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Systemic Pathology > YR3 8 L HO1 > Flashcards

YR3 8 L HO1 Flashcards

1
Q

Liver Structure/Function - Zone 1 oxygen rich blood

A

Hepatic artery

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2
Q

Liver Structure/Function - Zone 1 nutrient rich blood

A

Portal vein

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3
Q

Liver Structure/Function - Zone 1 Blood vessels origin

A

Portal triad

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4
Q

Liver Structure/Function - Zone 1 is active in

A

Plasma protein synthesis & general protein metabolism

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5
Q

Liver Structure/Function - Zone 3 is last to

A

Receive oxygen & nutrients and close to the central vein

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6
Q

Liver Structure/Function - Zone 3 is rich in

A

Smooth ER and mixed function oxidases e.g. cytochrome P450

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7
Q

Liver Structure/Function - Bile movement

A

Blood moves to the centre, bile movies opposite

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8
Q

Liver Functions

A

1)Metabolic 2)Bile pigments, bile salts, cholesterol 3)Phagocytosis 4)Extramedullary haemopoiesis 5)Detoxification (conjugation - lipid to water soluble)

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9
Q

Liver Metabolic Functions

A

1)Carbohydrate 2)Lipid 3)Protein 4)Plasma proteins synthesis (serum albumin, most globulins) 5)Clotting factors (fibrinogen, prothrombin, V, VII, IX, X) 6)Vitamins A, D B12 7)Fe storage

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10
Q

Liver Reactions to Injury

A

1)Regeneration 2)Fibrosis 3)Bile duct hyperplasia

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11
Q

Liver Rxns to Injury - Regeneration; types

A

Micro vs. Macronodular

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12
Q

Liver Rxn to Injury - Fibrosis; types

A

1) Biliary (portal) 2)Post-necrotic 3)Diffuse (intra/interlobular) 4)Periacinar (centrilobular)

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13
Q

Liver Disease - Clinical Signs

A

1)Jaundice (icterus) 2)Hepatogenous photosensitivity 3)Coagulopathies 4)Diarrhoea 5)Oedema, Ascities 6)Weight loss

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14
Q

Incidental Liver Lesions

A

1)Tension lipidosis 2)Capsule plaques or tags 3)Telangiectasis 4)Gall bladder anomalies

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15
Q

Incidental Liver Lesions - Tension lipidosis

A

Common in horses - caused by capsular tension. Lesion - well demarcated area of fatty change

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16
Q

Incidental Liver Lesions - Capsule plaques

A

Diaphragmatic surface of horse livers - due to strongyle migration

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17
Q

Incidental Liver Lesions - Telangiectasis

A

Localised dilation of sinusoids - slightly sunken foci. Common in old cats and cattle

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18
Q

Liver Postmortem Changes

A

1)Autolysis 2)Putrefaction 3)Pseudomelanosis 4)Bile imbibition 5)Haemoglobin imbibition

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19
Q

Liver Postmortem Changes - Putrefaction

A

Also called pseudonecrosis. Irregular pale tan foci which may contain gas bubbles

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20
Q

Liver Postmortem Changes - Advanced Putrefaction

A

Foci of post mortem bacterial invasion and gas production. The diffuse pallor is due to autolysis

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21
Q

Liver Postmortem Changes - Pseudomelanosis

A

Pigmentation due to iron sulphide and sulphur methaemoglobin. Proximity to intestines - the same process results in the greenish pigmentation of the abdominal wall

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22
Q

Liver Postmortem Changes - Bile Imbibition

A

Yellow/Green discolouration of the liver or any tissues adjacent to the gall bladder due to leakage

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23
Q

Liver Congenital Anomalies

A

Cysts - Differentiate from parasites/tumours (may be acquired) e.g. Congenital Biliary Cysts

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24
Q

Liver Displacement/Rupture

A

1)Diaphragm - displacement caudally, hernia 2)Torsion of lobe - Pigs, dogs; usually the left lateral lobe > causes shock & death 3)Rupture

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25
Q

Liver Displacement/Rupture - Rupture

A

Most common cause is trauma. Inflammation, fatty change and amyloidosis may predispose

