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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
chronic and sever in jury of liver many lead to
- end-stage liver (cirrhosis)
26
hepatic fibrosis occurs in response to
- chronic injury and repeated injury or chronic inflammation
27
biliary hyperplasia predominantly occurs with what
- disease that causes biliary inflammation, obstruction and cholestasis
28
pathophysiology of end stage liver (Cirrhosis)
- diffuse process in liver characterized by severe fibrosis and replacement of normal hepatic lobules with nodular regeneration and abnormal vasculature
29
what percentage of hepatic parenchyma can be removed without significant impairment of function
- 75%
30
congenital abnormalities of the liver (3)
- biliary cysts - ductal plate malformations - portosystemic shunts
31
predisposed breeds to congenital polycystic disease
- cairn terriers - west highland white terriers - bull terriers - persian cats
32
ductal plate malformations also known as
- congenital hepatic fibrosis
33
clinical signs of ductal plate malformations
- young dog with chronic progressive liver failure | - portal hypertension, ascites, icterus, end-stage liver disease
34
breeds predisposed to ductal plate malformations
- young dogs | - boxers
35
acute hepatitis results in what liver lesion
- embolic pattern which is randomly multifocal
36
liver disorder that is most common in vet med
- chronic hepatitis
37
chronic hepatitis characterized by
- fibrosis, mononuclear inflammatory cells, hepatocellular loss, nodular regeneration and structural remodeling of hepatic lobule and vasculature
38
chronic hepatitis occurs with
- chronic persistent antigenic stimulus (infections, immune mediated disease, metabolic disease, toxins, drugs)
39
nonspecific reactive hepatitis is due to
- livers response to systemic inflammation, most likely from GI disease
40
cholangitis definition
- inflammation of biliary ducts
41
neutrophilic cholangitis caused by
- infectious | - caused by ascending bacterial infection
42
lymphocytic cholangitis caused by
- chronic, immune-mediated biliary disease of cats
43
cholangiohepatitis caused by
- extension of bacterial cholangitis into surrounding periportal parenchyma
44
cholangiohepatitis is inflammation of
- biliary ducts and extension of inflammation into surrounding liver parenchmya
45
which of the following causes greater elevation of serum ALT: - acute hepatitis - chronic hepatits - nonspecific reactive hepatitis - cholangitis - cholangiohepatitis
- cholangiohepatitis
46
which of the following may cause mild elevation of serum ALT and ALP: - acute hepatitis - chronic hepatits - nonspecific reactive hepatitis - cholangitis - cholangiohepatitis
- nonspecific reactive hepatitis

Pathology I (42 decks)

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