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Pathology I > P27 - Hepatobiliary and Exocrine Pancreas > Flashcards

P27 - Hepatobiliary and Exocrine Pancreas Flashcards

1
Q

functional subunit of liver parenchyma

A
  • hepatic lobule
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2
Q

space of Disse

A
  • perisinusoidal space between sinusoid and hepatic plate

- hepatic stellate cells present

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3
Q

function of hepatic stellate cells (2)

A
  • storage for Vit A

- response to hepatic injury by producing collagen (hepatic fibrosis)

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4
Q

kupffer cells function

A
  • remove infectious agents, endotoxins, immune complexes, senescent cells, particulate debris, and other substance from portal blood that drains GI tract
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5
Q

how do kupffer cells function immunologically

A
  • antigen-presenting cells and initiators of cytokine signaling
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6
Q

bile flows in what direction compared to blood

A
  • opposite
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7
Q

what part of the hepatocyte has the least oxygenated blood and what is it susceptible to

A
  • surrounding central veins (zone 3)

- hypoxic injury

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8
Q

bilirubin comes from the breakdown of what

A
  • heme
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9
Q

bile acid metabolism (synthesis and excretion)

A
  • synthesized in liver and excreted into gallbladder
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10
Q

portals of entry into hepatocytes (4)

A
  • direct extension (penetrating trauma)
  • hematogenous spread
  • retrograde biliary infection
  • retrograde pancreatic ductular infection
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11
Q

describe random pattern of hepatocellular degeneration and necrosis

A
  • multifocal areas of degeneration and necrosis scattered randomly throughout the liver with no predictable lobular pattern
  • hematogenous route of entry
  • embolic pattern
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12
Q

describe zonal pattern of hepatocellular degeneration and necrosis

A
  • specific areas of degeneration and necrosis that are restricted to particular portion of hepatic lobule
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13
Q

zones of hepatic lobule (3)

A
  • zone 1 - periportal
  • zone 2 - mid-zonal
  • zone 3 - centrilobular
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14
Q

cause of random pattern of hepatocellular degeneration and necrosis

A
  • blood-borne infectious agents (viruses, bacteria, protozoa)
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15
Q

cause of zonal pattern of hepatocellular degeneration and necrosis (3)

A
  • hypoxic injury
  • zonal hepatitis
  • hepatotoxicities
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16
Q

cytochrome P450 enzyme converts drugs or chemicals into what

A
  • toxic metabolites
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17
Q

three causes of hyperbilirubinemia

A
  • hemolytic disease (prehepatic)
  • liver failure (hepatic)
  • cholestatic disease (posthepatic)
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18
Q

how does hemolytic disease lead to hyperbilirubinemia

A
  • hemolysis leads to accumulation of bilirubin in blood

- exceeds liver capacity to remove bilirubin from blood

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19
Q

how does liver failure lead to hyperbilirubinemia

A
  • hepatic dysfunction leads to failure of hepatocytes to uptake bilirubin from blood
20
Q

cholestasis is the reduced…

A
  • outflow of bile
21
Q

cholestatic disease can occur in what 2 ways

A
  • extrahepatic

- intrahepatic

22
Q

what causes acholic feces

A
  • complete obstruction of outflow of bile leads to maldigestion of fats and clay-colored feces
23
Q

response of liver to injury (3)

A
  • regeneration
  • fibrosis
  • biliary hyperplasia
24
Q

what components of the liver can regenerate

A
  • all components
25
Q

chronic and sever in jury of liver many lead to

A
  • end-stage liver (cirrhosis)
26
Q

hepatic fibrosis occurs in response to

A
  • chronic injury and repeated injury or chronic inflammation
27
Q

biliary hyperplasia predominantly occurs with what

A
  • disease that causes biliary inflammation, obstruction and cholestasis
28
Q

pathophysiology of end stage liver (Cirrhosis)

A
  • diffuse process in liver characterized by severe fibrosis and replacement of normal hepatic lobules with nodular regeneration and abnormal vasculature
29
Q

what percentage of hepatic parenchyma can be removed without significant impairment of function

30
Q

congenital abnormalities of the liver (3)

A
  • biliary cysts
  • ductal plate malformations
  • portosystemic shunts
31
Q

predisposed breeds to congenital polycystic disease

A
  • cairn terriers
  • west highland white terriers
  • bull terriers
  • persian cats
32
Q

ductal plate malformations also known as

A
  • congenital hepatic fibrosis
33
Q

clinical signs of ductal plate malformations

A
  • young dog with chronic progressive liver failure

- portal hypertension, ascites, icterus, end-stage liver disease

34
Q

breeds predisposed to ductal plate malformations

A
  • young dogs

- boxers

35
Q

acute hepatitis results in what liver lesion

A
  • embolic pattern which is randomly multifocal
36
Q

liver disorder that is most common in vet med

A
  • chronic hepatitis
37
Q

chronic hepatitis characterized by

A
  • fibrosis, mononuclear inflammatory cells, hepatocellular loss, nodular regeneration and structural remodeling of hepatic lobule and vasculature
38
Q

chronic hepatitis occurs with

A
  • chronic persistent antigenic stimulus (infections, immune mediated disease, metabolic disease, toxins, drugs)
39
Q

nonspecific reactive hepatitis is due to

A
  • livers response to systemic inflammation, most likely from GI disease
40
Q

cholangitis definition

A
  • inflammation of biliary ducts
41
Q

neutrophilic cholangitis caused by

A
  • infectious

- caused by ascending bacterial infection

42
Q

lymphocytic cholangitis caused by

A
  • chronic, immune-mediated biliary disease of cats
43
Q

cholangiohepatitis caused by

A
  • extension of bacterial cholangitis into surrounding periportal parenchyma
44
Q

cholangiohepatitis is inflammation of

A
  • biliary ducts and extension of inflammation into surrounding liver parenchmya
45
Q

which of the following causes greater elevation of serum ALT:

  • acute hepatitis
  • chronic hepatits
  • nonspecific reactive hepatitis
  • cholangitis
  • cholangiohepatitis
A
  • cholangiohepatitis
46
Q

which of the following may cause mild elevation of serum ALT and ALP:

  • acute hepatitis
  • chronic hepatits
  • nonspecific reactive hepatitis
  • cholangitis
  • cholangiohepatitis
A
  • nonspecific reactive hepatitis

Pathology I (42 decks)

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