Term
| True or FAlse: The clinical signs of liver dz are usually specific and therefore recognition and diagnosis is simple to the astute practitioner. |
|
Definition
| -FALSE: they are non-specific thus diagnosis depends on serum chen and U/S |
|
|
Term
| What are the clinical signs for liver failure? |
|
Definition
-icterus (disturbed bile flow)
-hepatic encephalopathy: head pressing
-metabolic disturbences: bleeding, hypoalbuminemia
-vascular alterations: portal hypertension, ascites
-cutaneous: photosensitization (HERBIVORES), hepatocutaneous syndrome |
|
|
Term
| What is hyperbilirubinemia? |
|
Definition
| -in bilirubin in serum > 2mg/dL (except w/ low PCV) |
|
|
Term
| What causes prehepatic hyperbilirubinemia? |
|
Definition
|
|
Term
| What is caused by hepatic hyperbilirubinemia? |
|
Definition
| -cholestatic: dec uptake, conjugation, and secretion |
|
|
Term
| If a horse's fat is really yellow, do you automatically think icterus? |
|
Definition
| -herbivore fat is usually more yellow |
|
|
Term
| What causes posthepatic hyperbilirubinemia? |
|
Definition
| -red outflow of bile from gallbladder or bile duct |
|
|
Term
| In sheep, chronic copper tox results in hyperbilirubinemia by which of the 2 mechanisms? |
|
Definition
|
|
Term
| What causes hepatic encephalopathy? |
|
Definition
| -inc plasma ammonia levels |
|
|
Term
| What are the major reasons for hepatic encephalopathy? |
|
Definition
-prtosystemic shunt: blood shunted to systemic circulation bypassing liver
-hepatic dz: red hepatic function = less ammonia eliminated |
|
|
Term
| What are the clinical signs of hepatic encephalopathy? |
|
Definition
-dullness & depression
-compulsive aimless movement
-head-pressing
-seizures
-mania
-hypersalivation |
|
|
Term
| Do metaboic disturbances occur w/ acute or chronicliver dz? |
|
Definition
|
|
Term
| What causes bleeding tendencies w/ chronic liver dz metabolic disturbances? |
|
Definition
-impaired synth of clooting factors
-impaired platelet function
-dec fat absorption limits vit K uptake (biliary obstruction)
-DIC |
|
|
Term
| How does chronic liver dz cause hypoabuminemia? |
|
Definition
-dec albumin synth by liver
-loss of albumin in ascitic fluid or GI tract: portal hypertension |
|
|
Term
| What hemodynamic alterations lead to hypoalguminemia in chronic liver dz? |
|
Definition
-protal hypertension
-ascites |
|
|
Term
| Which cutaneous manifestations due to chronic liver dz occurs in herbivores only |
|
Definition
|
|
Term
| Describe primary photosensitization seen w/ chronic liver dz. |
|
Definition
-preformed agent deposited in tissues: St. John's wort, buckwheat, tetracyclines
-inborn errors of metabolism: abnormal porphyrin metabolism |
|
|
Term
| Describe secondary photosensitization seen w/ chronic liver dz. |
|
Definition
| -imparied excretion of phylloerythrin in bile HERBIVORES ONLY |
|
|
Term
| What cutaneous manifestation of chronic liver dz occurs in dogs and cats only? What is it? |
|
Definition
-hepatocutaneous syndrome: superficial ncrolytic dermatitis
-crusting, ulceration, and full-thickness necrosis of pawpads, mucocutaneous junctions, and pressure points |
|
|
Term
| Describe the immunological manifestations of chronic liver dz. |
|
Definition
-Kupffer cells are in sinusoids, pdc inflammatory and immune-related proteins
-usually not an issue
- |
|
|
Term
| What is hepatitis? What causes it? |
|
Definition
-inflammation of the liver parenchyma
-cause: infectious agent or secondary to inflamm response |
|
|
Term
|
Definition
| -inflammation of large bile ducts |
|
|
Term
| What is cholangiohepatitis? |
|
Definition
| -inflammation of biliary ducts and adjacent hepatic parenchyma |
|
|
Term
| What is portal hepatitis? |
|
Definition
| -accumulation of inflammatory cells w/in portal areas |
|
|
Term
| What are the three routes of infection to the liver? |
|
Definition
-hematogenous
-ascending through biliary tract: cholangitis => cholangiohepatitis
-direct extension/penetrating wound |
|
|
Term
| What are the typical clinical signs of acute hepatitis? |
|
Definition
-anorexia
-vomiting
-lethargy
-diarrhea |
|
|
Term
| What is the prognosis of typical acute hepatitis? |
|
Definition
| -most recover spontaneously w/ supportive care (antiemetics and fluids) |
|
|
Term
| What happens if acute hepatitis recurrs due to Ag persistence? |
|
Definition
-may become chronic
-rebiopsy in 4-5w |
|
|
Term
| Does toxin-induced necrosis stimulate inflammation w/ acute hepatitis? What causes this?> |
|
Definition
-no
-acute viral infections |
|
|
Term
| What is the typical cause of chronic hepatitis? |
|
Definition
-idiopathy
