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Pathology II Master > Liver (LS) > Flashcards

Liver (LS) Flashcards

1
Q
  • necrosis/degeneration of the liver
  • most common response to hepatic injury
A

Hepatosis

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2
Q

What 2 things can trigger caspase activation → Apoptosis?

A
  • TNF-a
  • Fas Ligand
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3
Q

List the 3 morpholoical patterns of hepatocellular degeneration.

A
  • Random
  • Zonal
  • Massive
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4
Q

Which morphological pattern is of diagnostic importance but of little significance on hepatic fxn?

A

Random hepatocellular degeneration/necrosis

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5
Q

Causes of Random Hepatocellular Degeneration?

(3)

A
  • Bacteriema
  • Septicemia
  • Viruses
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6
Q

“Sawdust Liver” in Cattle is an example of what pattern of hepatocellular degeneration?

A

random hepatocellular degeneration/necrosis

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7
Q

Lesion of “Sawdust Liver” in cattle?

A

minute, yellowish foci of coagulative necrosis distributed throughout liver

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8
Q

Causes of Centrilobular Hepatocellular Degeneration/ Necrosis?

(5)

A
  • Hypoxia
  • Right sided HF
  • Rift Valley fever
  • ICH
  • Toxic
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9
Q

Necrosis of an entire hepatic lobule or contiguous lobule.

(ALL hepatocytes w/in affected lobule are necrotic)

A

Massive Hepatocellular Degeneration/Necrosis

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10
Q

Causes of Massive Hepatocellular Degeneration/Necrosis?

(4)

A
  • Vit E, Se deficiency → pigs
  • Toxic
  • Plants
  • Chemicals
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11
Q

Lesions of Massive Hepatocellular Degeneration/Necrosis?

A

extreme periacinar necrosis w/ remaining normal zones

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12
Q

Which of the 3 zones of the hepatocyte is most well nurished?

A

Zone 1

(Periportal)

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13
Q

List 2 diseases that are examples of massive hepatocellular degeneration/necrosis?

A
  • Hepatosis dietetica ⇒ swine
  • Massive Liver Necrosis ⇒ sheep
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14
Q

Characteristics of Hepatosis dietetica in Swine?

(4)

A
  • Vitamin E/Se deficiency
  • hemorrhagic massive necrosis
  • deep red, friable liver
  • may have ascites, “mulberry heart dz” & “ white mm. dz”
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15
Q

Characteristics of Massive Liver Necrosis in Sheep?

A
  • areas of California
  • Birdfood Trefoil (Lotus tenuis)
  • hepatoxicity
  • Photosensitization
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16
Q

How does hepatic regeneration take place?

A

replication of mature hepatocytes → incr. in lobular size

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17
Q

What 2 factors stimulate hepatocyte replication?

A
  • TGF-a
  • Hepatocyte GF
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18
Q

What factor inhibits hepatocyte proliferation?

A

TNF-B

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19
Q

When will scarring occur during hepatic regeneration?

A

If the normal extracellular matrix scaffolding is damaged

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20
Q

The space of Disse holds _____ ______ that are responsible for producing collagen.

A

stellate cells

(or Ito cells, lipocytes)

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21
Q

Hepatic fibrosis?

A

overall increase in the extracellular matrix w/in the liver

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22
Q

What are Stellate cells normally responsible for?

A

primary storage site for retinyl esters (Vit A)

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23
Q

What happens to stellate cells (Ito cells/lipocytes/HSCs) when the liver is injured?

A

become activated → change phenotype to myofibroblast type →

synthesize collagen types: I, III, & IV → hepatic fibrosis

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24
Q

Pathogenesis of Fibrosis?

A

HSC change & start making collagen → fibrosis → progressive bridging→nodular regeneration

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25
Q

Which form of hepatic necrosis if more likely to impair hepatic function?

A
  • Bridging fibrosis (from one portal tract to another)
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26
Q

Migrating nematode larvae lead to what form of fibrosis?

A

focal or multifocal hepatic fibrosis

(random)

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27
Q

Definition of Cirrhosis?

A

diffuse hepatic fibrosis w/ hyperplastic nodule formation

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28
Q

Term that refers to proliferation of new biliary ducts w/in portal areas & periportal regions

A

Biliary hyperplasia

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29
Q

What is the hallmark of Cirrhosis?

A

total absence of any normal lobular architecture

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30
Q

Lesions characteristic of Cirrhosis?

(4)

A
  • total loss of normal lobular architecture
  • shrunken, fibrotic, mulit-nodular nodules
  • regenerative nodules
  • “bunch of grapes” + shunts
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31
Q

Causes of Cirrhosis?

