

A

Toxins, drugs, infections, pancreatitis

May be idiopathic

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8
Q

What conditions can lead to a chronic hepatopathy?

A

Inflammatory disease, abscesses, granulomas, metabolic storage disease, neoplasia, infectious organisms, endocrine disease, congenital abnormalities

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9
Q

What are some general treatments of hepatopathies?

A

Initially supportive- fluids, vomiting/diarrhea control, coag treatment, antibiotics if indicated

  • Drug cessation
  • Toxin removal
  • Infectious disease treatment
  • Nutritional support
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10
Q

Which medications offer specific liver support?

A

Silymarin- milk thistle
N-acetylcysteine or S-adenosylmethionine
Vit-K supplementation in icterus

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11
Q

T/F: Acute hepatopathies usually resolve with time.

A

True- primary causes is not always found but enzymes will return to normal with supportive care

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12
Q

What percentage of acute hepatopathies progress to chronic hepatitis?

A

25%

Fibrosis, inflammation, necrosis

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13
Q

What is extrahepatic liver disease?

A

Non-primary hepatic diseases which affect the liver and cause liver values to increase

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14
Q

What are some common extrahepatic diseases?

A
  • Toxin or drug induced
  • Breed related (huskies)
  • Enodcrinopaties (most common)
  • Hypoxia and hypotension (HBC, seizure, AHDS)
  • Muscler injury
  • Neoplasia
  • Bone disorders
  • GI disease
  • Pancreatitis
  • Systemic infection
  • Pregnancy in cats
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15
Q

Which endocrinopathies have liver effects?

A

Diabetes mellitus
Cushing’s Disease
Hypothyroidism
Hyperthyroidism

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16
Q

What liver value will raise in pregnant cats?

A

ALP

17
Q

What are some common hepatotoxins?

A 
Plants- cycad palms, aminita
Xylitol
Supplements and nutraceuticals
Aflatoxin
Drugs
18
Q

What can xylitol cause?

A

Acute hypoglycemia and liver failure

19
Q

What are the main drugs that are known to cause liver issues?

A

Diazepam, methimazole, acetaminophen

Sulfonamides, phenobarbitol, NSAIDS, prednisone, azathioprine, oxibendazole

20
Q

What infectious agents effect the liver?

A

Bacteria, lepto, tick born infections, canine adenovirus, heartworm, neospora, leshmania, toxoplamsa. hepatozoon, histoplasmosis, heterobilharzia, flukes, abscesses

21
Q

What are the liver flukes of small animals?

A

Platynosomum fastosum, Heterobilharzia americanum, Eurytrema procyonis, Amphimerus pseudofelis, Metrochis conjuctus

22
Q

What are chronic hepatopathies usually associated with and what is the chronicity?

A

Inflammatory infiltrates that can progress to fibrosis and cirrhosis

Weeks to months in duration

23
Q

What conditions are classified as chronic hepatopathies?

A

Copper stoage disease, drug induced disease, infectious induced, immune mediated, result of toxin

24
Q

What are some canine breed associated hepatopathies?

A

Immune mediated/inflammatory- cocker spaniel, doberman, poodle

Copper storage disease- bedlington, lab, westie, dalmation, skye, doberman, german shepherd

Amyloid- sharpei, abyssinian, siamese, can lead to hemoabdomen if fractures

Benign hyperphosphastasemia- scotties, huskies

Gallbladder mucocele- shelti, pug

25
Q

What is copper hepatopathy?

A

Aka wilsons disease in humans

Chronic disease associated with errors of copper metabolism

26
Q

What are some clin path findings associated with copper hepatopathy?

A

Glucosuria in advanced disease

Elevated ALT first with other values follow

27
Q

What are some causes of copper hepatopathy?

A

Bedlingtons- deletion of exon 2 in commd1 gene (prevention of copper excretion in bile)

Increased copper uptake, defect in copper metabolism, altered excretion of copper

28
Q

T/F: Clinical signs may not be apparent until the disease is very severe with copper hepatopathy?

A

True- severe accumulation leading to inflammation can take a long time before it causes any clinical signs

29
Q

How do you diagnose copper hepatopathy?

A

Liver biopsy and copper quantification

30
Q

How do you treat copper hepatopathy?

A

Copper restricted diets

Chelation therapies

  • D-penicillamine: copper mobilization and increased binding, must supplement B6 and do NOT give with zinc
  • Zinc- increases binding, more mild effect than D-pen
  • Trientine HCl- increases urine excretion of copper and decrease GI absorbtion, EXPENSIVE
31
Q

What is the prognosis of copper hepatopathy?

A

Good if found before a crisis

32
Q

What is lymphocytic plasmacytic liver disease?

A

Chronic inflammatory hepatitis with a suspected immune mediated etioloty

33
Q

How do you treat chronic inflammatory hepatitis?

A

Prenisone/prednisolone or other imune modulated medications

Liver and other supportive care as needed

34
Q

What is the prognosis of chronic inflammatory hepatitis?

A

Can go into remission but may lead to fibrosis and cirrhosis

35
Q

What animal is chalangitis/cholangiohepatitis syndrome (CCHS) more common in?

A

Cats- most common acquired inflammatory liver disease

36
Q

Does CCHS have a more chronic or acute presentation?

A

Can be either

Usually has concurrent inflammatory disease in GI or pancreas and may be icteric

37
Q

What are the categories of CCHS and how are they diagnosed?

A

Dx via biopsy

Suppurative- often associated with bacterial infection and more acute clinical disease
Lymphocytic without destructive cholangitis
Lymphocytic with destructive cholangitis- permanent icterus

38
Q

What are some primary feline hepatopathies?

A

Small cell lymphoma
Lymphoproliferative disease
Lymphocytic portal hepatitis

SAM 2 (21 decks)

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