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68 Cards in this Set
- Front
- Back
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What percentage of cardiac output does the liver receive?
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25%
67% portal vein 33% hepatic artery |
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What percentage of total body weight is the liver in carnivores, omnivores and herbivores?
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Carnivores 3-4%
Omnivores 2% Herbivores 1% |
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What are composes the portal triad?
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Bile ductule
branches of the portal vein Hepatic artery Nerves and lymphatics |
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How much of the liver paranchyma must be injured to see clinical signs?
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75% of the liver
Liver enzymes such as AST, ALT LDH are used as biomarkers of liver injury |
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What are the three portals of entry of injurious agents to the liver?
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Hematogenous
Biliary or pancreatic ducts Direct trauma to the liver |
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What are the four possible causes of liver atrophy?
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increaed catabolism
decreased blood flow decreased bile flow pressure |
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Does the liver have regenerative capacity? How much? What cells differentiate into hepatocytes or bile duct epithelium?
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yes
60% in a week oval/stem cells |
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What describes hepatocellular nodular proliferation, fibrosis and impaired blood flow?
What stage of liver disease do you seen this? |
Cirrhosis of the liver
end stage liver failure |
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What do you see increase with a liver with fibrosis?
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increased connective tissue
proliferation of Ito or stellate cells |
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What things are necessary for liver regeneration?
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intact reticular framework
good blood supply patent bile ducts |
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What are the general responses of liver to injury?
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Regeneration of parenchyma
Replacements by fibrosis Biliary hyperplasia |
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What are the three type of liver necrosis?
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random
zonal massive |
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What are the three types of random necrosis?
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single cell, multifocal or piecemeal
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What does massive hepatic necrosis mean? What is one of the most common causes?
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the entire lobe is effected
Hepatosis dietetica of swine Vit E/selenium deficiency |
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What is the cause of biliary cysts?
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abnormal development of bile ductules
can be an incidental finding but polycystic liver disease can be fatal |
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What does right sided heart failure show grossly in the liver?
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nutmeg liver appearance
due to chronic passive congestion located in the central veins |
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How are acquired shunts caused?
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chronic portal hypertension
see tortuous veins |
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What are substances that can accumulate in the liver?
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Lipid
Glycogen Amyloid Copper |
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What is hepatic vein thrombosis characterized by?
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hepatomegaly, acsites and abdominal pain
affects the inferior vena cava thrombosis is caused by slowing of blood flow |
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What is a portosystemic shunt look like grossly and on histology?
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grossly small
histologically small hepatocytes, small portal veins, multiple and prominent arterioles |
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Does telanglectasis have clinical significance? Who is it commonly seen in? What will the liver look like?
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No
Cattle and old cats Sinusoids dilated and filled with blood |
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What are mechanisms of hepatic lipidosis?
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1) Excessive entry of FA into liver
2) Decreased oxidation of FA b/c of abnormal hepatocyte function 3) Increased esterification of FA 4) Decreased apoprotein synthesis 5) Impaired secretion from liver |
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What does a liver look like grossly with hepatic lipidosis?
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Enlarged, heavy, uniformly pale, greasy, tissue will float
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What conditions can cause fatty liver?
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late pregnancy, heavy lactation, dietary excess
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Is hepatic lipidosis reversible? What can it lead to? Are livers with hepatic lipidosis more susceptible to toxic insults and trauma?
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Yes
Hepatic necrosis, fatty cysts, fat embolism, liver hemorrhage Yes |
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When does ketosis occur? What two instances specifically?
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Following excessive fat metabolism
Lactation in cattle, or ewes carrying twins |
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What bovid is affected by fatty liver syndrome?
Pathogenesis? |
Obese dairy cattle a few days after parturition who go off feed
Adipose gets mobilized -> increase influx of FA to liver -> dec export out |
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What endocrine disorders can causes fatty liver?
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Diabetes mellitus
hypothyroidism |
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What is the accumulation of fat within cells arising as a consequence of cellular injury? What causes the accumulation?
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Fatty degeneration
Decrease export of lipoproteins and oxidation of FA due to injured hepatocytes |
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In what three conditions does glycogen accumulation occur?
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Diabetes mellitus, hyperadrenocorticism, glycogen storage diseases
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What is the ddx for steroid induced hepatopathy? How do you differentiate? Where is the liver swollen particularly in this disorder
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Hepatic lipidosis
PAS stain for glycogen Hepatocytes are swollen in the mid-zonal areas |
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Why does hepatic amyloidosis usually occur
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Prolonged antigenic stimulation such as a chronic infection or repeated inoculation of an antigen
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Where does amyloid usually accumulate in the liver? What does this result in? What stain is used to detect amyloid?
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Space of Disse
Atrophy of the hepatic cords Congo Red |
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What should you look for as a toxic cause of hepatitis?