(4)

A
  • chronic toxicity
  • obstruction
  • Right sided heart failure → chronic congestion
  • chronic hepatitis
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32
Q

Which pattern of Cirrhosis is usually assocaited with acute toxic hepatitis?

A

Portal Cirrhosis

(Hobnail liver)

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33
Q

Which pattern of Cirrhosis shows scarring around central veins & generally lacks the essential features of cirrhosis?

A

Cardiac Cirrhosis

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34
Q

What are some possible consequences of hepatic dysfunction & failure?

(7)

A
  • Icterus/jaundice
  • Hepatic coma
  • Metabolic disturbacnes
  • Vascular & hemodynamic alterations
  • Cutaneous manifestations
  • Hepatorenal syndrome
  • Accumulation of wastes
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35
Q

List the species & condition where hepatic encephalopathy is common?

(3)

A
  • Ruminants & horses → hepatic failure
  • Dogs & Cats →congenital portosystemic shunts
  • ALL → end stage liver dz. (cirrhosis)
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36
Q

List the 2 metabolic disturbances of hepatic failure!

A
  • bleeding tendencies
  • hypoalbuminemia
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37
Q

Causes of hypoalbuminemia?

(2)

A
  • Decreased production → severe, chronic liver dz.
  • Portal Hypertension → ascites → pulls albumin out of vasculature
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38
Q

Pathogenesis of vascular & hemodynamic alterations of hepatic failure?

A
  • Fibrosis→ increased resistance→portal hypertension→acquired portosystemic shunts
  • increased pressure + decreased albumin= ascites
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39
Q

Name the syndrome that has CS of:

crusting, erosions & ulceration of the epidermis of muzzle, mucocutaneous areas of face, footpads & pressure points of the skin in some dogs with severe hepatic dz.

A

Hepatocutaneous syndrome

AKA

Necrolytic migratory erythema

AKA

superficial necrolytic dermatitis

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40
Q

List the typical cutaneous lesions associated with Hepatocutaneous syndrome.

(3)

A
  • alopecia
  • erythemia
  • necrosis
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41
Q

Which form of photosensitization is hepatic dysfunction responsible for?

A

Secondary photosensitization

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42
Q

What animals does secondary or hepatogenous photosensitization occur in?

A

herbivores w/ impaired excretion of phylloerythrin in bile

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43
Q

Which breed of sheep are more prone to secondary photosensitization due to an inherited defect?

A
  • Mutant Corriedale Sheep
  • inability to excrete conjugated bilirubin
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44
Q

How do regenerative nodules arise? Age related?

A
  • response to hepatic injury
  • no
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45
Q

Congential porphyria is a metabolic disorder seen in what two species?

A
  • Cattle
  • Cats
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46
Q

Pathogensis of Congenital porphyria?

A

abnormal heme metabolism→abnormal excretion & accumulation of porphyrins → porphyrins are photodynamic

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47
Q

Give 3 examples of disturbances of liver growth.

A
  • Nodular hyperplasia
  • Regenerative nodules
  • Cholangiocellular (biliary) hyperplasia
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48
Q

What species get Nodular hyperplasia? Hepatic Dysfunction?

A
  • Dog → old
  • No, does not cause significant hepatic dysfunction
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49
Q

How can you distinguish regenerative nodules?

A
  • significant fibrosis
  • only a single portal tract apparent
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50
Q

Hepatic lipidosis/fatty liver/steatosis is normal in what animals?

A

Chicks up to 3 days old

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51
Q

Causes of Fatty Liver?

(LOTS)

A
  • Dietary- starvation, choline deficiency
  • Ketosis
  • Pregnancy toxemia
  • Toxic & anoxic
  • Bovine Fatty Liver Syndrome → fat cow syndrome
  • Feline Fatty Liver Syndrome → fat cat won’t eat!
  • Hyperlipidemia → horses & sheep
  • Hepatic lipidosis → ponies, mini’s & donkeys
  • Endocrine → DM, Hypothryoidism
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52
Q

Pathogenesis of Fatty Liver?

A

increase FAs/carbs → abnormal hepatocyte function → esterification of FFAs to TGs → decreased apoprotein synthesis →impaired secretion of lipoprotein

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53
Q

Lesions of Fatty Liver

(7)

A
  • pale tan to yellow
  • swollen
  • friable
  • enhanced lobular pattern (nutmeg liver)
  • greasy
  • bulging edges
  • floats in formalin
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54
Q

Lesions of Glycogen Accumulation?