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26
Q

Liver Pigments & Deposits

A

1)Melanosis 2)Lipopigments 3)Haemosiderin 4)Bile pigment 5)Indole melanins 6)Iron-porphyrin 7)Crystalloid material 8)Amloid

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27
Q

Liver Pigments & Deposits - Congenital Melanosis

A

Calves, lambs, piglets -no pathological significance

28
Q

Liver Pigments & Deposits - Lipopigments; type

A

Yellow to Brown 1)Ceroid due to auto-oxidation of polyunsaturated fat 2)Lipofuscin - age pigment

29
Q

Liver Pigments & Deposits - Lipopigments; disease

A

Storage disease (ceroid-lipofusinosis)

30
Q

Liver Pigments & Deposits - Haemosiderin

A

If severe, grossly dark brown

31
Q

Liver Pigments & Deposits - Haemosiderosis

A

1)Iron overload 2)Haemolytic anaemias 3)Copper deficiency 4)Cachexia

32
Q

Liver Pigments & Deposits - Cholestasis

A

Greenish or orange bile oozes from cut surfaces. Distinguish from fatty liver.

33
Q

Liver Pigments & Deposits - Bile Pigmentation

A

May be olive green to yellow ochre. Birds - green due to biliverdin 1)Cholestasis 2)Obstructive icterus

34
Q

Liver Pigments & Deposits - Indole Melanin

A

From Pharlaris staggers & Tryptamine alkaloid. Greenish-grey: Parts of the brain & renal medulla

35
Q

Liver Pigments & Deposits - Iron porphyrin

A

Black pigment. From Fasciola & Schistosoma spp. Infections

36
Q

Liver Pigments & Deposits - Crystalloid Material

A

From Panicum spp. And Tribulus terrestris > Hepatogenous photosensitivity

37
Q

Liver Pigments & Deposits - Amyloidosis

A

Secondary to chronic inflammation. Amyloid deposited in space of Disse > Hepatomegaly, pale tan, predisposed to rupture

38
Q

Liver - Reversible Injury (Degeneration)

A

1)Cell swelling 2)Fatty change

39
Q

Reversible Injury - Cell Swelling

A

Aka ‘cloud swelling’ or ‘hydropic degeneration’ Grossly: the liver may be emlarged and light brown

40
Q

Reversible Injury - Fatty Change

A

Gross: Tan, creamy-yellow, enlarged w/ rounded edges, friable in consistency and often greasy to touch with a small amt. of bile oozing out of cut surface. Micro: Smooth edges of fat vacuoles

41
Q

Reversible Injury - Fatty Change; diseases

A

1) Diabetes 2)Pregnancy ketosis

42
Q

Causes of Fatty Liver

A

1)Physiological 2)Pathological

43
Q

Causes of Fatty Liver - Physiological

A

1)Fasting 2)Pregnancy (esp. ruminants) 3)Lactation (cow)

44
Q

Causes of Fatty Liver - Pathological

A

1)Genetic - hyperlipaemia in horses, cats 2)Metabolic - pregnancy toxaemia & ketosis, diabetes mellitus, hypothyroidism, hyperarenocorticism 3)Deficiencies - anaemia, choline, cobalt/vitB12 4)Toxicities - phosphorus, aflatoxin, myoporum spp.

45
Q

Ovine White Liver Disease

A

Ill thrift, photosensivity due to cobalt/vitB12 deficiency

46
Q

Changes in Liver &/ Hepatocyte Size - Atrophy

A

Due to shunts, malnutrition, ‘portal streaming’

47
Q

Changes in Liver &/ Hepatocyte Size - Hepatomegaly

A

1)Chronic passive congestion 2)Cell swelling 3)Fatty change 4)Amyloidosis 5)Diffuse inflammation 6)Diffuse neoplasia

48
Q

Patterns of Liver Necrosis

A

1)Single cell 2)Focal 3)Centrilobular 4)Midzonal 5)Periportal 6)Paracentral 7)Massive 8)Pannecrosis

