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Systemic Pathology II > Pathology of the Hepatobiliary System #4 > Flashcards

Pathology of the Hepatobiliary System #4 Flashcards

1
Q

Hepatitis is defined as ________ of the liver _______.

A

inflammation of the liver parenchyma

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2
Q

Cholangitis is defined as __________ of the ____ ______/_______.

A

inflammation of the bile ducts/ductules

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3
Q

Cholangiohepatitis is inflammation of the ____ _____ with extension into the liver _________.

A

inflammation of the bile ducts with extension into the liver parenchyma

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4
Q

Cholecystitis is defined as _______ of the _________.

A

inflammation of the gallbladder

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5
Q

Choledochitis is ________ of the ______/________ bile _____

A

inflammation of the larger/common bile ducts

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6
Q

What can be seen below?

A

MgDx: Multifocal Random (Miliary) Hepatitis
- This is a very common pattern you will see in practice.
* Caused by many infectious agents, including viruses, bacteria, and certain protozoa
- Random hepatocellular necrosis in the liver of a horse with Tyzzer’s disease

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7
Q
  • Equine herpes virus 1(EHV-1): _______ equine herpesvirus
  • Canid herpesvirus 1 (CHV-1): _____ and ____ in kidney; can also see necrosis in the _____.
  • Feline herpesvirus 1 (FHV-1): feline viral rhinotracheitis (______, nasal ______, conjunctival ______, ______).
  • Bovine herpesvirus 1 (BHV-1): infectious bovine __________
  • Suid herpesvirus 1 (SHV-1): ________; also affects the ____

All of these viruses cause hepatic _______ and ________

A
  • Equine herpes virus 1(EHV-1): abortigenic equine herpesvirus
  • Canid herpesvirus 1 (CHV-1): hemorrhages and necrosis in kidney; can also see necrosis in the liver.
  • Feline herpesvirus 1 (FHV-1): feline viral rhinotracheitis (sneezing, nasal discharge, conjunctival reddening, tearing).
  • Bovine herpesvirus 1 (BHV-1): infectious bovine rhinotracheitis
  • Suid herpesvirus 1 (SHV-1): pseudorabies; also affects the brain

All of these viruses cause hepatic necrosis and inflammation

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8
Q
A

Equine Herpesvirus Hepatitis, Hepatic Necrosis, Liver, Foal
Etiologic Agent: Equine Herpesvirus-1
* Very common abortigenic virus

Arrows pointing to areas of necrosis

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9
Q

This is a sample taken from a foal suffering from Equine Herpesvirus.
1. Below is a histological slide of what organ?
2. What is the etiologic agent associated with this condition?
3. What is the arrow pointing to below?

A
  1. The liver
  2. Equine Herpesvirus-1
  3. Eosinophilic intranuclear viral inclusion body (arrow pointing at it).

Equine Herpesvirus Hepatitis, Hepatic Necrosis, Liver, Foal.
Etiologic Agent: Equine Herpesvirus-1
Normal hepatic plate formation lost

Eosinophilic intranuclear viral inclusion body (arrow pointing at it).

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10
Q

Canine Infectious Hepatitis
1. Caused by ?
2. This condition causes _______ hepatocellular necrosis with __________ viral inclusion bodies in hepatocytes and endothelial cells. This is why you may see ________ and _______ clinically due to endothelial cell damage.
3. Rare cases encountered due to widespread use of effective ______ (utilizes CAV-__ in ___________ combination vaccine)
4. Recovered dogs may develop ______ edema (“_____ eye”)
5. Immune-complex ____ (type __ hypersensitivity) –> Ag-Ab complex lodged in _____ of organ –> ______ vessels, hemorrhage
6. Second exposure –> Ab in animal –> immune complex form –> see damages then. So clinical damage does not show until _________ exposure or ___________.

A
  1. Canine adenovirus 1 (CAV-1); Vaccine used is CAV-2 but provides cross protection so it is ok.
  2. This condition causes centrilobular hepatocellular necrosis with intranuclear viral inclusion bodies in hepatocytes and endothelial cells; this i why you may see hemorrhage and edema clinically due to endothelial cell damage.
  3. Rare cases encountered due to widespread use of effective vaccine (utilizes CAV-2 in distemper combination vaccine)
  4. Recovered dogs may develop corneal edema (“blue eye”)
  5. Immune-complex uveitis (type III hypersensitivity) –> Ag-Ab complex lodged in vessels of organ –> leaky vessels, hemorrhage
  6. Second exposure –> Ab in animal –> immune complex form –> see damages then. So clinical damage does not show until second exposure or vaccination.
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11
Q

Pictured below is a case of Infectious canine hepatitis in a dog. What are the sequelae associated with this condition?

