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MODULE 4 - Infectious Agents > PATHOLOGY - Patterns of Liver Disease > Flashcards

PATHOLOGY - Patterns of Liver Disease Flashcards

1
Q

What are the three zones of a hepatic lobule?

A
  • Periportal
  • Midzonal
  • Centrilobular
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2
Q

Which zone of the hepatic lobule is most vulnerable to hypoxic and toxic injury?

A

Centrilobular region

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3
Q

List the six functions of the liver

A
  • Bilirubin metabolism
  • Bile acid metabolism
  • Lipid metabolism
  • Xenobiotic (foreign substance) metabolism
  • Protein synthesis
  • Immune function
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4
Q

List the eight different methods of liver disease/injury

A
  • Vascular
  • Inflammatory (infectious, immune-mediated)
  • Trauma
  • Anomaly
  • Metabolic
  • Idiopathic
  • Neoplastic
  • Degenerative
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5
Q

What is icterus?

A

Another term for jaundice

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6
Q

Where in the body is it easiest to see jaundice/icterus? Why is this?

A

The oropharynx and the sclera of the eye as bilirubin has a higher affinity for elastic tissue

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7
Q

How much bilirubin is required to classify hyperbilirubinaemia?

A

0.5mg/dl

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8
Q

How much bilirubin is required to see icterus/jaundice?

A

2mg/dl

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9
Q

How long does it take for there to be maximum accumulation of bilirubin in the body?

A

2 days

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10
Q

What are the classifications of hyperbilirubinaemia?

A
  • Pre-hepatic hyperbilirubinaemia
  • Hepatic hyperbilirubinaemia
  • Post-hepatic hyperbilirubinaemia
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11
Q

What is the cause of pre-hepatic hyperbilirubinaemia?

A

Haemolysis

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12
Q

What are the potential causes of hepatic hyperbilirubinaemia?

A
  • Decreased functional hepatic mass
  • Intra-hepatic cholestasis
  • Anorexia/fasting (especially in horses)
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13
Q

What are the potential causes of post-hepatic hyperbilirubinaemia?

A
  • Obstructive extra-hepatic cholestasis
  • Biliary adenoma or cholangiocellular carcinoma (biliary tumours)
  • Cholelithiasis (gall stones)
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14
Q

What is cholestasis?

A

The impairment or stop of bile flow

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15
Q

What are the possible causes of cholestasis?

A
  • Impaired bile secretion from hepatocytes
  • Obstruction of the intra- or extra-hepatic bile ducts
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16
Q

What is hepatic regeneration?

A

Replication of mature hepatocytes and an increase in the size of pre-existing hepatic lobules

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17
Q

What is required during hepatic regeneration to prevent fibrosis and the formation of hepatic nodules?

A

The basement membranes supporting hepatocyte arrangement within hepatic lobules

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18
Q

What does centrilobular fibrosis indicate about the aetiology of the injury?

A

Centrilobular fibrosis indicates chronic toxicity or anaemia

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19
Q

What does periportal fibrosis indicate about the aetiology of the injury?

A

Periportal fibrosis indicates chronic inflammation

20
Q

Describe the appearance of cirrhosis

A
  • Nodulated due to attempted hepatic regeneration
  • Scarring and firm due to fibrosis
21
Q

List five possible causes of cirrhosis

A
  • Chronic toxicity
  • Chronic cholingitis
  • Chronic cholestasis
  • Chronic hepatitis
  • Idiopathic
22
Q

What is cholangitis?

A

Inflammation of the bile duct system

23
Q

What is hepatitis?

A

Inflammation of the liver

24
Q

What is the main consequence of cirrhosis?

A

Liver failure

25
Q

List five of the other consequences of cirrhosis

A
  • Hepatic encephalopathy
  • Hyperbilirubinaemia
  • Coagulation disorders
  • Panhypoproteinaemia
  • Portosystemic shunting
26
Q

List the three main ways disease inducing agents enter the liver

A
  • Direct entry
  • Haematogenous (carried by the blood)
  • Retrograde biliary transport
27
Q

List the six hepatic defences against disease

A
  • Skin
  • Ribcage
  • Omentum
  • Kupffer cells
  • IgA antibodies in the billary tree
  • Terminal sphincter of the billary tree
28
Q

Which disease causes are indicated by focal hepatic lesions?

A
  • Neoplasia
  • Vascular
  • Trauma
29
Q

Which disease aetiologies are indicated by random, multifocal hepatic lesions?

A
  • Metastatic neoplasia
  • Infection
  • Hyperplasia
30
Q

Which disease aetiologies are indicated by diffuse hepatic lesions?

A
  • Toxins
  • Hypoxia
  • Metabolic disease
  • Degenerative disease
31
Q

Give examples of neoplastic focal liver disease

A
  • Hepatocellular adenoma
  • Hepatocellular carcinoma
  • Billary adenoma
  • Cholangiocellular carcinoma
  • Carcinoid
32
Q

Why is infarction of the liver very rare?

A

Due to the dual blood supply from the hepatic portal vein and the hepatic artery

33
Q

What is most likely to cause vascular damage to the liver?

A

Torsion of the liver lobes

34
Q

In which species is hepatic nodular hyperplasia most common?

A

Dogs

35
Q

Which metastatic neoplasia is most commonly found on the liver?

A

Metastatic lymphoma

36
Q

List three examples of viruses which directly attack the liver

A
  • Herpesviruses
  • Infectious canine hepatitis
  • Rabbit haemorrhagic disease virus
37
Q

Which disease directly attacks the liver causing haemorrhage and hepatocyte displacement?

A

Leptospirosis

38
Q

List the two main haematogenous causes of liver abscesses in cattle

A
  • Secondary to rumenitis
  • Secondary to omphalitis
39
Q

Give a specific example of a trematode parasite which causes disease within the liver

A

Fasciola hepatica (liver fluke)

40
Q

How long does it take the liver to look histologically normal after a single non-lethal insult?

A

1 week

41
Q

What is the result of single/multiple lethal hepatotoxic insults?

A

Hepatic necrosis

42
Q

What is the result of chronic hepatotoxic insult?

A

Fibrosis and eventual cirrhosis

43
Q

What are the possible causes of hypoxic damage to the liver?

A
  • Anaemia
  • Congestive heart failure
44
Q

On gross examination, what would be the early sign of hepatic hypoxia?

A

Yellow centrilobular areas

45
Q

On gross examination, what would be the signs of severe/chronic hypoxia of the liver?

A

Red centrilobular areas (haemorrhage and necrosis) and yellow periportal areas

46
Q

On gross examination, what would be the appearance of a liver with hepatic amyloidosis?

A
  • Yellow
  • Waxy
47
Q

Why should you not take a biopsy of a liver that is suspected to have hepatic amyloidosis?

A

Because livers suffering from hepatic amyloidosis are prone to rupture and haemorrhage

MODULE 4 - Infectious Agents (20 decks)

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