-seen w/ resistant bacteria or fungi, persistent biliary inflammation |
|
|
Term
| What cytologically characterizes chronic hepatitis? |
|
Definition
| -fibrosis w/ lymph, plasma cells, or granulomas |
|
|
Term
| What are the liver's 3 basic responses to injury? |
|
Definition
-regen
-fibrosis
-biliary hyperplasia |
|
|
Term
| What is the lesion due to localized chronic hepatic inflammation? How does it affect hepatic function? |
|
Definition
-abscesses or granulomas
-DOES NOT alter function |
|
|
Term
| What lesions do you see due to generalized chronic hepatic inflammation? |
|
Definition
| -loss of parynchema due to fibrosis and nodular regen |
|
|
Term
| What is the third feature of end-stage liver failure (fibrosis + nodular regen + x)? |
|
Definition
| -disorganized hepatic architecture |
|
|
Term
| What are the clinical signs seen w/ chronic liver failure? |
|
Definition
-icterus
-hepatic encephalopathy
-hypoglycemia: esp in neonates
-melena
-ascites
-vomiting
-wt loss
-lethargy
-PU/PD |
|
|
Term
| What category of portal hypertension occurs due to chronic liver failure? |
|
Definition
|
|
Term
| What are the two potetial sequelae to intraheptic portal hypertension? |
|
Definition
-acquired portosystemic shunts
-ascites |
|
|
Term
| What is non-specific reactive hepatitis? |
|
Definition
-secondary reactive hepatopathy in response to systemic illness
-most often secondary to dz of GI tract |
|
|
Term
| What lesions occur w/ non-specific reactive hepatitis? |
|
Definition
-mild portal inflammation w/out necrosis
-reactive Kupffer cells
-residual hepatic inflammaiton |
|
|
Term
| What virus is behind infectious canine hepatitis? |
|
Definition
|
|
Term
| Infectious canine hepatitis is uncommon but what are the clinical signs? |
|
Definition
-some are asymptomatic
-vomiting, melena, fever, abdominal pain
-peracute dz = death w/in hrs |
|
|
Term
| What cells does Canine Adenovirus 2 have a predilection to? |
|
Definition
| -endo cells and hepatocytes |
|
|
Term
| What lesions do we see onnecropsy due to infectious canine hepatitis? |
|
Definition
-enlarged, friable liver w/ multiple foci of necrosis: enhanced lobular pattern
-fibrin over liver
-gallbladder edema
-widespread petechia and eccymoses: paint brush hemorrhages |
|
|
Term
| What lesions do we see due to herpesvirus infections? |
|
Definition
| -multifocal random small foci of necrosis on multiple orgnas including liver |
|
|
Term
| What lesions do we see due to canine herpesvirus? |
|
Definition
|
|
Term
| What is the name for EHV-1? |
|
Definition
|
|
Term
| What is the name for BHV-1? |
|
Definition
|
|
Term
| What is the name for FHV? |
|
Definition
|
|
Term
| Random multifocal pattern of hepatic necrosis seen with herpesviruses indicates which route of infection? |
|
Definition
|
|
Term
|
Definition
| -acute herpesvirus dz in psittacine birds |
|
|
Term
| What are the clinical signs of Pacheco's dz? |
|
Definition
|
|
Term
| What lesions do we see due to Pacheco's dz? |
|
Definition
-enlarged, friable liver that may have yellow-gray foci or mottling
-multifocal and random to massive hepatic necrosis |
|
|
Term
| What clinical signs do we usually see w/ bacterial hepatitis? |
|
Definition
-often clinically insignificant
-usually only small foci of inflammation
-caused by any bacteremia |
|
|
Term
| What causes liver abscesses? How does it get there? |
|
Definition
-bacteria
-via portal v, umbilican v, hepatic a (bacteremia), biliary tract (ascending), parasitic migration |
|
|
Term
| What is the typical pattern of lesions due to hematogenous spred of infectious agents? |
|
Definition
|
|
Term
| In which animal is hepatic necrobacillosis and abscesses common? |
|
Definition
|
|
Term
| What is the mechanism behind cattle hepatic necrobacillosis? |
|
Definition
| -rumenitis: rumen mucosal damage allows rumen microflora to enter portal circulation |
|
|
Term
| What is the typical organism behind feedlot hepatic necrobacillosis? |
|
Definition
-Fusobacterium necrophorum
-may see purulent abscesses due to T. pyogenes |
|
|
Term
| What must occur for hepatic abscesses due to hepatic necrobacillosis to be clinically significant? What happens next |
|
Definition
-they must break into hepatic v or caudal vena cava to fomr a thrombus
=> passive hepatic cogestions, embolic pneumonia, or fatal toxemia |
|
|
Term
| What category of portal hypertension is it if we have a thrombus in hepatic vein? |
|
Definition
|
|
Term
| What gross lesions may be seen w/ hepatic congestion? |
|
Definition
-enhanced lobular pattern: nutmeg liver
-fibrin accumulation b/n lobes or on capsule
-ascites
-hepatic fibrosis w/ chornicity |
|
|
