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Exam I
Path of Liver 5
76
Veterinary Medicine
Professional
02/02/2017

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Cards

Term
What are the 6 categories of hepato-toxic injury?
Definition
-pdn of metabolites
-formation of adducts forming neogens
-trigger apoptosis
-damage cell membranes
-disrupt pumps for secretion of bile
-damage cell membranes
Term
What is the acute cell response to toxic liver lesions?
Definition
-swelling
-lipid accumulation
-necrosis
Term
What does acute liver intoxication cause? Clinical signs?
Definition
-acute liver failure may occur if significant functional mass is lost
-CS: anorexia, vague GI signs, abdominal pain, neuro distrubances
Term
What lesions does acute fatal liver intoxication cause?
Definition
-deep reddish purple swollen liver: zonal pattern
0edema of gallbladder wall and attachments
-widespread terminal hemorrhage
Term
True or FAlse: Acute fatal liver intox causes icterus and/or photosensitization.
Definition
-FALSE, does not cause these
Term
What are predictalbe (intrinsic) hepatotoxins?
Definition
-cause hepatic injury in all susceptble animals receiving a sufficient dose
-majority of cases
Term
What are idiosyncratic liver toxins?
Definition
-cause hepatic injury in a minority of exposed animals that is typically not dose-related
Term
What causes the toxicity of blue-green algae?
Definition
-protozoa
-dead or dying algae have preformed toxin: accumulates in water, late summer to early fall
Term
What are the clinical outcomes of blue-green algae?
Definition
-acute intoxication in livestock
-diarrhea, prostration, and death: due to fast death factor
Term
What lesions do we see due to blue-green algae?
Definition
-zonal to massize hepatic necrosis
-red, swollen, hemorrhagic liver
-hemorrhagic gastroenteritis
Term
What are the systemic signs of liver failure?
Definition
-icterus
-hepatic encephaopathy
-photosensitization
Term
What is the mechanism behind herbivore photosensitization due to chronic liver failure?
Definition
-chlorophyll => phylloerythrin => accumulates in skin => photosensitization
Term
HOw do animals consume pyrrolizidine alkaloids?
Definition
-consumption of plants: Senecio, Cynoglossum, Crotolaria, Heliotropium
-alkaloids are metabolized to reactive pyrroles by MFO system
Term
What do pyrrolizidine alkaloids do inthe body?
Definition
-interfere w/ mitosis in hepatocytes
Term
What lesions do pyrrolizidine alkaloids cause?
Definition
-CHRONIC
-fibrosis, nodular regen, biliary hyperplasia
-crhonic damage = liver failure
Term
Where do aflatoxins come from? What do they do in the body?
Definition
-Aspergillus flavis: metabolized by MFOs to toxic pdts
-in RNA and protein synth at high doses
-commonly in fungal contaminated feed: corn, peanuts,and cotton seed
Term
Which spp are most commonly affected by aflatoxins?
Definition
-pigs, dogs, horses, cattle: young especially
Term
What lesions do we see due to acute aflatoxins? Which species?
Definition
-centrilobular to massive hepatic necrosis and hemorrhage
-dogs
Term
What lesions do we see due to chronic aflatoxins?
Definition
-pale, fibrotic, and bile-staine dliver
-lipidosis and necrosis of cells, fibrosis and biliary hyperplasia
Term
Which muschroom leads to liver failure? Lesions? Clinical signs?
Definition
-Amanita phalloides (aka death cap)
-shrunken liver w/ hemorrhages
-loss of hepatoytes and lipidosis, death in 3-4d
Term
What kind of hepatoxin is Acetaminophen? Which sp? CS?
Definition
-intrinsic
-cats > dogs
-heinz bdy anemia
Term
HOw do anticonvulsants affect the liver? CS?
Definition
-chronic hepatotoxicity in small proportion of treated dogs: idiosyncratic hepatotoxin
-end-stage liver: ascites, jaundice, and coagulopathy
Term
What kind of rxn does Diazepam cause in liver? Spp? CS?
