pathology of liver and pancreas

Question 1

Describe the make up of a liver lobule

Answer 1

about 2mm in diameter
polyhedron bounded by portal areas which contain a branch of the portal vein, hepatic artery, and a bile duct. hepatocytes are arranged in converging radiating cords which centre on the central vein. Sinusoids and bile canaliculi in between

Question 2

What are the three hepatic zones?

Answer 2

periportal around portal triads
midzonal
centrilobular

Question 3

What is a PSS?

Answer 3

congenital - blood shunts from the portal vein into the vena cava by passing the liver
Acquired - secondary to fibrosis - multiple thin walled shunts

Question 4

Most kind of congenital cysts are ____ cysts. Cats > dogs

Answer 4

biliary

Question 5

Tension lipidosis looks like ___ and occurs due to ____

Answer 5

focal areas of subcapsular change

local ischaemia

Question 6

Which species commonly get capsular fibrosis tags in old age?

Answer 6

Horses

often due to parasitic migration or peritonitis

Question 7

what is telangiectasis?

Answer 7

foci of sinusoidal dilatation

Question 8

Passive venous congestion of the liver is usually associated with ____

Answer 8

right sided heart failure

Question 9

What does passive venous congestion look like grossly?

Answer 9

Enlarged liver with rounded borders. Oozes blood on cut surface
enhanced lobular pattern - nutmeg liver

Question 10

What does passive venous congestion look like microscopically?

Answer 10

periacinar areas congested atrophy of hepatocytes

periportal areas - fatty change

Question 11

Which species get congenital melanosis of the liver?

Answer 11

calves and lambs

Question 12

What is the cause of haemosiderin pigmentation of the liver?

Answer 12

chronic passive venous congestion

Question 13

what kind of pigmentation do you get with obstructive jaundice

Answer 13

bile pigmentation

Question 14

What is the cause of lipofuscein pigmentation?

Answer 14

ageing

Question 15

What are the common causes of vacuolar hepatopathies?

Answer 15

hypoxia, mild toxic damage, metabolic stress

Question 16

What accumulates in the liver in hyperadrenocorticism?

Answer 16

glycogen

Question 17

what does steroid hepatopathy look like grossly?

Answer 17

enlarged pale liver

Question 18

How does fatty liver come about?

Answer 18

dietary: obesity or starvation
Increased energy demand: pregnancy, lactation, starvation
disease: DM, ketosis, regnancy toxaemia
abnormal hepatocyte function (prevents fatty acids complexing with proteins to form low density lipoproteins)

Question 19

What is the pathogenesis of lysosomal storage diseases?

Answer 19

inherited deficiencies of lysosomal enzymes

Question 20

How do you diagnose lysosomal storage diseases?

Answer 20

liver biopsy or post mortem.

Will see macrophages with stored material in liver, spleen, LNs)

Question 21

Where does amyloidosis occur?

Answer 21

under the endothelium and basement membrane of organs - glomeruli, islets of langerhans in pancreas, liver.

Question 22

What does the liver look like grossly in amyloidosis?

Answer 22

pale friable liver prone to rupture

Question 23

what does amyloidosis look like microscopically?

Answer 23

acidophilic material - green on congo red

Question 24

What causes periacinar fibrosis?

Answer 24

chronic passive congestion

Question 25

How does biliary fibrosis occur?

Answer 25

chronic inflammation centred on the portal triads

Question 26

What does cirrhosis look like?

Answer 26

extensive fibrotic lesions

seen in end stage liver, may have concurrent nodular regeneration

Question 27

Which species suffers from immune mediated cholangitis?

Answer 27

immune mediated

Question 28

Salmonellosis in calves may lead to what change in the liver?

Answer 28

Cholangitis

Question 29

What are the 4 potential sequelae to hepatitis if the animal survives?

Answer 29

Complete resolution by regeneration
repair by fibrosis and scarring
Encapsulation by abscessation
Persistence- granulomatous disease

Question 30

Three families of virus that cause hepatitis?

Answer 30

Adenovirus
Herpes virus
Coronavirus (FIP)

Question 31

What age of animals are mainly affected by canine infectious hepatitis?
What kind of virus is it?

Answer 31

Young dogs

adenovirus type 1

Question 32

how is canine infectious hepatitis shed?

Answer 32

in the urine - long term

Question 33

What cell types does canine infectious hepatitis have tropism for?

Answer 33

endothelium - widespread haemorrhages particularly on serosal surfaces
hepatocytes

Question 34

what might the lymph nodes and tonsils look like in canine infectious hepatitis cases?

Answer 34

reddened and enlarged. sometimes haemorrhagic

Question 35

what ocular changes might you see in recovering canine infectious hepatitis patients?

Answer 35

immune mediated uveitis

corneal opacity

Question 36

4 examples of herpesviruses

Answer 36

Equine herpes
IBR
feline viral rhinopneumonitis
aujezsky’s disease

Question 37

What might you suspect if there are pinpoint foci of necrosis on the liver?

Answer 37

herpesvirus

necrosis also in the lungs, kidneys, spleen

Question 38

What is the pathogenesis of FIP?

Answer 38

enteric coronavirus that has mutated leading to systemic vasculitis and effusions.
Pyogranulomatous lesions in organs

Question 39

What are the two forms of FIP?

Answer 39

dry - granulomatous

wet - effusive

Question 40

What are the three routes of bacterial infection in the liver?

Answer 40

Direct extension from adjacent tissues
Haematogenous spread
Abscessation e.g. from rumenitis in cows

Question 41

What organism causes bacillary necrosis?

Answer 41

fusobacterium necrophorum

Question 42

What are the 2 main causes of bacillary necrosis?

Answer 42

calves - umbilicus

cattle - rumenitis

Question 43

What does bacillary necrosis look like grossly?

Answer 43

multiple pale foci of necrosis

may develop into abscesses

Question 44

What does bacillary necrosis look like microscopically?

Answer 44

coagulative necrosis with bacteria at the periphery