Hepatobiliary 1

Question 1

What are your 4 portals of entry into the liver?

Answer 1

Direct extension

Hematogenous spread

Retrograde Biliary Infection-ascending

Retrograde Pancreatic ductular infection-ascending from intestines through pancreatic duct

Question 2

Sublethal injury and degeneration results in?

Answer 2

autophagy of damaged organelles and accumulation of lipofuscin pigment

Question 3

Specific areas of degeneration and necrosis that are restricted to a particular portion of the hepatic lobule is considered?

Answer 3

Zonal Necrosis

Question 4

What kind of necrosis occurs with hypoxic injury?

Answer 4

Centrilobar hepatic necrosis-Zone 3

Question 5

Other than hypoxic injury, when else can Zone 3 become necrotic

Answer 5

hepatotoxicity

Question 6

Why is zone 3 most susceptible to hepatotoxicity?

Answer 6

Mixed function oxidases which are present in zone 3. They function in the metabolism of drugs and toxins-Cyt450

Question 7

If you have hemolytic dz what kind of hyperbilirubinemia would this cause?

Answer 7

Prehepatic

Question 8

What occurs with obstruction of the extrahepatic bile ducts?

Answer 8

Extrahepatic cholestasis

Question 9

What occurs with impairment of bile flow within the canaliculi

Answer 9

Intrahepatic cholestasis

Question 10

What parts of the liver can regenerate?

Answer 10

All

Question 11

What leads to the progressive loss of function due to loss of normal architecture and less efficient hepatic lobules with fibrosis and altered blood supply?

Answer 11

Chronic injury and regeneration leads to this

Question 12

What is an increase in the amount of collagen within the liver?

Answer 12

Hepatic fibrosis

Question 13

What cells produce collagen in the liver?

Answer 13

Stellate cells within the space of Disse

Question 14

What dz would cause biliary hyperplasia?

Answer 14

biliary inflammation, obstruction, and cholestasis

Also considered to be a non-specific response to a variety of liver insults

Question 15

What are 4 causes of end stage liver

Answer 15

Chronic hepatoxicity
chronic hepatitis/cholangiohepatitis
chronic biliary obstructive dz
chronic degenerative liver dz

Question 16

How much of the liver can be removed without significant impairment of function?

Answer 16

75%

Question 17

What are some consequences of hepatic failure?

Answer 17

Hyperammonemia

Icterus/Jaundice

Metabolic disturbances

Vascular and hemodynamic alterations

Cutaneous Manifestations

Immunologic manifestations

Coagulation abnormalilties

Hypoalbuminemia and ascites

Question 18

4 congenital abnormalities

Answer 18

Biliary Cysts

Ductal plate malformations

Portosystemic shunts

Port vein hypoplasia

Question 19

What spp of animals is polycystic dz reported in?

Answer 19

Dog, cat, goat, sheep

Question 20

What are predisposed breed to polycystic dz?

Answer 20

Persian Cats

Bull terriers

West Highlands

Cairn Terriers

Question 21

Histologically characterized by diffuse periportal to bridging fibrosis with numerous small, often-irregular bile ducts and reduction in the number of portal vein branches, is what dz?

Answer 21

Ductal plate malformations

Question 22

What dz is often progressive with portal hypertension leading to ascites, icterus, and end stage liver dz?

What breed is predisposed?

Answer 22

Congenital hepatic fibrosis

YOUNG DOGs—Boxers

Question 23

What dz results in an embolic pattern which is randomly multifocal

Answer 23

Acute Hepatitis

Question 24

Acute hepatitis is characterized by?

Answer 24

Inflammation

Hepatocellular necrosis

Apoptosis

Question 25

What is characterized by fibrosis, mononuclear inflammation cells, hepatocellular loss, nodular regeneration, and structural remodeling of the hepatic lobule and vasculature

Answer 25

Chronic hepatitis

Question 26

What is characterized by mild mononuclear inflammatory infiltrates in the portal tracts, less commonly around central veins

Answer 26

Nonspecific reactive hepatitis

Question 27

What is a diffuse process in th eliver that is a response to sytemic inflammation

Answer 27

Nonspecific reactive hepatitis

Question 28

What is nonspecific reactive hepatitis most commonly stemming from?

Answer 28

GI dz

Question 29

What values in blood work would you see a mild elevation in, for nonspecific reactive hepatitis?

Answer 29

ALT ALP

Question 30

Chronic cholangitis may lead to?

Answer 30

Cholestasis and posthepatic hyperbilirubinemia

Question 31

What are your two kinds of cholangitis?

Answer 31

Neutrophillic Lymphocytic

Question 32

What is a chronic, immune-mediated biliary dz of CATS

Answer 32

Lymphocytic

Question 33

Inflammation of the biliary ducts and extension of inflammation into the surround liver parenchyma is called?

Answer 33

Cholangiohepatitis

Question 34

What causes cholangeiohepatitis?

Answer 34

Extension of bacterial cholangitis into the surrounding into periportal hepatic parenchyma

Question 35

Why would you see a greater elevation of serum ALT in cholangiohepatitis?

Answer 35

There is damage to more hepatocytes