Definition
-idiosyncratic: inherited hepatic enzyme difference
-cats
-inappetence, vomiting, lethargy, jaudce
Term
What kind of rxn does Trimethoprim-sulfa cause in the liver? Which species? Lesions?
Definition
-acute hepatic injury (idiosyncratic)
-dogs
-submassive to massive hepatic necrosis, sometimes bile duct destruction
Term
What kind of rxn does Carprofen cause in the liver? Species? CS?
Definition
-acute idiosyncratic hepatic necrosis
-dogs
-anorexia, vomiting, lethargy
Term
Which chemicals commonly affect the liver?
Definition
-phosphorus
-carbon tetrachloride
-chronic copper accumulation in rums
Term
What is hepatocellular nodular hyperplasia? What does it look like?
Definition
-age-related lesion commonly in dog only
-NOT ASSOC W/ DYSFUNCTION
-raised, red to yellow or tan, well-demarcated nodules
Term
What are regenerative nodules? Species affected?
Definition
-proliferation of hepatocytes in response to hepatocellular loss or destruction
-ALL SPECIES
Term
What is the major difference functionally b/n nodular hyperplasia and nodular regen?
Definition
-nodular regen = loses function
-nodular hyperplasia= architecture is saved and so is function
Term
Primary hepatic neoplasms can arise from which elements? Give examples of each.
Definition
-Epi elements: adenomas/carcinomas from hepatocytes, bile duct epi
-Mesenchymal: sarcomas from CT or blood vessels
Term
Majority of neoplasms in liver are what?
Definition
-metastases from other organs or sites
Term
What is hepatocellular adenoma? What does it look like?
Definition
-uncommon benign neoplasm of hepatocytes
-single and well-demarcated
Term
What CS do we see with hepatocellular adenoma?
Definition
-no clinical dz
-cannot be distinguished from nodular hyperplasia
Term
What is hepatocelllular carcinoma?
Definition
-malignant neoplasm of hepatocytes uncommon in all species
Term
What do hepatocellualr carcinomas look like?
Definition
-solitary and may involve entire love
-soft and friable
-gray-tan or yelow-brown tissue
Term
What are the clinical signs of hepatocellular carcinomas? Where do they metastasize?
Definition
-anorxia, vomiting, weakness, and lethargy
-hepatomegaly
-metastasize late in course of dz: lung and regional LN
Term
What are cholangiocellular adenomas? Species?
Definition
-benign neoplasm of bile duct epi
-most common in cats but still uncommon
Term
What do cholangiocellular adenomas look like?
Definition
-solitary, discrete, firm white or gray masses
-cystic variants may become large and compress but do not infiltrate or invade
Term
What are cholangiocellular carcinomas? Species?
Definition
-malifnant neoplasma of bile duct epi
-MOST COMMON PRIMARY MALIGNANT TUMOR IN LIVER OF CATS
Term
What do cholangiocellular carcinomas look like?
Definition
-multiple disseminated nodules most common
-typically firm and raised, pale gray to toan masses, often w/ central depression
Term
Do cholangiocellular carcinomas met?
Definition
-yes commonly met
-to lungs, regional LN
Term
Which animals are most commonly affected by hemangiosarcomas?
Definition
-GSD, Goldens 8-13y
Term
Which organs are involved in hemangiosarcomas?
Definition
-liver
-spleen
-RA
-lungs
Term
What are the clinical signs fo hemagiosarcomas?
Definition
-weakness, abdominal distension, inc HR/RR, pale mucous membranes
-sudden death: severe heorrhage
-hemopericardium and RHF
-regen anemia
Term
Which liver lesiosn do we expect to see w/ R-sded heart failure (like with hemangiosarcomas)?
Definition
-passive congestion
Term
Give a few examples of mesenchymal neoplasms that arise in the lvier? ARe they common?
