Liver Review Flashcards
A low protein diet should not be fed to dogs with liver disease unless the dog has:
a. Liver failure
b. Ascites
c. Muscle wasting
d. Hepatic encephalopathy
D
The most common hepatic neoplasia in dogs is
a. Hemangiosarcoma
b. Lymphoma
c. Hepatocellular adenocarcinoma
d. Mast cell neoplasia
C
A 5-year-old, female, spayed, domestic shorthair presents with the complaint of
vomiting, poor appetite, and lethargy for 4 days. On physical examination, you find
icteric mucus membranes and fever. A CBC and serum Chemistry reveal the
abnormalities in the table below. Based on the appropriate differential diagnoses for
this patient, which one of the following is most indicated in this patient?
a. Denamarin
b. Clavamox
c. Ursodiol
d. Feeding tube
B
A dog presents for acute liver injury. The dog ingested a toxic dose of acetaminophen.
Which of the following treatments is most indicated in this patient?
a. Vitamin K
b. N-Acetylcysteine
c. Ursodiol
d. Vitamin E
B
A 10-year-old, male, neutered Shetland Sheepdog presents with acute vomiting. On
physical examination the patient is icteric, has abdominal pain, and a fever. CBC shows
a leukocytosis with a left shift. Chemistry reveals mild hyperbilirubinemia, severely
increased serum ALP enzyme activity, and moderately increased serum ALT enzyme
activity. The only medications the dog has been administered is a 5-day course of
carprofen 2 months ago for forelimb lameness that resolved. Which one of the following
should be high on your differential list for this patient?
a. Gallbladder mucocele
b. Copper hepatopathy
c. Drug-associated hepatitis
d. Reactive hepatitis
A
Which one of the following treatments are controversial when treating acute pancreatitis
in the dog?
a. Antibiotics
b. Early Enteral nutrition
c. Analgesia
d. Antiemetics
A
A 3-year-old, male, neutered, Miniature Schnauzer presents with signs of acute
vomiting. On physical examination, the patient has marked abdominal pain, icteric
mucous membranes, and appears dehydrated. You perform an abdominal fast scan
and note abdominal fluid. You perform an abdominocentesis. The fluid contains
numerous degenerate and non-degenerate neutrophils but no bacteria. Which one of
the following is the most likely diagnosis?
a. Septic peritonitis
b. Pancreatitis
c. Hepatitis
d. Gallbladder mucocele
B
A 2-year-old, female spayed, mixed-breed dog presents to you for not eating well,
lethargy, weight loss, and appearing yellow on her belly per the owner. Physical
examination reveals a depressed mentation, thin body condition of 3/9, and icteric
mucus membranes. Vital parameters are normal. A CBC and Chemistry is performed as
shown below. What is the most likely cause of icterus? Assume any values that you do
not have are normal.
a. Pre-hepatic disease
b. Hepatic disease
c. Post-hepatic disease
d. Sepsis causing cholestasis
B
A dog presents for yellow discoloration, anorexia, and weakness. Physical examination
reveals tachycardia, pale and icteric mucus membranes, weak pulses, and tachypnea.
Which test will likely reveal the cause of icterus in this patient?
a. Biochemistry
b. Liver biopsy
c. Abdominal ultrasound
d. Complete blood count
D
You perform a SNAP CPL test on blood from a dog that has acute vomiting and
lethargy. The result is positive. Which one of the following statements is correct?
a. The dog has acute pancreatitis.
b. The dog could have acute pancreatitis but this could also be a false positive.
c. The dog has chronic pancreatitis.
d. This test is not useful to rule in or out pancreatitis in this dog.
B
A 5-year-old, female spayed, Golden Retriever presents to you for an acute history of
vomiting, diarrhea and anorexia. Physical examination reveals 5% dehydration and
cranial abdominal pain. Significant laboratory abnormalities are: Cholesterol 800 mg/dl
(129-332 mg/dL), ALP of 800 U/L (8-70), ALT 425 U/L (16-75), GGT 20 (1-5), T.
Bilirubin 2.3 mg/dL (0.2-0.4). Abdominal ultrasound reveals hypoechoic pancreas and
hyperechoic mesentery with extrahepatic biliary obstruction. What is the best initial
treatment plan for this dog in addition to IV fluids and Cerenia?
a. Ursodiol and buprenorphine
b. Buprenorphine and early enteral nutrition
c. Buprenorphine and nothing per os for 72 hours
d. Rimadyl and omeprazole
B
A 7-year-old, male castrated, Labrador was found to have increased liver enzymes on
bloodwork 4 weeks ago prior to a dental procedure. He presents to you 2 months later
for a recheck exam. He is not showing any clinical signs and his physical examination is
unremarkable. Which one of the following statements is correct? Assume any values
that you do not have are normal.
a. If an abdominal ultrasound is unremarkable, no further tests are indicated.
b. An ACTH stim is necessary because the dog likely has hyperadrenocorticism.
c. A liver biopsy is indicated to determine the underlying cause of persistent liver
enzyme elevation.
d. This breed is not predisposed to liver disease; therefore, benign neglect is
appropriate
C
What test can differentiate between congenital extrahepatic shunts and portal vein
hypoplasia (microvascular dysplasia)?
a. Liver biopsy
b. Protein C
c. Bile acids
d. Liver aspirate
B
Which of the following scenarios is an indication to perform a liver biopsy?
a. A 12 year old cat with vomiting, weight loss, good appetite with a new finding of
mildly increased ALT activity
b. An 8 year old dog receiving prednisone with a history of chronically elevated ALP
c. Asymptomatic 12 year old dog with a new finding of mildly elevated ALP
d. Asymptomatic 8 year old dog with a chronic history of progressively increased ALT
and ALP
D
Which of the following is most important when treating a cat with hepatic lipidosis?
a. Appetite stimulants
b. B12 and carnitine
c. Nutrition via feeding tube placement
d. Antiemetics
C