(4)

A
  • hepatomegaly
  • pallor
  • fatty degeneration
  • nutmeg liver
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55
Q

Glycogen accumulation in the liver occurs with metabolic alterations due to what 2 things?

A
  • DM
  • Glycogen storage Dz.
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56
Q

Steroid-Induced Hepatopathy is seen primarly it what species?

A

DOGS!!!

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57
Q

Etiology of Steroid-Induced Hepatopathy?

A

Iatrogenic

Hyperadrenocorticism

58
Q

Pathogenesis of Steroid-induced Hepatopathy?

A

Glucocorticoids induce glycogen synthetase enhancing hepatic storage of glycogen

59
Q

List the 3 types of Amyloidosis.

A
  • Primary
  • Secondary
  • Inherited/Familial
60
Q

Primary amyloidosis is a defect in what?

A

AL from IG/plasmacytomas

61
Q

What is the most common form of amyloidosis in vet med?

A

Secondary amyloidosis

62
Q

Secondary amyloidosis is assocaited w/ what 2 things?

A

chronic infection

tissue destruction

63
Q

Secondary amyloidosis is a defect in what protein?

A

serum amyloid-associated (SAA) protein

64
Q

Inherited/familial Amyloidosis is seen in what breeds?

A
  • Shar-Pai dogs
  • Abyssinian cats
  • Siamese cats
65
Q

Cu accumulation occurs in what animals?

A
  • Sheep → poor storage regulation
  • Dogs → hereditary disorders of Cu metabolism
66
Q

What does Cu toxicosis lead to (@ the cellular level)?

A

production of reactive O2 species → destructive lipid peroxidation rxns

67
Q

Causes of Cu Toxicosis in Rumis?

(3)

A
  • Dietary excess
  • + molybdenum
  • Pastures containing Pyrrolizidine alkaloids
68
Q

List plant species that contain pyrrolizidine alkaloids!

A
  • Heliotropium spp.
  • Crotalaria spp.
  • Senecio spp.
69
Q

How to Pyrrolizidines prevent hepatocellular proliferation?

A

via their toxic action on the spindle during mitosis

70
Q

Dog breeds with hereditary disorders of Cu metabolism?

(3)

A

Dalamatians

Bedlington terriers

West Highland white terries

71
Q

How is biliary excretion of Cu impaired in dogs with hereditary disorders of Cu metabolsim?

A

abnormal Cu binding by metallothionein

72
Q

Sequelae of Chronic Cu Poisoning in Sheep?

A

acute, severe intravascular hemolysis & hepatocellular necrosis

73
Q

Sequelae of hereditary disorders of Cu metabolism in Bedlington & West Highland white terriers?

(5)

A
  • ongoing necrosis of hepatocytes
  • chronic inflammation
  • fibrosis
  • cirrhosis
  • hepatic failure
74
Q

Tensions lipidosis (steatosis) is seen in what 2 animals?

A

Cattle

Horses

75
Q

Lesions of Tension lipidosis? Pathogenesis?

A
  • discrete, pales areas of parenchyma adjacent to ligament attachement sites
  • impede blood supply due to tension on the liver capsule → hypoxia → hepatocyte lipidosis
76
Q

Does tension lipidosis cause signifcant functional loss to the liver?

A

NO!

77
Q

List the 3 forms of Portosystemic shunts.

A
  • Congenital
    • Intrahepatic
    • Extrahepatic
  • Acquired
    • usually extrahepatic
78
Q

Where are congenital portosystemic shunts usually limited to?

A
  • a single, large-caliber vessel
  • in absence of hepatic dz.
79
Q

When do Intrahepatic portosystemic shunts occur?

A

when the ductus venosus fails to close @ birth

80
Q

Where are Intrahepatic portosystemic shunts often located? in what animals?

A
  • Left side of liver
  • large breed dogs
81
Q

Where to Congenital Extrahepatic portosystemic shunts often occur? What animals?

A
  • Portal vein to azygous vein anastomoses
  • more often in small breed dogs
82
Q

Where can Acquired Portosytemic Shunts be located?

A
  • cranial mesenteric veins - caudal vena cava
  • renal veins - caudal vena cava
83
Q

Causes of Prehepatic Portal Hypertension

A
  • portal vein thrombosis
  • tumors
  • increased splenic flow
84
Q

Causes of Intrahepatic Portal Hypertension?

A
  • anything that causes Cirrhosis (most common)
85
Q

Causes of Posthepatic Portal Hypertension?

