Test results that suggest/indicate hepatic disease/dysfunction (describe lesion, finding pathogenesis)

Question 1

Acanthocytosis

Answer 1

Hemangiosarcoma – possibly vascular trauma

Lipid metabolism defect – altered lipid composition of erythrocyte membrane

Question 2

Anemia

Answer 2

Hepatitis (chronic) – anemia of inflammatory disease

decreased functional mass – possibly decreased EPO or abnormal protein or amino acid metabolism

Question 3

Codocytosis

Answer 3

decreased functional mass – altered lipid composition of erythrocyte membrane

Question 4

Microcytosis

Answer 4

decreased functional mass, portosystemic shunt – possibly decreased transferrin production and thus decreased delivery of iron to erythrocyte precursors

Question 5

Decreased UN

Answer 5

decreased functional mass – decreased urea production

Question 6

Hyperammonemia

Answer 6

Decreased functional mass, PSS – inadequate fixing of NH4+ into urea

Question 7

Hyperbilirubinemia

Answer 7

cholestasis, decreased conjugated bilirubin transport – inadequate biliary excretion of bilirubin

Question 8

Hypercholesterolemia

Answer 8

Cholestasis – increased production of cholesterol, decreased clearance of lipoproteins

Question 9

Hyperglycemia

Answer 9

Cirrhosis, hepatopathy – hyperglucagonemia or increased gluconeogenesis of hepatocutaneous syndrome

Question 10

Hyperuricemia

Answer 10

Decreased functional mass – decreased conversion of uric acid to allantoin by hepatocytes

Question 11

Hypoalbuminemia

Answer 11

decreased functional mass – decreased albumin production

Question 12

Hypocholesterolemia

Answer 12

decreased functional mass – decreased cholesterol synthesis

Question 13

Hypofibrinogeniemia

Answer 13

decreased functional mass – decreased fibrinogen production

Question 14

Hypoglycemia

Answer 14

decreased functional mass – decreased gluconeogenesis

Question 15

Hypoproteinemia

Answer 15

decreased functional mass – decreased production of albumin and globulins other than gamma-globulins

Question 16

Increased ALT, AST, SDH, LDH, GDH

Answer 16

damaged hepatocytes – release of cytoplasmic enzymes due to blebbing or necrosis

Question 17

Increased ALP

Answer 17

cholestasis – increased production of L-ALP

Question 18

Increased GGT

Answer 18

biliary hyperplasia – increased production of GGT

Cholestasis, possibly hepatocyte damage – release of GGT from damaged cells

Question 19

Gross lipemia

Answer 19

decreased functional mass – decreased clearance of lipoproteins

Question 20

Ammonium (bi)urate crystalluria

Answer 20

decreased functional mass, urea cycle defect – inadequate fixing of NH4+ into urea and decreased conversion of uric acid to allantoin

Question 21

Bilirubinuria

Answer 21

Cholestasis, decreased conjugated bilirubin transport – inadequate biliary excretion of bilirubin

Question 22

Hyposthenuria or isosthenuria

Answer 22

decreased functional mass – decreased renal medullary tonicity due to decreased urea, increased NH4+ excretion may inhibit concentration mechanism

Question 23

Urate cyrstalluria

Answer 23

decreased functional mass – decreased conversion of uric acid to allantoin

Question 24

When is ammonium (bi)urate crystalluria normal?

Answer 24

Dalmatians

Question 25

When is urate crystalluria normal?

Answer 25

English bulldogs

Question 26

Prolonged PTT or PT

Answer 26

Cholestasis – decreased vitamin K-dependent coagulation factors due to impaired intestinal absorption of vitamin K
Decreased functional mass – decreased clearance of inhibitors of coagulation factors such as fibrin or FDPs, decreased production of most coagulation factors

Question 27

Steatorrhea

Answer 27

Cholestasis – defective lipid digestion because bile acids are not delivered to intestine

Question 28

Transdate

Answer 28

decreased functional mass, cirrhosis – increased Na and water retention, decreased plasma oncotic pressure, portal hypertension, decreased lymph drainage