Hepatobiliary 1 Flashcards

1
Q

How is the blood supply entering the liver arranged?

A

The liver is supplied by the hepatic artery and hepatic portal vein

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2
Q

The most specific blood marker for indicating hepatocellular damage in dogs and cats is

A

ALT

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3
Q

You are presented with a dog with notable jaundice on his mucous membranes and sclera. What is the most appropriate first test to do in order to progress your case workup?

A

PCV- to rule in or out pre-hepatic jaundice

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4
Q

where does the hepatic portal vein come from

A

from the gastrointestinal tract- can contain infectious agents and toxic substances

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5
Q

List 5 clinical signs of liver disease

A

lethargy
anorexia
weight loss
PUPD
V+/D+

Very non-specific

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6
Q

what is portal hypotension

A

increased intrahepatic resistance to portal blood flow
- so blood backs up basically if there is inflammation

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7
Q

Describe what you can see with hepatic encephalopathy

A

Waxing and waning; non-localising on neuro exam
Hyperactive &/or depressed/dull/clumsy
Circling, pacing, central blindness
Salivation, especially cats
Seizures —> coma

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8
Q

T/F it is always abnormal to see bilirubin in cat urine

A

True

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9
Q

where should liver normally sit on radiograph

A

Liver should sit behind the last rib

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10
Q

which is US good for looking for in the liver

A

mass lesion
nodular disease
significant change in echotexure

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11
Q

describe what you normally see of the liver on US

A

moderately and uniformly echoic- less echoic than spleen (“kidney, liver, spleen”)
coarsely granular parenchyma
uniform texture

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12
Q

List 8 possible causes of secondary hepatopathies

A

GI disease
Pancreatitis
endocrine disease- e.g. cushings
RHF
hypoxia
toxaemia
sepsis/ bacteraemia
drug induced in dogs

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13
Q

List 5 broad causes of acute liver disease in dogs

A

toxic/drug induced
infectious
sepsis/endotoxaemia
congenital causes
metabolic

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14
Q

describe how to sample liver

A

ultrasound guided FNA
surgical biopsy

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15
Q

Describe the 5 main aspects of managing liver disease

A

supportive- very important
treat the cause
treat hepatic encephalopathy
manage coagulopathy as necessary
liver support

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16
Q

what fluid do you need to avoid when treating liver disease

A

LRS- hartmanns
because it contains lactate and liver can’t metabolise lactate

17
Q

List 2 negative prognostic factors of liver disease

A

ascites and splenomegaly- suggests portal hypertension has developed

18
Q

how does liver disease cause hepatic encephalopathy

A

ammonia and other toxins from the GIT aren’t detoxified and they affect the brain and cause neurological signs