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125 Cards in this Set

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The liver filters blood from the entire abdominal cavity except for...
...kidney and rectum
Describe hepatic blood flow from the central vein to the vena cava.
portal v > central v. > hepatic v. > caval v.
Choose lobular or acinar pattern...
...centers on central vein.
Lobular
Choose lobular or acinar pattern...
...centrals on portal vein.
Acinar
Choose lobular or acinar pattern...
...corners are the central vein.
acinar pattern
Choose lobular or acinar pattern...
...corners are the portal triad.
lobular pattern
Which zone has the lowest oxygen levels? The highest?
Zone 1 gets most O2;
Zone 3 gets least O2.
Which cells are responsible for Vitamin A storage? Where are these cells found?
Ito cells found in space of Disse
Artiodactyls lack which type of liver cell?
Kupffer cells
What is unique about the basement membrane that liver sinusoid endothelial cells rest upon?
IT DOESN'T EXIST!!! no basement membrane!
What are three general functions of the liver?
Make proteins
Detoxify
Storage
Histologically, where are bile cysts most likely found?
centrolobular hepatocytes (Zone III)
Histologically, which area has the most cyt P450 activity?
centrolobular hepatocytes (Zone III)
Histologically, which area has the most glycogen synthesis?
centrolobular hepatocytes (Zone III)
Histologically, which area has the most concentration of O2 and nutrients?
periportal hepatocytes
Histologically, which area has the most resistance to toxic and anoxic stress?
periportal hepatocytes
Histologically, which area has the most regeneration?
periportal hepatocytes
What is the function of Kupffer cells? Where are they located?
Fe recycling, phagocytosis, degrade bacterial endotoxin - located in sinusoids.
What is the function of Ito cells? Where are they located?
Vit. A storage, collagen synthesis - located in space of Disse
How can hydropic hepatic change be detected histologically?
Cell swelling due to water uptake can be seen as pinching-off of sinusoids (common with all swelling).
What are gross characteristics of hepatic lipidosis?
Hepatomegaly
Friable
Rounded edges
Greasy
Yellow
Floats in formalin
T or F:
Hepatic lipidosis is common in dogs.
False!
Hepatic lipidosis must be distinguished from what two differentials in dogs?
Steroid hepatopathy;
Amyloidosis
What are causes of hepatic lipidosis in cats?
Diet change;
Change in olfaction
What are some signs of hepatic lipidosis in cats?
Anorexia
Vomiting
Hard stools/constipation
+/- icterus
What horse breeds are predisposed to hepatic lipidosis?
Shetland ponies and miniature horses (equine hyperlipemia): the Gary Colemans of the horse world
How will hepatic lipidosis present histologically?
Fat droplets in cells;
Nuclei pushed to one side
T or F:
Glycogen accumulation disorders in the liver are usually genetic.
True! THey usually are!
What clinical values will be abnormal in a dog with glucocorticoid hepatopathy?
Alkaline phosphatase will be HIGH
How does glucocorticoid hepatopathy differ from hepatic lipidosis histologically?
Both have swollen hepatocytes;
Lipidosis has fat droplets and eccentric compressed nuclei while glucocorticoid hepatopathy doesn't.
What process causes a green or brown liver?
Bile backup (cholestasis - either extra or intrahepatic)
What animals normally have yellow serum and fat?
Horses and Jersey Cattle
What is the #1 external sign of a biliary blockage?
White feces
What are some biochemical parameters used to assess hepatic function?
ALT, GGT, SAP, bile acids
Plasma protein
Bilirubin
BSP
What are some causes of histologically diffuse hepatic necrosis?
Vit E deficiency
viral infection
toxins
vascular accidents
Equine Serum hepatitis
How can Equine Serum Hepatitis be diagnosed?
Only at necropsy
What is the most common histologic pattern of hepatic necrosis?
Centrolobular
What are some causes of histologically random, multifocal hepatic necrosis?
usually infectious (viral, bacterial, or fungal)
What are some causes of periportal necrosis?
Aflatoxin
Phosphorus poisoning
What are some causes of midzonal necrosis?
Yellow fever (primates)
Aflatoxins (pigs/horses)
Human eclampsia
Hexachlorophene toxicosis (cats)
Generalized liver inflammation describes...
...hepatitis
Inflammation of the bile ductules describes...
...cholangitis
What does cholangiohepatitis describe?
Inflammation of the liver and surrounding bile ductules
What does pericholangitis describe?
Inflammation around bile ductules but not directly affecting them
What condition is associated with suffusive (paintbrush) hemorrhage in the stomach? What is the causative agent?