49
Q

Patterns of Liver Necrosis - Focal>Small

A

Small necrotic foci - Scattered, Multifoci, Need light to see. Causes - Bacterial septicaemia e.g. salmonellosis, Virus e.g. EHV1, Protozoa e.g. Toxoplasma

50
Q

Patterns of Liver Necrosis - Focal>Large

A

Foci can be >20mm and coalescing. Causes - Necrobacillosis by Fusobacterium necrophorum

51
Q

Patterns of Liver Necrosis - Centrilobular (Periacinar)

A

Causes - hypoxia, passive congestion, exogenous toxins

52
Q

Patterns of Liver Necrosis - Zonal

A

Causes - 1)various plant toxicities 2)polychlorinated biphenyl (PCB) toxicity

53
Q

Patterns of Liver Necrosis - Periportal

A

Causes - 1)phosphorus poisoning 2)acute sporidesmin toxicity (facial eczema)

54
Q

Patterns of Liver Necrosis - Massive/Submassive

A

Causes - 1)Serum hepatitis in horses 2)Cardiac failure in pigs 3)Acute iron toxicity in piglets 4)Acute parenteral copper toxicity in calves 5)Hepatosis dietetica in pigs

55
Q

Hepatosis dietetica in pigs

A

Deficiences in VitE/Se, S-containing aa or choline. Often diet high in polyunsaturated fats. Lesion - Necrotic lobules collapse, healing results in post necrotic scarring

56
Q

VitE / Se Deficiency / Xs Dietary Unsaturated Fats in Pigs

A

1)Hepatosis dietetica 2)Muscular dystrophy 3)Mulberry heart 4)Yellow fat disease 5)Exudative diathesis 6)Fibrinoid necrosis of arterioles 7)Serous effusions

57
Q

Patterns of Liver Necrosis - Pannecrosis

A

Liver literally a ‘bag of blood’. Outcome 1)Rift Valley fever in lambs 2)Some haemorrhagic fever in man

58
Q

Circulatory Changes and Vascular Anomalies

A

1)Obstruction of the hepatic artery 2)Portal Vein 3)Obstruction of efferent vessels 4)Portosystemic shunts

59
Q

Obstuction of the Hepatic Artery

A

1)Small foci of necrosis - parasitc migration 2)Large necrotic segments of the liver: Horses - Strongylus vulgaris arteritis, Cats - Aortic/hepatic arterial thrombosis

60
Q

Portal Vein - Portal Streaming

A

Selective distribution of blood in the liver

61
Q

Portal Vein - Portal Hypertension; cause

A

1)Severe, widespread hepatic necrosis 2)Widespread hepatic fibrosis 3)Right-sided congestive heart failure 4)Cardiac tamonade > Sequelae - Ascites (often containing fibrin)

62
Q

Chronic Passive Congestion; definition

A

Liver swollen and darker than normal with severe ascites - the pattern on cut surface may resemble a nutmeg. The nutmeg-like appearance is due to centrilobular necrosis / fibrosis, sinusoidal engorgement and periportal fatty change

63
Q

Chronic Passive Congestion; causes

A

1)Congestive (right) heart failure 2)Caudal vena cava thrombosis 3)Liver incarceration in diaophragmatic hernia 4)Chronic partial torsion of a lobe

64
Q

Obstruction of Efferent Veins; causes

A

1)’Nutmeg’ liver 2)Cardiac fibrosis 3)Cyanotic induration > Chronic Passive Congestive synonyms

65
Q

Portosystemic Shunts

A

Dog & Cats, Congenital or Acquired. High NH3 and Bile Salts, Low urea and albumin, Ammonium biurate crystals in urine. Liver is small, firm and nodular

66
Q

Portosystemic Shunts - Congenital

A

Young runts with nervous signs (hepatic encephalopathy). Five types (intra/extra hepatic) 1)Patent ductus venosus 2)Portal vein atresia 3)Portocaval 4)Portoazygos 5)Portocaval-azygos

67
Q

Portosystemic Shunts - Acquired

A

Portal hypertension present

Systemic Pathology (14 decks)

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