What are the 5 functions of the liver?
*Stressed in class*
The ________ delivers oxygenated blood into sinusoids of the liver.
The __________ delivers deoxygenated, nutrient-rich blood from GIT to sinusoids of the liver.
Hepatic artery (25% of total blood)
Hepatic Portal vein (75% of total blood)
What is responsible for the absorption and digestion of fat and fat soluble vitamins (A, E, D, K)?
What happens to cholesterol blood levels when the bile duct is obstructed?
(Bile is the major elimination route)
T/F: Anything that affects the blood flow from the hepatic artery or the hepatic portal vein (anemia, shock, heart failure, etc), can affect liver enzyme values.
Which zone of the liver is most prone to hepatotoxins? Which is most prone to hypoxia?
Zone 1 (Area of portal triads)
Zone 3 (Area around central vein)
Where in the liver is plasma filtered?
Space of Disse (between hepatocytes and endothelial cells)
Intrahepatic ducts -> ______ bile duct -> cystic duct -> ________
What cells located in sinusoids scavange bacteria and other foreign material in the liver?
At what serum bilirubin level is bilirubinemia clinically detectable?
T/F: Bilirubinuria is always abnormal in the cat.
*Stressed in class*
Severe pancreatitis causing bile duct obstruction is what type of icterus (preheptatic, posthepatic, hepatic)?
Acute cholangitis is what type of icterus (preheptatic, posthepatic, hepatic)?
What type of icterus (preheptatic, posthepatic, hepatic) is characterized by increased production of bilirubin with cholestasis? What are your main rule outs?
R/O: Parasites, agglutination (Make blood smear), IMHA (Do Coomb's test), FeLV
PCV usually <20%, regenerative hemolytic anemia, enzymes WNL or mildly elevated
What type of icterus (preheptatic, posthepatic, hepatic) is defined as impaired hepatic uptake, conjugation or excretion of bilirubin resulting in severe intrahepatic cholestasis? What are your main rule-outs?
R/O: Lipidosis, inflammatory hepatopathyies, extrahepatic infections (Toxoplasia, FIP), acetaminophen (toxins)
An increase of ____ times the upper reference range indicates mild elevation, it is moderate if it is ____ times the upper reference range, and marked if ____ times the upper reference range.
Match liver enzyme to liver site:
Hepatocyte membrane integrity
Hepatocyte or biliary epithelial necrosis
Induction phenomenon (dogs)
ALT, AST, ALP, GGT
Hepatocyte membrane integrity and Hepatocyte or biliary epithelial necrosis: ALT, AST
Cholestasis and Induction phenomenon (dog): ALP, GGT
What does ALP do when you administer steroids? What other drug does this to liver enzymes?
What crystals can occur due to any cause of decreased hepatic function, including shunts and organ failure?
Ammonium biurate urinary crystals
What endocrine diseases cause elevated liver enzymes?
Hypoglycemia only occurs after approximately ___% of hepatic function is lost. It is the result of reduction in hepatic ______ stores, gluconeogenesis, and clearance of _____.
Bile acids are useful to diagnose what in dogs and cats?
PSS - dogs and cats
Value limited for screening of most other hepatobiliary diseases
*Stressed on slides/in lecture*
What diagnostic modality has the highest correlation with actual liver weight in dogs (include patient positioning)?
Right lateral abdominal rads
*Starred on slides*
What can be used to determine liver size as well as for diagnosing hepatic mass lesins and PSS?
*Starred on slides*
What is the best way to biospy a liver (according to Dr. Settles)?
What are the 3 most common causes of hepatic infections?
T/F: The biliary system is predominatly affected in cats while the parenchyma of the liver is the primary target of liver disease in dogs.
T/F: Substantial weight loss is a predisposing factor for hepatic lipidosis in cats.
True (>25% of body weight)
Which liver enzyme is usually the highest in cats with hepatic lipidosis?
ALP (more than GGT or ALT)
Which 2 cell types are abundant in the periportal area with inflammatory liver disease?