Infectious canine hepatitis; Canine Adenovirus ! causes it
What is the site of replication for CAV-1?
Tonsil
What are symptoms of infection with CAV-1?
Pharyngitis & laryngitis
What virus causes multifocal hepatic necrosis with intranuclear inclusions in many animals?
Herpesvirus
What is a remarkable sign of equine herpesvirus infections? What condition does this virus cause?
Abortion storms! Equine rhinopneumonitis
What type of virus is FIP? What type of exudate does the FIP virus induce?
Coronavirus; induces pyogranulomatous inflammation
Lymphocytic pericholangitis in horses is caused by...
Equine infectious anemia virus
Tyzzer's disease is caused by...
...Clostridium pilforme
T or F:
Tyzzer's disease can only be diagnosed at necropsy.
True
"Chinese characters" or "pick-up sticks" in cells must be seen to diagnose what disease?
Tyzzer's Disease (C. piliforme infection)
What is another name for "redwater" disease in the cow? What agent causes this?
Bovine bacillary hemoglobinemia (C. hemolyticum bovis in association of Fasciola hepatica)
Where do the clostridial spores reside in redwater disease?
In Kupffer cells
What toxin is responsible for the damage seen in Bovine bacillary hemoglobinemia?
Phospholipase C
Clostridial hepatic disease in sheep is called...
...Black disease
How does black disease differ from redwater disease in terms of host? Disease agent? Signs?
Sheep = black dz; cow = redwater
C. novyi = black; C. hemolyticum = redwater
hemoglobinuria = redwater; no hemoglobinurea = black
Paratyphoid nodules in the liver are indicative of what condition?
Salmenellosis
Rabbit fever is caused by...
...Francisella tularensis
What are some histologic signs of hepatic leptospirosis infection?
Dissociation of hepatic cord architecture; centrilobular hepatic necrosis
What are common causes of hepatic ulcers in ruminants?
Umbilical infection;
Hardware disease;
Rumen ulcers
Which zoonotic infection can be transmitted across intact mucous membranes and skin?
Tularemia!
What infection greatly impacts seals and sea lions?
Leptospirosis!
T or F:
Fusobacterium necorphorum are an important cause of hepatic abcesses.
False!
They don't cause abscesses but cause coagulative necrosis that subsequently liquifies.
What are some important causes of granulomatous hepatic disease?
Mycobacterium
Corynebacterium
Histoplasmosis
Rhodococcus equi
Yersinia
Many metabolites are made more toxic by the liver. What is this process called?
Bioactivation
What are the factors contributing to hepatotoxicity? Which is the most important?
Anoxia (most important)
Protein intake
Fasting
T or F:
Hepatotoxicity primarily presents as a centrolobular pattern.
True
What are some general responses that the liver has to hepatotoxins?
Cellular swelling
Fatty change
Necrosis
Fibrosis
Biliary hyperplasia (nonspecific)
Nodular regeneration
Neoplasia (aflatoxins in trout)
Which hepatotoxin generally affects growing ruminants?
Pyrrolizadine alkaloids
What zonal pattern of hepatic necrosis do aflatoxins induce in cats?
periportal
Megalocytes are a characteristic of which type of hepatotoxin?
Pyrrolizidine alkaloids
Midzonal necrosis is a characteristic of aflatoxicosis in which species?
Rabbit
Swine, dogs, and cattle with aflatoxicosis have what pattern of hepatic necrosis?
Centrilobular
Mixed function oxidase activates which toxins?
Pyrrolizidine alkaloids
CCl4
Which hepatotoxin is associated with heart failure?
Gossypol
What is the mechanism of Cu toxicity? Which species is particularly susceptible?
lipid peroxidation of cell membranes and Hgb denaturation; sheep are particularly susceptible
Cu toxicity is inversely proportional to what other nutrients?
Zn and Mo
What are some gross lesions associated with copper accumulation?
Intravascular hemolysis
hepatocellular necrosis (centrilobular to midzonal to massive)
icterus
What is the pathognomic lesion associated with Cu toxicity in sheep?
Gunmetal gray kidneys
What are all the drugs associated with acute liver disease in dogs?
You're a freak if you can rattle all of these off.
What is the mechanism of acetominophen toxicity in cats?
Idiosynchratic hepatoxicity; acetominophen depletes glutathione
What are causes of vena cava or portal vein thrombosis in the dog?
amyloidosis
Pancratitis
Portal hypertension
Steroids
In which species are portosystemic anastamoses reported?
Dog, cat, horse, calf
What are some physiologic sequelae to portosystemic anastomosis?