A
  • Chronic passive congestion
  • thrombosis of hepatic veins (Budd-Chiari syndrome)
  • vena cava/hepatic vein obstruction
86
Q

Changes in blood flow that result from portal hypertension

A

blood can’t easily pass through liver → bypasses liver & flows into small veins which feed directly into the vena cava → veins become engorged, dilated, tortuous & rupture → collateral veins form (same thing happens) → bleeding

87
Q

Sequelae of Portal Hypertension?

(3)

A
  • Ascites
  • Splenomegaly
  • Hemolysis
88
Q

Causes of Acute Passive Congestion?

(3)

A
  • acute HF
  • shock
  • barbiturate overdose
89
Q

“Brisket dz” & pulmonary hypertension are other names for?

A

high altitude dz.

90
Q

Causes of Chronic Passive Congestion of the liver?

(4)

A
  • chronic right-sided HF
  • obstruction of the hepatic vein
  • lobar congestion
  • valvular insufficiency → tricuspid endocardiosis
91
Q

Gross appearance of Passive Congestion

(2)

A
  • nutmeg liver
  • mottled w/ red center & yellow peripheral lobular appearance
92
Q

Cardiac sclerosis/cirrhosis means?

A

post-necrotic fibrosis around the central veins

93
Q

Dz characterized by intimal thickening & occulsion of the central vein by fibrous CT.

A

Hepatic Venoocclusive Dz.

94
Q

Etiology of Hepatic Venoocclusive Dz.

(2)

A
  • Hepatotoxicity → pyrrolizidine, alkaloid, aflatoxin
  • Vitamin A toxicosis in Cheetahs!
95
Q

Sequelae of Hepatic venoocclusive dz.

(4)

A
  • passive hepatic congestion (nutmeg liver)
  • ascites
  • hepatic failure
  • icterus
96
Q

Marked dilation of sinusoids in areas where hepatocytes have been lost is known as? Common in what animals?

A

Telangiectasis

Cattle

97
Q

Lesions of Telangiectasis?

A

multiple variable sized, red foci

98
Q

Penetrating wounds to the liver cause what? Where?

A
  • discrete areas of inflammation + necrosis
  • capsule
  • Hepatic parenchyma
99
Q

Characteristics of Acute Hepatitis?

A
  • inflammation
  • hepatocellular necrosis
  • Apoptosis

(varies by host response & stage of lesion)

100
Q

3 Causes of Acute Hepatisis?

A

B acterial

Protozoal

Viral

101
Q

What is a common bacterial cause of acute hepatisis in neonates? How does it get in?

A
  • E. coli
  • seeds the liver via umbilical vein (Naval ill), portal venous system or hepatic arterial system
102
Q

When does Chronic Hepatisis result?

A

after continued inflammation due to a persistant Ag stimulus

103
Q

Characteristics of Chronic Hepatisis?

(3)

A
  • fibrosis
  • mononuclear cells
  • regeneration
104
Q

How does chronic, suppurative hepatisis manifest?

A

as discrete or multiple abscesses

105
Q

What form of hepatisis is due to primary infection of another organ that spreads to the liver?

A

Nonspecific Reactive Hepatisis

106
Q

Lesion of Nonspecific, Reactive Hepatisis?

(4)

A
  • scattered pale foci
  • no evidence of necrosis
  • pigemented MØs
  • reactive Kuppfer cells
107
Q

Characteristics of Cholangitis?

A

inflammation centered on the biliary tract

108
Q

Inflammation of the gallbladder?

A

Cholecystitis

109
Q

Refers to inflammation that affects the biliary tracts & hepatic parenchyma

A

Cholangiohepatisis

110
Q

Things that cause Necrotizing Hepatitis?

(give main categories)

A
  • Viral
    • ICH (K9 Adenovirus 1)
    • Herpesvirus
    • Rift Valley Fever
  • Bacterial
    • C. haemolyticum → bacilary hemoglobinuria
    • C. novyi Type D → infectious necrotic hepatisis
    • C. piliforme → Tyzzer’s Dz.
    • Lepto
    • Francisella tularensis → tularemia in rodents/rabbits
    • Salmonella
  • Protozoal
111
Q

Causes of Suppurative Hepatisis

(5)

A
  • Yersinia spp.
  • Nocardia spp.
  • Actinomyces spp.
  • A. pyogenes
  • Fusobacterium necrophorum
112
Q

Causes of Nonspecific Hepatitis

(5)

A
  • Salmonellosis
  • Campylobacter fetus infection
  • Listeriosis
  • Coccifiosis in rabbits
  • metazoan parasites
113
Q

How does Herpesvirus affect the liver?

