Small Animal Medicine Exam II Flashcards
What happens in zone 1 cells in the liver?
What happens in zone 2 cells in the liver?
What happens in zone 3 cells in the liver?
Describe diarrhea as a potential symptom of liver disease.
Describe vomiting as a potential symptom of liver disease.
Describe PU/PD as a potential symptom of liver disease.
Describe dysuria as a potential symptom of liver disease.
Describe anesthetic intolerance as a potential symptom of liver disease.
Describe acholic feces as a potential symptom of liver disease.
Describe hypoglycemia as a potential symptom of liver disease.
What are your top 3 differentials for a patient with abdominal enlargement?
What are the four different mechanisms of ascites/edema?
Describe the different characteristics of ascites due to a liver pathology.
What are your differentials for transudate ascites?
What are the 3 causes of liver derived ascites?
What are some causes of pre-hepatic ascites?
What are some causes of intrahepatic ascites?
What are some causes of post-hepatic ascites?
Describe RAAS activation as a potential cause of ascites.
Describe hypoalbuminemia as a potential cause of ascites.
What is jaundice? What are the two primary mechanisms of jaundice?
What is cholestasis? What are some general causes?
What is the key anatomical difference in the cat and the dog when it comes to the liver?
What is the clinical significance of bilirubinuria?
What is hepatic encephalopathy? What are some general causes?
What is type A hepatic encephalopathy?
What is type B hepatic encephalopathy?
What is type C hepatic encephalopathy?
List some of the different clinical signs of hepatic encephalopathy.
Describe hypersalivation as a potential clinical sign of hepatic encephalopathy.
Describe polyuria (dogs) as a potential clinical sign of hepatic encephalopathy.
Describe a Grade 0 hepatic encephalopathy.
Describe a Grade 1 hepatic encephalopathy.
Describe a Grade 2 hepatic encephalopathy.
Describe a Grade 3 hepatic encephalopathy.
Describe a Grade 4 hepatic encephalopathy.
Describe the onset and presentation of the clinical signs of HE.
Describe the pathogenesis/cause of HE.
What are the main sources of ammonia in the body?
How does the liver detoxify ammonia?
Why is ammonia toxic to the brain?
List some of the predisposing factors of hepatic encephalopathy.
What is the prognosis of HE? What are some negative prognostic indicators?
Polyuria and polydipsia are common clinical signs in hepatic disease in dogs. What are the general causes?
List some of the coagulation proteins made by the liver.
Describe coagulopathies as a complication to liver disease.
What are two primary metabolic disturbances we may see in patients with liver disease?
Few changes on a CBC are consistent with hepatobiliary disease. What are they?
____ and ____ are present in the hepatocytes cytology and are released as a result of hepatocellular membrane damage.
_____ and _____ are serum enzymes that reflect new synthesis and release of enzymes from the biliary tract in response to certain stimuli such as ____.
Describe ALT as a hepatocellular enzyme.
What are some reasons for increased ALT?
Describe AST as a hepatocellular enzyme.
Describe alkaline phosphatase (ALP) as a hepatocellular enzyme.
What are some reasons for increased ALP?
The half -life of ____ is shorter in cats than dogs, so an increased level is always significant.
Describe GGT as a hepatocellular enzyme.
Draw out the pathway of bilirubin in the body.
What tests estimate hepatic function?
____ are fairly common to see in a cat’s CBC with HL.
____ in the urine of cats is always abnormal.
What are the different functional tests of the liver?
Draw out the pathway of bile acids in the body.
What is a bile acid stimulation test?
Describe the clinical significant of urine bile acid testing.
Describe the pathway of ammonia in the body.
Describe the pathway of ammonia in the body.
Why do we test ammonia levels? How do we do it?
Draw out the coagulation pathway.
Describe the clinical significance of coagulation tests in patients with hepatobiliary disease.
What is the clinical significance of radiography in patients with hepatobiliary disease?
Shape NOT function
What is the clinical significance of CT in patients with hepatobiliary disease?
What is the clinical significance of scintigraphy in patients with hepatobiliary disease?
What are the pros and cons to testing ammonia levels in our small animal patients?
____ and ___ are the most important coagulation tests to run on patients with hepatobiliary disease.
____ are best to assess over size or look for choleliths, while ____ is best for everything else. ____ is the gold standard to diagnose PSS.
In most cases of primary hepatobiliary disease, ____ is needed to establish a definitive diagnoses, prognosis and a basis for treatment. It is strongly recommended before committing to the use of ____, ____ and ____ therapies.
What are some reasons for a liver cytology/biopsy?
What are the advantages to a liver FNA?
What are the disadvantages to a liver FNA?
You cannot diagnose hepatitis with an ____.
Name and describe the different techniques for a liver biopsy.
What should you do once you collect a liver biopsy?
Differentiate between the prevalence of hepatobiliary disease in the cat versus the dog.
Differentiate between hepatic metabolism in the ct versus the dog.
Differentiate between liver enzymes in the cat versus the dog.
Differentiate between dietary requirements when it comes to hepatic diseases in the cat and the dog.