A

Infectious Canine Hepatitis, Hepatic Necrosis, Liver, Dog.

Damage to hepatocytes and endothelial cell damage.
- Increased liver enzymes, jaundice sometimes if liver damaged enough. (this is due to damage to hepatocytes).
- Hemorrhages seen as well b/c of endothelial cell damage.

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12
Q
  1. This is a histological slide of what organ?
  2. What is the arrow pointing to in this image? What is special about this?
A
  1. The liver
  2. Intranuclear inclusion bodies in hepatocytes and endothelial cells
    - More amphophillic (more basophilic than eosino) and that is one way you can tell this is an adenovirus infection, not herpes. But do PCR to confirm this hunch.

Infectious Canine Hepatitis, Hepatic Necrosis, Liver, Dog.

More amphophillic (more basophilic than eosino) and that is one way you can tell this is an adenovirus infection, not herpes. But do PCR to confirm this hunch.

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13
Q
  1. What is your top DDx based on this image below?
  2. Name the etiologic agent of this condition.
  3. What is the sequelae caused by?
A
  1. Infectious canine hepatitis –> Corneal edema or “blue eye.”
  2. Either caused by CAV-1 or Adenovirus-1
  3. Blue eye caused by Ag-Ab complexes lodged in vessels
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14
Q
  1. Theiler’s disease, aka ________ ________ _______
  2. Cause = __________
  3. Thought to be associated with administration of ________, _______, _______
  4. 2013 associated with infection by equine _______ and _______ disease associated virus
  5. 2018 associated with infection by equine _________-hepatitis
  6. ________, _______ liver (“________” liver)
A

Theiler’s disease, aka Equine Serum Hepatitis.
* Cause = unknown?
* Thought to be associated with administration of xenobiotics, vaccines, idiopathic
* 2013 associated with infection by equine pegivirus and Theiler’s disease associated virus
* 2018 associated with infection by equine parvovirus-hepatitis
* Small, flaccid liver (“dishrag” liver)

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15
Q

What condition is pictured below? What is the etiologic agent?

A

Equine Serum Hepatitis, Liver, Horse.

Cause: Parvovirus
Dishrag liver

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16
Q

Bacterial Diseases
* Routes of Infection
- Portal vein
- Umbilical vein – newborn animals
–> may see hepatic abscesses; becuse infetion travels from umbilical vein to liver.
- Hepatic artery
* Biliary system
* Secondary to parasitic migration
* Direct extension from other tissues
* Reticulum – hardware disease, ruminal acidosis

A
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17
Q
A

Hepatic necrobacillosis (Fusobacterium necrophorum infection) in an ox

Multifocal areas of coagulative necrosis; surrounded by reddened areas.

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18
Q
A

More chronic case of above

Multiple Caseous Granulomas, Tuberculosis, Mycobacterium bovis, Liver, Cow

19
Q

What are some Sequelae of Abscesses?

  • Complete _______ or _______
  • Sometimes can Induce _________ to adjacent organs to body ____, ________, _________
  • Extend to hepatic vein → thrombophlebitis of _____ ____ → ______ → pulmonary ________/________
  • Toxemia due to _______ toxin –> shock –> → death
A
  • Complete healing or encapsulate
  • Sometimes can Induce adhesions to adjacent organs to body wall, omentum, intestines
  • Extend to hepatic vein → thrombophlebitis of vena cava → endocarditis → pulmonary abscess/emboli
  • Toxemia due to bacterial toxin –> shock –> → death
20
Q
A

Omphalophlebitis with miliary abscesses in the left lobe of the liver in a calf.

Track will eventually close, so if any infection in umbilical chord can travel up and enter liver.

always clean umbilical chord!

21
Q

Tyzzer’s Disease
* Cause: __________ ________ (Gram__)
* Species affected: ?
* ___________, ______________ animals
* Pathogenesis: Ingestion → _________ tract → _______
* __________ hepatic ________

A

Tyzzer’s Disease
* Cause: Clostridium piliforme (Gram -)
* Species affected: Foals, calves, cats, dogs
* Young, immunocompromised animals
* Pathogenesis: Ingestion → gastrointestinal tract → liver
* Multifocal hepatic necrosis

22
Q
A

Foal liver with multifocal hepatitis in Clostridium piliforme infection (Tyzzer’s disease).

23
Q
A

Tyzzer’s = IC IB
Tyzzer’s Disease (Clostridium piliforme; arrows), Foal

Arrow pointing at bacteria

24
Q

Parasites
* Migrating larvae –> how they cause damage –> __________ bacterial infection
* Liver _________ and/or ____ ____ as final “resting place”!