Decreased plasma protein
Hypoalbuminemia
Decreased amino acid utilization
Decreased production of bile salts
Decreased serum cholesterol and fatty acids
Abnormal liver function tests
How can a hepatic portal shunt result in hypoglycemia?
Increased insulin in circulation due to lack of insulin degradation by liver.
T or F:
The liver is the primary organ responsible for ammonia detoxification.
True! It metabolizes ammonia to urea
What is the most common cause of post-hepatic portal hypertension?
Passive congestion due to r-sided heart failure
What are some causes of intrahepatic portal hypertension?
Chronic hepatic disease
Increased collagen
Loss of normal lobular architecture
What are two major causes of prehepatic portal hypertension?
NEoplasia
Thrombosis
Choose chronic or acute passive hepatic congestion...
...nutmeg liver.
chronic
Choose chronic or acute passive hepatic congestion...
...bleeds freely when incised.
acute
Choose chronic or acute passive hepatic congestion...
...more pronounced lobular pattern
BOTH!
Choose chronic or acute passive hepatic congestion...
...atrophy of centrolobular hepatic plates
chronic
Milk spots in swine livers are caused by...
...parasite migration
How can a photosensitivity disease be acquired?
Via liver damage;
Ingesting preformed photodynamic agent
What are three general mechanisms of congenital or hereditary photosensitization?
(1) Defect in bilirubin metabolism causes retained phylloerythrin
(2) Decrease in heme synthesis in liver increases phylloerythrin concentration
(3) formation of abnormal porphyrin in erythrocytes
What is the fancy-ass term for "pink tooth"? What other clinical finding would be evident in these animals?
Osteohemochromatosis;
Urine turns red on exposure to light
What are the clinical signs of Theiler's disease? How can it be diagnosed?
Abrupt onset of blind staggers, icterus, and death; diagnosed at necropsy (dishrag liver w/centrilobular hepatic necrosis and inflammation)
What is the etiological cause of toxic hepatopathy of neonatal foals?
Dietary Fe inoculant (iron fumurate)
What is the most important histological finding in chronic active canine hepatitis?
piecemeal necrosis of limiting plate
What is the most important cause of chronic active canine hepatitis?
UNKNOWN!!!
Which species are prone to Hepatosis dietetica? What is the cause?
Young Swine; deficiency of Vit E or Se
Familial amyloidosis is seen in which species?
Shar-pei dogs
Abyssinian and siamese cats
How does hepatic amyloidosis present grossly?
Waxy, pale, NOT greasy, not as friable as hepatic lipidosis
Where can evidence of amyloidosis be seen in the liver?
Hepatic sinusoids (need fluorescent stain)
T or F:
Hepatic amyloidosis cannot be reversed.
Pretty much true, unless the underlying disease process can be cured
What is the most common type of amyloidosis? Which proteins are produced?
Secondary amyloidosis;
Liver produces Serum Amyloid Associated protein, precursor to Amyloid Associated fibrils
What heptatic lesion mimics hemangiosarcoma grossly?
Telangectasia
What two hepatic conditions do or may arise from a Vitamin E and/or Se deficiency?
Hepatosis dietetica (young swine)
Sawdust liver (young cattle)
What benign finding histologically mimics Pb poisoning inclusions in dogs?
Canine crystalloids
What is a unique hepatic response to injury?
Biliary hyperplasia!
What are the two kinds of cirrhosis? What are general causes of each?
Central cirrhosis (R-sided heart failure and passive congestion);
Cirrhosis with nodular regeneration (secondary to massive liver necrosis >10%)
Post necrotic scarring of the liver describes...
...cirrhosis
Which of the following are possible systemic sequelae to liver injury?

a) Bleeding abnormalities
b) Panhypoproteinemia
c) Localized icterus
d) hepatic encephalopathy
A and D;
you'd have hypoALBUMINemia and generalized icterus (no such thing as localized icterus)
What is the cause of prehepatic icterus?
erythrolysis
What is the cause of hepatic icterus?
hepatocyte injury
What is the cause of posthepatic icterus?
bile flow obstruction
T or F:
Nodular hepatic hyperplasia (hepatoma) is always benign.
True! It is a common change in older dogs.
T or F:
Nodular regeneration begins as proliferation from the portal regions.
True! This is where the limiting plate is...
T or F:
Hepatocellular carcinoma is not very common and is typically of little clinical significance.
False!
While it is uncommon, it is a pretty big deal!
How can hepatocellular carcinoma be differentiated from hepatic lymphoma?
Histo!
What is the major cause of death from animals with hepatic hemangiosarcoma?
Bleeding out;
Can also be from cardiac tamponade