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copper
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What are the three ways you can classify hepatitis?
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Time, location, etiology
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What is a typical presentation for herpes viral hepatitis? What are four agents that cause this? Do they have Inclusion bodies?
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Multifocal necrosis
IBR, EHV-1, CHV-1, pseudorabies Intranuclear IBs |
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Is infectious canine hepatitis very contagious? What virus is it caused by?
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Yes
Canine adenovirus-1 |
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What will the liver look like with ICH? What are two other signs outside the liver?
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Enlarged, congested, friable, petechia, and paintbrush hemorrhages
Gall bladder edema & corneal edema "blue eye" |
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What do you see on histo with ICH? Is there a lot of inflammation?
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Periacinar necrosis, baso INIBs
No |
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What are the two presentations of bacterial infections of the liver? What is the usual pattern?
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Abscess or granulomas
Multifocal necrotizing (a little larger than with viral) |
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Bacillary hemoglobinuria is caused by what bacteria? Who is this seen in? What causes the anaerobic environment for the bacteria? Lesion?
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Clostridium haemolyticum
Cattle & sheep Migration of the liver fluke A single large lesion of necrosis |
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What is black disease caused by? Who is it seen in?
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Clostridium novyi
Sheep |
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What bacteria causes Tyzzer's dz? Who is it typically seen in? What kind of lesion does it cause? How do you diagnose it?
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Clostridium piliforme
Young or immunocompromised Multifocal necrosis and colitis See large bundles of long bacilli |
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What type of infection route causes abscesses? Who is it commonly seen in? What lobe is more frequently effected?
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Hematogenous
Cattle Left lobe |
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Can liver abscesses be incidental? What vessel can they break into? What would this cause?
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Yes
Vena cava or hepatic vein Pulmonary abscess or shock |
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What is the most common general cause of granulomatous hepatitis?
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Fungal infections ex. TB
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What causes "milk spots" in pig livers? What are these spots?
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Ascaris suum
Multiple areas of fibrosis |
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Where do Fasciola hepatica adults reside? Fascioloids magna?
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Bile duct
Cyst on the liver parenchyma |
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What cestode forms hydatid cysts in the liver? What is this important to differentiate this from?
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Ecchinoccus granulosus
Congenital cysts |
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What protozoal agent causes coccidiosis in rabbits?
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Eimeria stiedea
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T/F
Bioactivation of a toxin can be more toxic than the original agent. |
True
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What are the four general hepatotoxic agents?
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1) Plants
2) Mycotoxins 3) Chemicals 4) Therapeutic agents |
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What is the main preformed toxin of blue-green algae? What kind of pattern does it cause?
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Microcystin
Centrilobular to massive hepatic necrosis |
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What are the three histological signs of pyrrolizidine alkaloid toxicity?
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1) Portal fibrosis
2) Biliary hyperplasia 3) Megalocytosis |
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Who is alsike clover toxicity most common in? How are the lesions different from pyrrolizidine alkaloid hepatotoxicity?
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Horses
NO megalocytosis |
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What type of toxins are ingested in moldy feed?
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Alfatoxins
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What type of liver problem can cause hepatic encephalopathy? What toxic substance is believed to cause the CNS signs?
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Chronic or acute liver failure, portosystemic shunts
Ammonia |
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What is the abnormal accumulation of bile in the liver, bile ducts or GB? What is a visible sign of this dz? What substance is this due to?
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Cholestasis
Icterus Bilirubin |
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What do you see microscopically with cholestasis?
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Bile pigment in canaliculi and hepatocytes
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Who is hepatocellular nodular hyperplasia commonly seen in?
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Older dogs
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Are most malignant neoplasias of the liver primary or metastatic? Where do primary tumors arise from?
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Metastatic
Hepatocytes, bile ducts or mesenchymal tissue |
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What is a benign neoplasia of hepatocytes called? Who is this seen in?
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Hepatocellular adenoma
Young ruminants |
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Who are hepatocellular carcinomas most seen in?
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Dogs
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What do metastatic lesions look like in the liver?
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Multifocal nodules with the color and consistancy of the primary tumor site
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What is the function of the gall bladder? What can GB distention be caused by?
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Stores, concentrates and releases bile
Fasting |
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What are gall stones composed of? Are GB neoplasias common?
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Cholesterol, bile pigments, salts of bile acids, calcium salts and a proteinaceous matrix
No |
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What are the causes of biliary obstruction? What are two causes of GB edema?
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Cholangitis, parasites or fibrosis, cholelithiasis
Rt. sided heart failure and ICH |
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Can cholecystitis be acute or chronic? What causes fibrinous? Hemorrhagic cholecystitis?
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Yes
Acute salmonellosis and yersiniosis Salmonellosis and arsenic toxicity |
