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Oregon State Small Animal Med I > Liver > Flashcards

Liver Flashcards

1
Q

Which liver disease is most likely to develop DIC with decreased platelets?

A

Acute liver disease

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2
Q

What liver enzymes may be increased with hepatocellular damage?

A

ALT and AST

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3
Q

What liver enzymes may be increased with cholestasis?

A

ALP and GGT

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4
Q

Which liver enzyme has a shorter half life and is more affected by muscle damage…AST or ALT?

A

ALT

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5
Q

Which species is it more concerning that ALP is elevated? Why?

A

Cats because there is no inducible reasons for why a cat would have an elevated ALP level, unlike in dogs.

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6
Q

If AST is higher than the ALT, what does this indicated?

A

Muscle damage

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7
Q

In the cat, what does an elevated GGT indicate?

A

Pancreatitis and biliary disease

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8
Q

Increased ALT and GGT ( with GGT being more elevated) in a cat may indicate which diseases?

A

Cholestatis or choleohepatitis

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9
Q

What liver function tests are based off of substances synthesize in the liver?

A
  1. BUN
  2. Glucose
  3. Albumin
  4. Cholesterol
  5. Clotting factors
  6. Anticoagulants
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10
Q

What are some reasons other than liver failure why a patient may have a decreased BUN?

A

Diets

Medullary washout

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11
Q

What substances are taken up into the liver that and secreted by the liver that measured to determine liver function?

A
  1. Bile acids

2. Bilirubin

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12
Q

What substances are conjugated in the liver that can be measured to help us determine liver function?

A

Bilirubin

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13
Q

What is metabolized by the liver that can be measured to help us determine liver function?

A

Ammonia

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14
Q

Why would cholesterol increase in liver disease?

A

A bile flow issue leading to cholestatic disease

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15
Q

Why would cholesterol decrease in liver disease?

A

It is synthesized in the liver, so if the liver is damaged, it won’t be made.

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16
Q

Why would albumin decrease in liver disease?

A

It is synthesized in the liver

17
Q

Which liver enzyme tests will have decreased values early in liver disease? Late?

A

Early:
BUN, cholesterol and albumin
Late:
Glucose

18
Q

Which two situations would we be most likely to see elevated ALP and GGT levels?

A

Glucocorticoid use or

Vaculour hepatopathy

19
Q

What liver enzyme would you expect to see elevated in a cat with hepatic lipidosis?

A
  1. ALP will be the highest
  2. ALT
  3. GGT
20
Q

Which liver enzymes tests will not be on routine blood chemistry and must be ordered separately?

A

Bile acids

Ammonia

21
Q

Why would platelet count increase in liver disease?

A

The patient is suffering from a hepatocellular carcinoma and is most likely a dog

22
Q

Which organs does GGT enzyme come from other than the liver?

A

Pancreas
Kidney
Intestines

23
Q

Which diseases are associated with vacuolar hepatopathy?

A
  1. Cushings
  2. Diabetes
  3. Hypothyroidism
  4. Idiopathic (scottie)
24
Q

Which liver diseases are associated with a patient coming into the clinic sick?

A
  1. Acute Hepatopathy (Hepatitis or hepatotoxicity)
  2. Chronic hepatitis
  3. Lymphoma
  4. PSVA
  5. Vaculoar hepatopathy
  6. Hepatic lipidosis
25
Q

Which liver diseases are associated with a patient coming into the clinic normal?

A
  1. Chronic hepatitis
  2. Lymphoma
  3. Biliary mucocele
  4. Vacuolar hepatopathy
  5. PSVA
  6. Cholangitis-L/P
  7. Reactive hepatopathy
26
Q

What P/E findings are common with liver disease?

A
  1. Icterus
  2. Hepatomegaly
  3. Ascites
  4. Hepatic encephalopathy
27
Q

Why would an animal with liver disease potentially have ascites?

A

Portal hypertension due to chronic hepatitis that is end stage and likely has fibrosis causing hypertension.

28
Q

What are you likely to see on cbc with liver disease?

A

Anemia that can be from chronic disease, regenerative due to hemorrhage from the portal hypertension, or iron deficiency microcystic anemia from the liver not producing iron

29
Q

What liver diseases commonly have iron deficiency anemia on CBC?

A

Shunts

Hepatic lipidosis in cats

30
Q

When does hypoglycemia occur with liver disease patients?

A

When there is less than 30% functional liver mass left

31
Q

Describe hepatocutaneous dogs..

A

These dogs have a rare condition where they are hyperglycemic due to increased glucagon production which decreases insulin. They don’t metabolize amino acid correctly. these dogs have concurrent diabetes mellitus with a swiss cheese liver. usually a fatal disease.

32
Q

Why would we ever see elevated globulins with liver disease?

A

Increased: cats with cholangitis in a chronic immune situation and rarely decreased because globulins are secreted from other parts of body than the liver

33
Q

What other differentials besides liver disease will there be hypocholesterolemia and hypoalbuminemia? How would you tell these differentials apart from liver disease?

A
  1. GI Disease in dogs
  2. Histiocytic sarcoma in dogs

Is there panhypoproteinemia? If so, probably GI disease

34
Q

Describe how bilirubin is made?

A

Hemoglobin and myoglobin breakdown into unconjugated where it travels to the liver and conjugated into bile then goes to the GI and becomes deconjugated and leaves via the feces or is reabsorbed from kidneys/liver.

35
Q

Is hypoglycemia due to liver disease more common in dogs or cats and why?

A

Dog, because cats have a stress response which keeps glucose high

Oregon State Small Animal Med I (1 decks)

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