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RUSVM Clinical Pathology > Liver > Flashcards

Liver Flashcards

1
Q

___________ enzymes detect hepatocellular injury

A

Leakage

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2
Q

_____________ enzymes detect cholestasis

A

Induced

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3
Q

If ALT is increased in middle aged dogs, you might suspect _____________ but in a young dog _____________ is more likely

A

Chronic hepatitis; protocaval shunt

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4
Q

T/F: AST is liver specific

A

False

Also from muscle - assay with CK to determine muscle or liver disease

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5
Q

What is used in large animals to detect hepatocellular damage?

A

SDH

GLDH - liver specific, more stable than SDH but assay is difficult

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6
Q

Alkaline phosphatase (ALP) is membrane bound at ??

A

Bile canalicular surface

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7
Q

Gamma glutamic transferase (GGT) is associated with ???

A

Epithelial cells in bile duct system

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8
Q

What are important isoenzymes of ALP?

A

Bone - young animals

Liver- cholestasis

Corticosteroid induced

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9
Q

T/F: ALP in cats can be increased due to steroid induction

A

False

Hyperthyroidism may increase ALP

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10
Q

If ALP is increased WITHOUT hyperbilibrubenemia, what should you suspect?

A

Steroids or anticonvulsant medication

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11
Q

Gamma glutamyl transferase can be induced with???

A

Cholestasis

Steroid

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12
Q

GGT is a better indicator of cholestasis in cats, except for in what disease

A

Hepatic lipidosis

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13
Q

ALT and AST - mild increase

ASP and GGT- markedly increased

Bile acids - increased

What is it? What can cause this?

A

Cholestasis

  • cholangitis
  • cholangiohepatitis
  • bile duct obstruction
  • hepatic lipidosis
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14
Q

What mild diseases can cause a reactive and secondary hepatopathy, increasing serum enzyme level?

A 
Hypoxia 
Infectious disease 
Metabolic disease 
GI disease 
Neoplasia 
Cardiovascular disease 
Nutritional abnormalities 
Inflammatory disorders 
Benign nodular hyperplasia in old dogs

ALT and ALP may increase, but not bile acids

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15
Q

What are secondary hepatopathies

A

Intrahepatic cholestitis assoc. with bacterial infection

Chronic intestinal inflammatory disease

Pancreatitis

Metabolic and endocrine disease

Nodular hyperplasia

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16
Q

What substances removed by the liver can be tested in a liver function test?

A 
Bilirubin 
Bile acid 
Cholesterol 
Ammonia 
Exogenous substances
17
Q

What substances synthesized by the liver can be measured in a liver function test?

A 
Albumin 
Urea
Cholesterol 
Glucose
Coagulation factors
18
Q

An increased bilirubin can be seen due to?

A

Increased production due to RBC destruction

Decreased uptake my liver

Blockage of bile flow (cholestasis)

19
Q

Bile acid increase can be due to?

A

Deviation of portal circulation (shunt or cirrhosis)

Decreased hepatocyte uptake

Decreased bile excretion

20
Q

If fasting, bile acids >25 umol/L indicates

A

Liver lesions!

21
Q

In chronic liver disease, what occurs to levels of albumin and globulin

A

Alb - synthesized in liver and will decrease

Glob - only some synthesized in liver (decrease) but most made in lymphoid tissue (increase)

22
Q

If both albumin and globulin are decreased what should you consider?

A

Blood loss
PLE
Exudative skin lesions

23
Q

If albumin is decreased but globulin in normal, what should you suspect?

A

Glomerular disease

Liver failure

24
Q

If albumin and cholesterol are decreased, what do you suspect

A

PLE

Liver failure

25
Q

If albumin in decreased and cholesterol is increased, you should suspect?

A

Nephrotic syndrome

26
Q

In liver failure, what is the serum glucose level?

A

Normal to decreased

27
Q

What occurs to ammonia and BUN in liver failure?

A

Ammonia increase

BUN decrease

28
Q

In a PPT and PT, what would you expect to see in liver disease

A

Normal to prolonged

Usually the last thing to go in liver disease

29
Q

ALT and AST - mod inc

ALP and GGT- mod/mark inc

Serum bilirubin- mod/mark inc

Bile acid- inc

Ammonia - inc

BUN, albumin, cholesterol - dec

What is this?

A

Liver failure

30
Q

What is the most common liver disease of dogs?

A

Primary chronic hepatitis in dogs

Usually mixed inflammatory cell infiltrates and hepatocellular necrosis

31
Q

What are the primary hepatitis?

A

Copper associated
Genetic
Drug induced (anti-epi, some NSAIDS)

Infectious (lepto or ICH)

Immune mediated

32
Q

AST and ALT - mod inc

ALP and GGT- mod inc

Serum bilirubin - normal to inc

Bile acids - Normal to inc

A

Primary hepatitis

-results depend on stage of disease

33
Q

Enzyme activity can be normal to increased

Bile acids are increase

Microcytic anemia

What do you suspect?

A

Portosystemic shunt (early)

34
Q

AST and ALT - inc

ALP and bili - norm to inc

Albumin, BUN, glucose, cholesterol and coats - dec

Bile acids- mark inc
Microcytic anemia

A

Portosystemic shunt (late)

RUSVM Clinical Pathology (18 decks)

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