Pathology of the Liver and Pancreas

Question 1

What are the characteristics of a normal liver lobe?

Answer 1

2mm
Pentagon
Bounded by portal tracts
Hepatocytes converge on central vein

Question 2

Why is the liver poorly oxygenated?

Answer 2

Portal veins contain mostly nutrients and is mixed eith hepatic artery on way to central vein

Question 3

How does bile flow relate to blood flow in the liver?

Answer 3

They flow in opposite directions. Bile is produced in the canaliculi and flows away from the central vein, towards the bile duct

Question 4

What are the zones in the liver lobule and how well is each one oxygenated?

Answer 4

1. Centrilobular - Least oxygenated
2. Midzonal
3. Periportal - Most oxygenated

Question 5

What usually causes passive venous congestion resulting in nutmeg liver?

Answer 5

Right sided congestive heart failure

Question 6

What is the gross and microscopic appearance of venous congestion?

Answer 6

G - Enlarged rounded borders, blood from cut surface and nutmeg liver

M - Congested venules and sinusoids, dark red hepatocytes in centrilobular zone, pale red hepatocytes in periportal zone

Question 7

How do congenital and acquired PSS differ anatomically?

Answer 7

C - Single shunt to larger BV

A - Multiple thin walled shunt

Question 8

What pigments can result in liver pathology and how do they come about?

Answer 8

Melanin - Congenital
Haemosiderin - Venous congestion
Bile - Icterus
Lipfuscin/cerioid - Ageing

Question 9

What is the gross and microscopic appearance of vacuolar hepatopathy?

Answer 9

G - Enlarged pale liver

M - Multifocal-diffuse swelling and vacuolation of hepatocytes

Question 10

Outline the pathogenesis of fatty liver…

Answer 10

Disease/NEB > abnormal hepatocyte function > decreased FA complexing > decreased low density lipoproteins

Question 11

Describe the gross and microscopic appearance of amyloidosis of the liver

Answer 11

G - Pale orange, enlarged fribale

M - Homogenous, acidophilic material, stains green in Congo red

Question 12

What can cause hepatic necrosis?

Answer 12

Ischaemia
Toxic damage
Nutritional deficiencies
Microbial infection

Question 13

What usually results in the liver from acute ingestion of toxins?

Answer 13

Decreased synthesis and increased consumption of clotting factors –> haemorrhage

Question 14

Give 4 examples of toxins that damage the liver

Answer 14

Ragwort
Copper
Sulphonamides
Paracetamol in cats

Question 15

What are the three types of liver inflammation and what parts of the liver do they affect?

Answer 15

Hepatitis - liver parenchyma
Cholangitis - bile ducts
Cholangiohepatitis - parenchyma and bile ducts

Question 16

What is the usual cause of hepatitis?

Answer 16

Infectious

Question 17

What can cause cholangitis?

Answer 17

Immune-mediated

Infection

Question 18

Acute hepatitis is followed by inflammation. If the animal survives how might it then progress?

Answer 18

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

Question 19

What types of viruses can cause hepatitis?

Answer 19

Adenovirus
Herpesvirus
Coronavirus

Question 20

What animals do viral hepatitis generally occur in?

Answer 20

Young

Unvaccinated

Question 21

What is the pathology of infectious canine hepatitis?

Answer 21

Widespread haemorrhages
Enlarged, reddened and haemorrhagic LNs
Inflamm in the eye with opaque corneas

Question 22

Give 4 examples of herpesviruses

Answer 22

Equine viral rhinopneumonitis
IBR
Refline viral rhinopnumonitis
Aujezsky’s

Question 23

What is the pathology of herpesvirus?

Answer 23

Aborted foetus/neonates
Pinpoint foci of hepatic necrosis
Necrosis to lungs, kidneys, spleen and adrenals

Question 24

What is the pathology of FIP?

Answer 24

Pyogranulomatous lesions in multiple organs esp liver

Question 25

What routes can the liver become infected with bacteria?

Answer 25

Direct - adjacent tissues Haematogenous - portal vein from GIT, hepatic artery with bateraemia, umbilicus Abscesses - umbilicus, rumenitis

Question 26

What does Fusobaterium necrophorum cause?

Answer 26

Bacillary necrosis in cattle/sheep

Question 27

What does Clostridium novyi type B cause?

Answer 27

Black's disease/infectious necrotis hepatitis in sheep

Question 28

What does Clostridium haemolyticum cause?

Answer 28

Bacillary haemogloburia in cattle/sheep

Question 29

What does Clostridium piliforme cause?

Answer 29

Tyzzer's disease in lab rodents, neonatal foals and immunocompromised SA

Question 30

What species in Lepto most common in?

Answer 30

Dogs

Question 31

What species is most affected by Salmonellosis? What is the principle species?

Answer 31

Calves | S. dublin

Question 32

How does the aetiology of bacillary necrosis differ in adults and calves?

Answer 32

A - enters circ following rumenitis | C - enters via umbilicus

Question 33

What is the pathology of bacillary haemoglobinuria?

Answer 33

Anaemia, icterus, haemogloburia Focally extensive hepatic necrosis Haemoglobin staining of kidneys

Question 34

How is Clostridum piliforme identified?

Answer 34

Wheat sheaf appearance of colonies in silver stain

Question 35

What are the clinical signs of leptospirosis?

Answer 35

Haemolytic anaemia Haemorrhages Icterus

Question 36

Which parasites is responsible for milk spot liver?

Answer 36

Ascaris suum

Question 37

Which parasite can damage the liver during migration in horses?

Answer 37

Strongyles

Question 38

What infectious causes can inflam the gallbladder?

Answer 38

Salmonella | Infectious canine hepatitis

Question 39

What is the consequences of gall bladder rupturing?

Answer 39

Bile peritonitis

Question 40

Which animal is liver hyperplasia common in?

Answer 40

Dogs

Question 41

Which species is primary liver neoplasia common in?

Answer 41

Dogs and cats

Question 42

Which cells can form a primary liver tumour?

Answer 42

Hepatocytes | Bilary epithelium

Question 43

What are the characteristics of haemangiosarcomas of the liver?

Answer 43

Primary or secondary Secondary from spleen or RA Prevalent in large breed

Question 44

Name 4 tumours likely to metastasise to the liver...

Answer 44

Melanoma Carcinoma Sarcoma Lymphoma

Question 45

Which breeds/species are most likely to suffer from pancreatic hypoplasia?

Answer 45

GSD | Calves

Question 46

What are the clinical signs of pancreatic hypoplasia?

Answer 46

Diarrhoea Weight loss despite increased appetite Potbellied Lack of abdominal fat

Question 47

What are the clinical signs of acute pancreatitis?

Answer 47

Shock | Increased lipase and amylase

Question 48

Outline the pathophysiology of chronic pancreatitis...

Answer 48

Repeated bouts of acute pancreatitis --> Fibrosis and atrophy --> EPI

Question 49

Which animals are affected by pancreatic hyperplasia?

Answer 49

Older cats and dogs

Question 50

Is pancreatic hyper and hypoplasia clinically significant?

Answer 50

Hyper - no | Hypo - yes, cause EPI

Question 51

What type of neoplasia is most common in SA pancreas?

Answer 51

Carcinoma

Question 52

Where do pancreatic carcinomas metastasis to?

Answer 52

``` Liver Peritoneum LNs Spleen Adrenals ```