Liver And Gall Bladder Flashcards by Josie Pugh

What are the livers two sources of blood?

Portal vein and hepatic artery

How well did you know this?

Not at all

Perfectly

What is the space of Disse?
What does it contain?

Fluid filled space between endothelial cells and hepatocytes (space is continuous with plasma). Interface for interaction between liver and blood
Contains Stellate cells

How well did you know this?

Not at all

Perfectly

What are 2 functions of stellate cells?

Store vit A
Can synthesize collagen and thus can cause hepatic fibrosis

How well did you know this?

Not at all

Perfectly

What are the two models describing the arrangement of the hepatic parenchyma?

Classical subunit is hepatic lobule
Classical subunit is hepatic acinus

How well did you know this?

Not at all

Perfectly

In the hepatic lobule model, what is the centre and what is the periphery? What is the shape?

Centre: hepatic venule or central venule
Periphery: portal venule hepatic arteriole bile duct, lymphatics, nerves
Shape: hexagonal

How well did you know this?

Not at all

Perfectly

In the hepatic acinus model, what is the centre, what is the periphery, and what is the shape?

Centre: terminal afferent branches of the portal venule and the hepatic arteriole
Periphery: hepatic venules
Shape: diamond shape

How well did you know this?

Not at all

Perfectly

What are the 3 zones and which is most and least oxygenated?

Zone 1 = periportal (most oxygenated)
Zone 2 = midlobular
Zone 3 = centrilobular (least oxygenated)

How well did you know this?

Not at all

Perfectly

What species is the gall bladder absent in? Where does the common bile duct empty into?

Horse and rat
Duodenum

How well did you know this?

Not at all

Perfectly

What are the 5 normal liver functions?

Bilirubin metabolism
Bile acid metabolism
Carbohydrate metabolism
Lipid metabolism
Protein synthesis

How well did you know this?

Not at all

Perfectly

What type of icterus is caused by an increase in the breakdown of RBCs?

Prehepatic icterus

How well did you know this?

Not at all

Perfectly

What is the cause of hepatic jaundice?

Decreased uptake of bilirubin due to liver disease (bilirubin accumulates because the liver is not removing it from the blood)

How well did you know this?

Not at all

Perfectly

What is the cause of post-hepatic icterus?

Decrease hepatic excretion of bilirubin with bile (cholestasis)

How well did you know this?

Not at all

Perfectly

What is the most common type of icterus in ruminants?

Prehepatic icterus

How well did you know this?

Not at all

Perfectly

What species develops physiologic icterus with starvation? Why?

Horses
Bilirubin uptake is energy dependent and is decreased during starvation

How well did you know this?

Not at all

Perfectly

What is random distribution of degeneration and necrosis caused by?

Bacteria, viruses, Protozoa

How well did you know this?

Not at all

Perfectly

What are the 5 types of zonal distribution of degradation and necrosis?

Centrilobular
Paracentral
Periportal
Midzonal
Bridging necrosis

How well did you know this?

Not at all

Perfectly

What are the 2 common causes of centrilobular pattern necrosis?

Toxins requiring metabolic activation
Passive congestion of the liver

How well did you know this?

Not at all

Perfectly

Describe the paracentral pattern of necrosis

Involves only a wedge around the central vein (one acinus affected)

How well did you know this?

Not at all

Perfectly

What is the term that describes necrosis of an entire hepatic lobule or contagious lobules?

Massive necrosis

How well did you know this?

Not at all

Perfectly

What are the two types of cholestasis? What is affected? What causes it?

Intrahepatic cholestasis- affects bile caniliculi or ductules within the liver, caused by liver injury (fibrosis)
Extrahepatic cholestasis- affects extrahepatic bile duct, caused by obstruction due to a mass within or outside of the lumen. Will lead to intrahepatic cholestasis

How well did you know this?

Not at all

Perfectly

When will you see regenerative nodules?

Extensive loss of hepatocytes and loss of extracellular matrix scaffold (reticulin)

How well did you know this?

Not at all

Perfectly

What are the 2 differentials when you see regeneration nodules (lumps and bumps)?

Neoplasia and granulomatous inflammation

How well did you know this?

Not at all

Perfectly

What is happening when a liver is small, firm and pale white and may have a nodular appearance to it?

Fibrosis

How well did you know this?

Not at all

Perfectly

What are the 3 processes of end stage liver (cirrhosis)?

Degeneration and necrosis
Regeneration (regenerative nodules)
Fibrosis

How well did you know this?

Not at all

Perfectly

What is the definition of hepatic failure?

Loss of adequate hepatic function as a consequence of either acute or chronic hepatic damage

What are the 4 consequences of hepatic failure?

Hepatic encephalopathy Metabolic abnormalities Vascular and hemodynamic alterations Cutaneous manifestations

What is an example of vascular and hemodynamic alteration?

Acquired portosystemic shunt which is an abnormal vascular communication between the portal vein and the systemic circulation

What are the two types of cutaneous manifestations?

Superficial necrolytic dermatitis Photosensitization secondary to hepatic dysfunction

If there is pale areas in the livers of horses and cattle, what is it and is there a cause for concern?

Tension lipidosis, incidental finding

What are 5 examples of hepatic lipidosis in vet med?