(4)

A
  • necrotizing
  • livers are swollen, friable, pale
  • mottled
  • + hemorrhages
114
Q

What causes bacillary hemoglobinuria in cattle & sheep?

A

C. hemolyticum takes over following damage by F. hepatica

115
Q

Infectious necrotic hepatits (Black dz) is most common in sheep & cattle. Is caused by?

A

C. novyi Type B takes over following F. hepatica migration

116
Q

What animals get Tyzzer’s Dz. due to C. piliforme?

(5)

A
  • Rodents
  • Foals
  • Calves
  • Dogs
  • Cats
117
Q

How does Leptospirosis lead to liver damage?

A

Ischemic injury to centrilobular areas due to intravascular hemolytic anemia

118
Q

Cause of Granulomatous Hepatisis?

(3)

A
  • Mycoses (fungal)
  • TB
  • FIP (can be pyogranulomatous too)
119
Q

What 2 nematodes cause Milk Spots on Pig Livers ?

A
  • Ascaris suum
  • Stephanurus dentatus
120
Q

What migrating nematode causes liver pathology in Horses?

A

Strongylus spp.

121
Q

What 2 migrating nematode larvae causes liver problems for dogs?

A
  • Capillaria hepatica
  • D. immitis
122
Q

What Cestodes cause Cysticercosis/Echinococcosis?

A
  • T. hydatigenal
  • E. granulosus (hydatid cysts)
123
Q

Most common liver fluke of ruminants?

A

F. hepatica

124
Q

2 examples of Idiosyncratic hepatoxins?

A
  • prolonged Halothane exposure
  • Diazepam Toxicity → cats
125
Q

Give the 3 step detoxification process.

A
  1. biotransformation
  2. conjugation
  3. transport across the cell membrane → excreted
126
Q

Characteristic lesion seen as a result of Pyrrolizidine Alkaloids?

A

megalocytes

127
Q

Susceptibility to Pyrrolizidine Alkaloids?

A

Swine > sheep > cattle & horses

128
Q

Mycotoxins that cause toxic liver damage? Where?

(5)

A
  • Alfaltoxin B1, B2, G1, G2 & M1→ Aspergillus spp.
  • midzonal lesions
129
Q

Pathogensis of White Phosphourus (in rodenticide)?

A

IF SURVIVE PAST DAY 5

  • liver disease = periportal necrosis, severe fatty changes
130
Q

Why is White Phosphorus so dangerous to the liver?

A

does NOT require bioactivation

131
Q

How do Chlorinated Hydrocarbons affect the liver?

(CCL4 used to be an anthelminthic)

A
  • bioactivated by MFO system →CCl3 -
  • centrilobular necrosis
  • Lipidosis
132
Q

Cresols (in “clay pigeons & asphalt shingles) causes what in pigs?

A

hemorrhagic necrosis (centrilobular to massive)

133
Q

Syndrome of acute hepatic necrosis in young, rapidly growing pigs caused by Vit E &/o Se deficiency?

A

Hepatosis dietetica

(Nutritional hepatic necrosis)

134
Q

Refers to pale, fatty livers in SHEEP that develop from a nutritional Cobalt deficiency?

A

White Liver Dz!

135
Q

Affected horses have hepatic failure after an injection containing equine serum

→ hepatic encephalopathy, icterus, intravascular hemolysis

A

Theiler’s Dz. (Equine serum sickness)

136
Q

“Dish-rag” liver is seen in what Dz?

A

Theiler’s Dz

(Equine Serum Sickness)

137
Q

List the Primary, Epithelial Neoplastic Dzs.

(4)

A
  • Hepatocellular adenoma (hepatoma)
  • ” carcinoma
  • Cholangiocellular adenoma
  • ” carcinoma
138
Q

What is a frequent, malignant neoplasm seen in SHEEP?

(rare in others!)

A

Hepatocellular carcinoma

139
Q

What is the most common primary hepatic neoplasm in cats?

(benign, not in others)

A

Cholangiocellular adenoma

140
Q

Malignant, primary neoplasms that occurs in all species?

A

Cholangiocellular carcinoma

141
Q

List the top 3 Secondary (metastatic) Neoplasms in order of occurrence!

A
  1. Lymphosarcomas
  2. Melanomas
  3. Hemangioscarcomas
142
Q

Lesions of Granulomatous Hepatitis?

A
  • numerous tan-yellow caseous, nodular masses
  • size: 0.5-3 cm
  • Scattered thoroughout hepatic parenchyma

Pathology II Master (15 decks)

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