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Gastrointestinal Pathophysiology > Vascular Diseases of the Liver > Flashcards

Vascular Diseases of the Liver Flashcards

1
Q

what is multiple portosystemic shunts often associated with?

A

ascites

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2
Q

how many vessels usually make up a congenital portosystemic shunt?

A

single, large caliber vessel

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3
Q

who primarily gets intrahepatic congenital portosystemic shunts?

A

large breed dogs

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4
Q

what is a major consequence of congenital portosystemic shunts?

A

decreased hepatic perfusion

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5
Q

what are the general clinical signs of congenital portosystemic shunts?

A

stunted growth/failure to thrive
gastrointestinal signs
neurological signs
urinary signs
ptyalism
copper irides

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6
Q

what can be seen on clinical pathology to diagnose a congenital portosystemic shunt?

A

fasting hyperammonemia
elevated SBA
synthetic failure
microcystic anemia
ammonium biurate crystalluria/urolithiasis

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7
Q

what things are low on a blood panel with a congenital portosystemic shunt?

A

albumin
cholesterol
glucose
BUN

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8
Q

what characterizes primary hypoplasia of the portal vein?

A

congenital: abnormally small extra- or intrahepatic portal veins

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9
Q

can the liver be grossly normal with primary hypoplasia of the portal vein?

A

yes

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10
Q

what is primary hypoplasia of the portal vein with portal hypertension accompanied by?

A

portal hypertension
ascites
multiple shunts

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11
Q

who is passive hepatic congestion common in?

A

all species with right congestive heart failure

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12
Q

what does telangiectasia result from?

A

dilated sinusoidss in areas where hepatocytes have been lost

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13
Q

what is a intrahepatic arteriovenous fistula?

A

direct anastomosis between the hepatic artery and branches of the portal vein
congenital or acquired

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14
Q

what is portal vein thrombosis associated with?

A

hypercoagulable states

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15
Q

where is hepatic infarction more common?

A

margins of liver

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16
Q

what is seen histologically with hepatic infarctions?

A

zone of coagulative necrosis bordered by inflammatory cells and congestion

17
Q

what are some common vascular lesions?

A

portosystemic shunts
chronic passive congestion
telangiectasia

18
Q

do the two blood sources to the liver mix?

A

yes: sinusoids

19
Q

what is prehepatic hypertension?

A

impaired flow prior to liver
thrombus/embolys
external compression

20
Q

what is intrahepatic portal hypertension?

A

increased sinusoidal resistance

21
Q

what are some causes of portal hypertension?

A

portal vein thrombosis
portal vein hypoplasia
chronic passive congestion
veno-occlusive disease
hepatic AV fistula

22
Q

what are the two types of extrahepatic congenital portosystemic shunts?

A

portocaval: caudal vena cava
porto-azygous: azygous vein

23
Q

what does abnormal ammonia metabolism lead to?

A

hepatic encephalopathy
ammonium biurate crystalluria/urolithiasis

24
Q

what imaging can be done to diagnose a congenital portosystemic shunt?

A

AUS especially intrahepatic
trans-splenic portal scintigraphy
CT angiography

25
Q

is primary hypoplasia of the portal vein associated with portal hypertension?

A

sometimes: non-cirrhotic portal hypertension

26
Q

what does chronic hepatic congestion look like?

A

central vein/sinusoidal distension/congestion
persistent hypoxia
replacement fibrosis
nutmeg liver: sinusoidal congestion with fibrosis

27
Q

how are intrahepatic arteriovenous fistulas classified?

A

branching pattern

28
Q

what leads to intrahepatic portal hypertension?

A

any chronic process that induced extracellular matrix deposition: inflammation, amyloid

29
Q

what are some causes of hepatic hypoperfusion?

A

congenital portosystemic shunts
portal vein hypoplasia
chronic passive congestion
veno-occlusive disease
portal vein thrombosis
hepatic infarction

30
Q

how can an intrahepatic congenital portosystemic shunt be addressed?

A

thrombogenic coils

31
Q

how can an extrahepatic congenital portosystemic shunt be addressed?

A

ameroid constrictors/cellophane bands

32
Q

is there ascites with congenital portosystemic shunts?

A

no: normal portal vein pressure

33
Q

what neurologic signs are seen with congenital portosystemic shunts?

A

especially postprandial
weakness
somnolence
head pressing
cortical blindness
aggression
seizures

34
Q

who usually gets primary hypoplasia of the portal vein with portal hypertension?

A

young large breed dogs

35
Q

what is histology of primary hypoplasia of the portal vein with portal hypertension indistinguishable from?

A

congenital portosystemic shunts

Gastrointestinal Pathophysiology (18 decks)

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