Pregnancy toxaemia Bovine fatty liver disease Feline fatty liver syndrome Hyperlipemia Endocrine disorders like diabetes and hypothyroidism

What are the 2 causes of glycogen accumulation (steroid hepatopathy)?

Prolonged administration of corticosteroids Secondary to hyperadtenocorticism

what is an example of circulatory disorders with disturbances of outflow? What is it secondary to?

central passive congestion within the liver, secondary to right-sided heart failure

What are 2 circulatory disorders that are problems with inflow?

anemia and congenital portosystemic shunt

What is only found in acquired shunts and absent in congenital portosystemic shunts?

portal hypertension

What will you see if you have a portosystemic shunt upon necropsy? How do you tell if it is acquired or congenital?

Blue vessels congenital - in younger, no fibrosis, diffuse liver atrophy acquired - in older animals, secondary to fibrosis (some sort of injury to the liver), may see ascites

if the liver is normal otherwise but has little red spots in cattle, horses and cats, what is the most likely cause? Is it significant?

Telangiectasis, no incidental finding

what is infarction?

it is necrosis, secondary to lack of blood flow

why are liver infarcts uncommon? What can they happen secondary to?

uncommon due to dual blood supply can occur secondary to torsion of a liver lobe, or can happen secondary to thrombosis

what is the most common cause of an enlarged, orange and friable liver?

amyloid accumulation

Bedlington terriers have a mutation that causes what?

copper accumulation/toxicity, the mutation decreases excretion of copper

what should you sample of you suspect copper toxicity?

fresh liver, blood sample is okay if you are in a hepatic crisis

what are some gross lesions seen with copper toxicity?

icterus, black kidneys because of hemoglobinuric staining, enlarged spleen because of hemolytic crisis

what are the three portals of entry to the liver?

hematogenous ascending from intestine through bile ducts direct penetration

what are the gross features of acute hepatitis?

white spots indicative of necrosis and inflammation

what are the gross features of chronic hepatitis?

fibrosis, nodular regeneration, granulomas, abscesses

what infectious disease causes multifocal hepatic necrosis and fetal abortion or neonatal death?

herpesvirus infections

what is a bacterial disease in foals that affects the cecum or colon and liver causing multifocal hepatic necrosis and possibly colitis and myocarditis?

Tyzzer's disease, caused by Clostridium piliforme

What 2 bacteria cause liver abscesses in feedlot cattle?

Fusobacterium necrophorum mixed with Trueperella pyogenes causes abscesses formation

are liver abscesses significant in feedlot cattle? When could it be a problem?

Typically an incidental finding that would cause liver condemnation at slaughter, unless the abscesses open into the central vein or vena cava and cause pulmonary embolism or cause central vein thrombosis and occlusion causing hepatic passive congestion and portal hypertension

what can cause liver abscess formation in foals?

Rhodococcus equi

what bacterial disease loves the kidneys, and causes intervascular hemolysis with visible hepatic necrosis, where should you isolate the organism?

Leptospirosis isolate culture from the kidneys

what are some protozoal diseases that can infect the liver?

toxoplasma and neospora

what are some fungal diseases that can infect the liver?

Aspergillus, blastomyces, coccidioides, and histoplasma

what nematode of pigs causes milk spotted liver?

Ascaris suum

What parasite when in the vena cava in large number can cause DIC, intravascular hemolysis and acute hepatic failure?

Dirofilaria immitis (vena caval syndrome)

What do cestodes do in the liver, what are the adult stages?

Cysticercus cyst (smaller) adult stage Taenia Hydatid cyst (bigger) adult stage Echinococcus

what trematode inhibits the biliary system of ruminants?

Fasciola hepatica

what trematode migrates through the parenchyma of ruminants?

Fascioloides magna

what trematode inhabits the bile duct of dogs and cats?

Metorchis

what is the most common pattern of acute liver toxicity? Why?

centrilobular necrosis because it is the zone with the lowest oxygen tension and the highest concentration of metabolic enzymes

what are the 6 major mechanisms through which toxicity occur, whats the most common?

1. production of injurious metabolites (most common) 2. formation of neoantigens 3. induction of apoptosis 4. injury to cell membranes and activation of proteases 5. disruption of bile secretion 6. mitochondrial damage

what can be seen histologically with Pyrrolizidine alkaloid toxicity?

megalocytes (big hepatocytes)

If an old dog comes into pathology with raised nodules (not many) on the surface of the liver with no fibrosis, what do you expect it is?

Nodular hyperplasia, not significant, age related

if you see an umbilicated, raised lesion on the liver of a cat, what do you suspect it is?

Chollangiocellular carcinoma

what causes bacillary hemoglobinurea in ruminants? What has a similar pathogenesis? How do you differentiate them?

Clostridium hemolyticum Infectious necrotic hepatitis (black disease) caused by Clostridium novyi Black disease, there is no intravascular hemolysis

What causes healthy well doing pigs to drop dead?

Hepatosis dietetica caused by vitamin E or Se deficiency

what causes infectious canine hepatitis?

Canine Adenovirus 1

what does lymphocytic cholangitis cause?

lymphocytic infiltration centered on bile ducts with bile duct hyperplasia and fibrosis

what are common causes of cholecystitis in cattle and dogs?

cattle - Salmonella Dublin dog - infectious canine hepatitis

what is it called when mucosa is thickened with many surface cysts? is it significant?

Cystic mucinous hyperplasia, incidental finding