What are your top 3 differentials for icterus or hyperbilirubinemia?
What are your top 4 differentials for the icteric cat?
What is primary (idiopathic) feline hepatic lipidosis?
What is secondary hepatic lipidosis?
Describe the pathogenesis of hepatic lipidosis in the cat?
Name the key proteins that play a significant role in feline hepatic lipidosis.
Feline hepatic lipidosis is an acquired _____ resulting from excessive accumulation of triglycerides in hepatocytes.
Feline hepatic lipidosis is sometimes secondary to another disease such as _____.
What are the clinical signs of feline hepatic lipidosis?
What are some key clinical pathology findings in a cat with hepatic lipidosis?
How can we use a liver aspirate to diagnose feline hepatic lipidosis?
How can we use a liver biopsy to diagnose feline hepatic lipidosis?
What are some negative prognostic indicators in feline hepatic lipidosis?
What is the prognosis for feline hepatic lipidosis?
What are the key principals of HL treatment?
Describe how we use fluids to treat a cat with hepatic lipidosis?
Describe how we use nutritional support to treat a cat with hepatic lipidosis?
What do we use to treat the clinical signs of hepatic lipidosis?
What is unique about the feline biochemistry panel?
Describe taurine an important nutritional player in HL treatment.
Describe carnitine as an important nutritional player in HL treatment.
Describe vitamin E as an important nutritional player in HL treatment.
Describe SAMe as an important nutritional player in HL treatment.
Describe B vitamins as an important nutritional player in HL treatment.
Lay out the entire treatment recommendation you would have for a cat with HL.
What are the effects of ursodiol? Why is it not recommended as an adjuvant treatment for feline HL.
Why should we avoid stanozolol (alkylated anabolic steroid) in cats with hepatic lipidosis?
Why should we avoid corticosteroids in cats with hepatic lipidosis?
Why should we avoid tetracyclines in cats with hepatic lipidosis?
Why should we avoid appetite stimulants in cats with hepatic lipidosis?
Why should we avoid propofol in cats with hepatic lipidosis?
Why should we avoid buprenorphine in cats with hepatic lipidosis?
What is the prognosis for a cat with hepatic lipidosis?
Describe the prevalence of cholangiocellular/cholangiohepatitis in cats.
Differentiate between cholangitis and cholangiohepatitis.
Describe the most common signalment and clinical signs for a cat with feline cholangitis-cholangiohepatitis syndrome.
What are some causes of neutrophilic feline cholangitis-cholangiohepatitis (CCHS) syndrome?
What are some causes of non-neutrophilic feline cholangitis-cholangiohepatitis (CCHS) syndrome?
Describe the pathogenesis of neutrophilic (suppurative) cholangitis in the cat.
What are the clinical signs of neutrophilic (suppurative) cholangitis?
What are some clinicopathological abnormalities we see in cats with neutrophilic (suppurative) cholangitis in the cat?
How do we diagnose neutrophilic (suppurative) cholangitis in the cat?
Describe the most common signalment/secondary signs of neutrophilic CCHS in the cat.
Describe the pathogenesis of lymphocytic cholangitis in the cat.
Describe the most common signalment for a cat with lymphocytic cholangitis.
What are some of the clinical signs of lymphocytic cholangitis in the cat?
What are some key clinicopathologic abnormalities we may find in a cat with lymphocytic cholangitis?
How do we diagnose lymphocytic cholangitis in the cat?
Lymphocytic cholangitis CANNOT be diagnosed with confidence via a _____.
List some of the general treatments for feline CCHS.
What is the treatment for neutrophilic (suppurative) cholangitis?
When treating neutrophilic CCHS, biochemical abnormalities should normalize if _____.
What is the treatment for lymphocytic cholangitis?
Describe the use of prednisolone as a treatment option for non-neutrophilic (lymphocytic) CCHS treatment.
Describe the use of concurrent metronidazole as a treatment option for non-neutrophilic (lymphocytic) CCHS treatment.
Describe how chlormabucil, azathiaprine, and mathotrexate as another immunosuppressive treatment for lymphocytic CCHS if prednisolone does not work.
What is the prognosis for CCHS?
Describe the prevalence of hepatic neoplasia in the cat.
What are the clinical signs of hepatic neoplasia in the cat?
What are the different kinds of primary hepatic neoplasias we find in the cat?
What are the different kinds of secondary hepatic neoplasias we find in the cat?
How do we diagnose and treat hepatic neoplasia in the cat?
Describe the prevalence of portosystemic shunts in the cat.
Describe the typical clinical presentation of a cat with a PSS.
How do we diagnose PSS In the cat?
How do we treat PSS In the cat?
What is the prognosis for a cat with PSS?
Why are cats more prone to toxic hepatopathy?
What are some drugs/compounds that are commonly associated with hepatotoxicity in cats?
Describe hyperthyroidism as a systemic disease that can cause secondary hepatobiliary signs.
Describe pancreatitis as a systemic disease that can cause secondary hepatobiliary signs.
Describe diabetes mellitus as a systemic disease that can cause secondary hepatobiliary signs.
What is triaditis syndrome?