Definition
-NOT COMMON AT ALL
-fibrosarcoma
-hemangiosarcoma
-leiomyosarcoma
-histiocytic sarcoma
Term
What are the two most common sites for neoplastic metastasis?
Definition
-liver and lungs
Term
Are metastatic or primary neoplasms more common in the liver?
Definition
-metastatic
Term
What is malignant lymphoma? Lesions?
Definition
-common metastatic neoplasm in liver
-hepatomegaly and enhanced lobular pattern
Term
True or FAlse: Live may be nearly replaced by neoplasm before icterus and other signs of liber involvement are seen.
Definition
-TRUE, need to kill about 85% of liver before signs happen
Term
True or False: Biliary carcinomas and metastatic carcinomas are often umbilicated.
Definition
-TRUE
Term
What is the purpose of the gallbladder?
Definition
-stores and concentrates bile
Term
What is the purpose of bile?
Definition
-bile acids for fat digestion
-excretory route for metabolites and drgus
-buffers to neutralize acid pH of ingesta
Term
Which species don't have a gallbladder?
Definition
-horse
-rat
-elephant
-dolphin
-llama
Term
Why is the gallbladder usually distended?
Definition
-anorexia: lack of cholecystokinin stimulus
Term
What are the clinical signs of gallbladder dz?
Definition
-vomiting, lethargy, anorexia, abdominal pain
Term
What gallbaldder dz commonly affects dogs? Which breed is predisposed?
Definition
-gallbaldder mucoceles and gallbladder wall necrosis
-Shetland sheepdogs
Term
What are gallbladder mucoceles?
Definition
-distension of gallbladder by accumulated mucus in lumen
Term
Is gallbladder rupture common? What can it result from?
Definition
-uncommon
-may result from: acute or chornic infection, traumatic insult, gallbladder mucocele
Term
How common are gallbladder mucoceles?
Definition
-reported in about half of dogs w/ gallbladder dz
Term
What results from gallbladder rupture?
Definition
-bile peritonitis
Term
What usually causes biliary obstruction?
Definition
-cholangitis or cholecystitis
-FB
-stenosis due to fibrosis and compression
Term
Complete obstruction of common bile duct leads to what?
Definition
-extrahepatic holestasis
-acholic feces: pale
-icterus
-bile leakage into portal areas
Term
What are the typical clinical sings of obstruction of individual intrahepatic ducts?
Definition
-asymptomatic! has to be common bile duct or something large to have clinical signs
Term
How common are cholelithiasis? What do they develop secondary to?
Definition
-uncommon
-develop secondary to chronic cholecystitis
Term
How do choleliths become clinically significant?
Definition
-if they cause obstruction
-cause jaundice
Term
What is cholecystitis?
Definition
-inflammation of gallbladder
Term
What causes acute inflammation of gallbladder?
Definition
-viral infections: acite canine hepatitis (dogs), acute fibrinous cholecystitis (calves w/ salmonella)
Term
What causes chronic inflammation of gallbladder?
Definition
-bacterial infection of biliary tree w/ reflux into gallbladder
-irritation from choleliths or parasites
Term
Which species get cystic mucinous hyperplasia?
Definition
-dogs sheep
-older in dogs
Term
What does cystic mucinous hyperplasia look like?
Definition
-gray-white diffusely sponge-like mucosal lining
Term
What are the typical clinical signs of cystic mucinous hyperplasia?
Definition
-usually no significance!
Term
What are gallbladder adenomas? Species? Lesions?
Definition
-benign
-rare except in cattle
-multinodular or papillary masses from mucosal surface
Term
What are gallbladder carcinomas?
Definition
-rare in domestic animals
-may invade liver directly or met
Term
LOOK AT IMPORTANT POINTS AT END OF LECTURE
Definition
Term
What are the potential consequences of cholecystitis?
Definition
-rupture possible but uncommon
-cholelith formation
-obstruction from inspissated bile/inflammatory debris
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