Hepatobiliary 2

Question 1

4 Circulatory Disorders?

Answer 1

Passive congestion

Congenital portosystemic shunt

Congenital portal vein hypoplasia

Portal hypertension with acquired vascular shunts

Question 2

What produces elevated pressure in the caudal vena cava that extends to the hepatic veins and its tributaries

Answer 2

Right sided heart failure

Question 3

High pressure in the hepatic vein leads to ______ of sinusoids

Answer 3

Centrilobar congestion

Question 4

Chronic hypoxi injury also leads to??

Answer 4

Steatosis

Question 5

All of the combined changes of passive congestion results in an accentuated lobular pattern which is termed?

Answer 5

Enhanced reticular pattern

Nutmeg Liver

Question 6

Passive congestion results in the liver grossly looking like?

Answer 6

Enlarged, with rounded edges

Question 7

What is an abnormal vascular structure that allows portal blood to bypass the liver and drain directly into the systemic circulation

Answer 7

PSS

Question 8

What CS do animals have with cPSS

Answer 8

stunted growth

may develop signs of hepatic encephalopathy

Question 9

Grossly, how does the liver look with CPSS

Answer 9

microhepatica

Question 10

What crystals do PSS patients have? and why?

Answer 10

Ammonium Biurates

They have abnormal ammonia metabolism

Question 11

What 6 things might you see with a patient that has a PSS

Answer 11

hyperammonemia

Decreased UN

Increased fasting and postprandial bile acids

Hypocholesterolemia

Hypoalbuminemia

Possible mildly elevated ALT

Question 12

What are your 2 types of PSS

Answer 12

Intrahepatic

Extrahepatic

Question 13

What are the differences between intra/extra hepatic shunts?

Answer 13

Intra: failure of closure of the ductus venosus, large breeds

Extra: Portal vein to caudal vena cava anastomosis OR to azygous vein.. Small breeds

Question 14

Whats another condition where animals typically have microhepatica and ascites and are indistinguisable from PSS?

What breeds has suspected inheritance?

Answer 14

Congenital Portal vein HypOplasia

Small breeds:
Yorkies, Maltese, Cairn terriers, Tibetan spaniels, Shih-tzues, Havanese

small breeds for small veins

Question 15

Most causes of portal hypertension are?

Answer 15

Intrahepatic: Fibrosis, hepatocellular swelling, regeneration

Question 16

What can lead to ascites and development of acquired portosystemic shunts?

Answer 16

Portal Hypertension

Question 17

When does lipidosis occur?

Answer 17

When hepatocyte triglyceride accumulation exceeds the rate of lipoprotein release

Question 18

When can hepatocellular lipidosis occur? 5

Answer 18

Excessive dietary intake of fats/carbs

Increased mobilization of body fat-DM, Starvation, etc

Hypoxia or mitochondrial damage

Increased glucose and insulin

Impaired secretion of lipoprotein from the liver due to secretory defects produced by hepatotoxins or drugs

Question 19

What other condition can cause a nutmeg liver?

Answer 19

Fatty Liver

Question 20

What condition is specific to dogs characterized by hepatocellular glycogen accumulation secondary to excess glucocorticoids?

Answer 20

Canine-steroid induced hepatopathy

Question 21

What causes the liver, grossly, to look enlarged with rounded edges, firable, and pale?

Answer 21

Hepatic amyloidosis

Question 22

Where does the amyloid deposit within the liver?

Answer 22

Space of Disse

Portal tracts

w/i and around blood vessels

Question 23

What chemical leads to the production of reactive oxygen and causes oxidative injury to mitochondria and cellular membranes?

Answer 23

Copper

Question 24

What spp is this common in? and what exacerbates is?

Answer 24

Sheep

Low dietary molybdenum and sulfur

Question 25

Chronic copper accumulation in the liver precedes rapid release of copper into blood resulting in???? What can trigger this?

Answer 25

Hemolysis Stress or illness

Question 26

Can dogs and cats get copper associated haptopathy, and if they can, what breeds?

Answer 26

Cats-no Dogs-Yes. Bedlington terriers, Labs.

Question 27

Hemochromatosis is also called?

Answer 27

Iron storage dz

Question 28

In what spp is iron storage dz inherited?

Answer 28

``` Ppl Mynah birds, Toucans Salers cattle Horses ```

Question 29

What dye do you use to see iron?

Answer 29

Prussian blue

Question 30

When will bile acumulate in the liver? What does it cause?

Answer 30

Cholestatic dz Hepatocellular injury

Question 31

Lysosomal Storage dz leads to? What stage of life do you see this in?

Answer 31

Accumulation of substances w/i lysosomes which results in cytoplasmic swelling and vacuolization of hepatocytes, macrophages, neurons, and other cells types Young animals