A

Parasites
* Migrating larvae –> how they cause damage –> secondary bacterial infection
* Liver parenchyma and/or bile duct as final “resting place”!

25
Q
A

Capsular and Portal Fibrosis (Milk-Spotted Liver), Ascaris suum Larval Migration, Liver, Diaphragmatic Surface, Pig

Fibrous tissue (scars) has been deposited in the migration tracks of the ascarid larvae and in adjacent portal areas (arrows).

26
Q

Fascioloides magna
* Liver fluke of ___________
* Lives in hepatic _________
* Cause extensive tissue damage by __________ through the liver

A

ruminants, parenchyma, migration

27
Q
A

Fluke Migration Tracts, Fascioloidiasis (Fascioloides magna), Liver, Cow

Could be their poop, but this is evidence that they just migrated into this part of the bodyl.

28
Q
A

Flukes are in the right hand corner
Destructive pigmented lesions produced by Fascioloides magna in an ox

29
Q
A

Cysticercosis, Liver, Mule deer.

Type of tape worm
Cysts in liver = within cysts you see cystolarvae

30
Q
A
31
Q
A

Coccidia that lives in bile ducts of rabbits
Coccidiosis in Rabbit: Eimeria stediae

Cholangiohepatitis caused by Eimeria stiedae, Rabbit

32
Q
A

Eimeria stiedae infection in the liver of a rabbit.
Epithelial cells contain numerous microgametocytes (green arrows) and macrogameocytes (black arrows)

33
Q
A

Very common disease in turkeys
Necrotizing hepatitis and typhlitis due to histomoniasis, Broiler

Also called black head disease
Necrotizing hepatitis is what you typically see

34
Q

Inflammatory Disease of the Liver
* Chronic hepatitis in dogs
* Feline triadidits

do not know the cause of either; not necessarily infectious diseases

A
35
Q

Chronic Hepatitis in Dogs
* Majority of cases are __________; unsure of _______
* A subset of cases are associated with _________ accumulation
* Hepatic necrosis with inflammation → May lead to _____________

A
  • Majority of cases are idiopathic; unsure of cause
  • A subset of cases are associated with copper accumulation
  • Hepatic necrosis with inflammation → May lead to cirrhosis
36
Q

Canine Copper-Associated Hepatopathy
* Most common in what dog breed?
* Genetic mutation in copper _________ proteins: _________ gene
* Other predisposing breeds:
* Doberman Pinscher, West Highland White Terrier, Labrador Retriever,
American and English Cocker Spaniel, Skye Terrier, Standard Poodle,
Dalmatian, and English Springer Spaniel.
* Can occur in any breed

A

Canine Copper-Associated Hepatopathy
* Bedlington terrier
* Genetic mutation in copper transport proteins: COMMD1 gene
* Other predisposing breeds:
* Doberman Pinscher, West Highland White Terrier, Labrador Retriever,
American and English Cocker Spaniel, Skye Terrier, Standard Poodle,
Dalmatian, and English Springer Spaniel.
* Can occur in any breed

37
Q
A

Canine Copper-Associated Hepatopathy in Bedlington Terriers
* Cause: mutation in COMMD1 gene; mutation –> cause of copper associated hepat.
* Develop when quite young: Progressive liver failure, including wasting, ascites, and signs of hepatic encephalopathy
* Accumulation of copper in the liver → acute hepatic necrosis → release of
copper into the systemic circulation → hemolytic crisis → anemia and icterus

38
Q
A

Hepatic Copper, Liver, Dog. Rhodanine stain.

Red staining = copper
this is something we can treat for

39
Q

How do you manage Canine Copper-Associated Hepatopathy?

A

Management:
* Dietary Cu restriction
* Cu chelation: e.g. D-penicillamine (D-Pen)
* Zinc (interferes with copper uptake in animals)
* Antioxidant treatment (e.g. Sadenosylmethionine [SAMe] and vitamin E)

40
Q

Feline Triaditis
* In cats, the common bile duct fuses with the pancreatic duct _________ entering the major papilla → predispose cats to triaditis (3?)

Dudoenal papilla join separately in dogs, join together in cats

A

Feline Triaditis
* In cats, the common bile duct fuses with the pancreatic duct before entering the major papilla → predispose cats to triaditis (cholangitis, pancreatitis, inflammatory bowel disease)

Dudoenal papilla join separately in dogs, join together in dogs

41
Q

Clinical signs for Feline Triaditis is nonspecific in general

A
42
Q
A
43
Q

FYI

A
44
Q

How do you Dx and Tx Feline Triaditis?

A

Systemic Pathology II (22 decks)

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