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Liver

Terms in this set (81)

What are two ways cholestasis can occur?
Intrahepatic and extrahepatic
What is a general prehepatic cause of hyperbilirubinemia?
Excess production of bilirubin (hemolysis)
What is a general hepatic cause of hyperbilirubinemia?
Impaired bilirubin uptake, conjugation, and secretion by hepatocytes
What is a general post-hepatic cause of hyperbilirubinemia?
Obstruction of bile outflow
A goat with copper toxicity may present with what cause for hyperbilirubinemia?
Pre-hepatic due to hemolysis
A dog with IMHA may present with what cause for hyperbilirubinemia?
Pre-hepatic due to hemolysis
Acute toxic hepatopathy is a ______ cause of hyperbilirubinemia
hepatic
A dog with copper associated hepatopathy is a _________ cause of hyperbilirubinemia
hepatic
Cholelithiasis is a form of ________ hyperbilirubinemia
post-hepatic
Icterus = hepatobiliary disease
NO!
Hepatic dysfunction = icterus
NO!
What is photosensitization?
Herbivores with cholestasis accumulate phytoporphyrins in the tissue
What is a common clinical sign of patients with hepatic encephalopathy?
Forebrain signs (head pressing)
What are reversible changes that can seen in the liver in response to injury?
Cytoplasmic vacuolation and hepatocellular atrophy
Examples of cytoplasmic vacuolation
Example of hepatocellular atrophy
What are the four types of irreversible changes seen with liver injury?
Single cell necrosis
Coagulative necrosis
Liquefactive/lytic necrosis
Caseous necrosis
Patterns of necrosis in the liver
What site in the liver is inflammation most commonly seen?
Portal tracts
What is non-specific reactive hepatopathy?
Secondary to systemic disease
Causes mild inflammation without death/fibrosis
Mild ^ in ALT/ALP
What are the two sequelae to necrosis and inflammation?
Regeneration and fibrosis
How much of the liver can be removed and then regenerated?
2/3
What can occur with repetitive injury/disruption of the normal liver extracellular matrix?
Nodular regeneration
What CS are commonly seen with focal hepatic lesions?
Usually none!
Where does fibrosis of the liver have the most impact on it's function? Why?
Perisinusoidal fibrosis
Reduced exposure of the hepatocytes to plasma
What can fibrosis of the liver lead to?
Portal hypertension and potentially ascites
Ductular reaction is hyperplasia of what?
The bile duct
What is cirrhosis? Gross appearance?
End stage liver disease.
Nodular regen, NO normal lobular architecture
What is a postmortem change and an incidental finding of the liver?
Post mortem - autolysis
Incidental - pseudomelanosis
Example of idiopathic capsular fibrosis in a horse
Examples of diaphragmatic hernias
Examples of liver ruptures
Examples of liver lobe torsion
What are the two main categories of vascular liver shunts?
Congenital (intra/extrahepatic)
Acquired (secondary to liver disease)
Examples of intra and extra hepatic shunts
Example of a congenital portosystemic shunt in a dog
Examples of intra and extra hepatic shunts
Portal vein hypoplasia is commonly seen in what species? What are the CS?
Dogs (yorkies/cairns) and cats
Portal hypertension and ascites
Example of an acquired portosystemic shunt in a dog
What can vascular shunts in the liver lead to in the bladder?
Accumulation of ammonium biurate crystals
Anemia can lead to what type of necrosis in the liver?
Centrilobular
Telangiectasis in the liver is indicative of what? What species?
Incidental finding, non pathologic.
Cattle and cats
How can TAG accumulate in the liver?
^ entry/synthesis of FA
v oxidation of FA
v synthesis/excretion of lipoprotein
v synthesis of phospholipid
What can right sided heart failure cause in the liver?
Chronic passive congestion
What is the pathogenesis of steroid hepatopathy?
Glycogen accumulation
What are common causes of hepatic lipidosis?
Starvation, hyperlipidemia, preg/lactation, diabetes mellitus, hypoxia, and toxins
What dietary aspect can cause liver abscesses in cattle?
Grain overload
Examples of hepatic lipidosis
What is hepatosis dietetica of swine?
Massive hepatic necrosis caused by vit E/selenium def
Examples of herpes lesions in the liver of a horse and dog
CAV1 can cause zonal centrilolobular necrosis in what age of dogs?
Young dogs
FIP can cause fibrinous or pyogranulomatous lesions where in the liver?
On the surface
What type of lesions can be seen on the liver of septic animals?
Multifocal/random necrosis
Leptospirosis can cause what type of damage to the liver?
Hepatocyte dissociation
What is the pathogenesis of black disease/redwater?
Fluke migration causes focal necrosis/hypoxia —> Clostridial spores germinate in the newly anaerobic conditions —> exotoxins cause necrosis/hemolysis
What is the causative agent of black disease?
Clostridium novyi type B
What is the causative agent of redwater?
Clostridium haemolyticum
What are parasitic diseases seen in the liver?
Histomoniasis in poultry/turkeys
Toxoplasmosis
What two fungi can infect the liver?
Histo/Aspergillus
What trematodes cause damage to the liver?
Fasciola hepatica
Fascioloides magna
Heterobilharzia americana
Milk spots in the liver are typically an incidental finding caused by what?
Larval nematodes migrating through the liver
What species is lymphocytic/plasmacytic cholangiohepatitis most commonly seen in? Cause?
Cats
Unknown, but response to immunosuppressants
What type of damage does heterobilharzia cause in the liver of a dog/horse
Granulomatous foci
What is triaditis?
concurrent inflammation of the pancreas, liver, and small intestine
What is the most important prognostic indicator of chronic hepatitis in dogs?
Fibrosis
What are the causes of chronic hepatitis in dogs?
Usually idiopathic
Copper related, infectious, or autoimmune
What is lobular dissecting hepatitis?
Variant of chronic hepatitis seen in young dogs, carries a poor prognosis and can commonly see portal hypertension, icterus, and ascites
Blue-green algae toxicosis causes what type of damage to the liver?
Disrupts cytoskeleton
Acute
What are the gross lesions seen in acute toxicosis of the liver?
Swelling, enhanced lobular pattern, and gall bladder edema
What are the gross lesions seen in chronic toxicosis of the liver?
Small, firm, and nodular liver
Pyrrolizidine alkaloid toxicosis can cause what type of damage to the liver?
DNA damage
Acute or chronic hepatopathy
Aflatoxicosis causes what type of damage to the liver?
Inhibits RNA/protein synthesis
Acute or chronic
Mushroom toxicosis causes what type of damage to the liver?
Inhibits RNA synthesis
Acute
Drug toxicosis to the liver causes what type of damage?
Acute
Sago palm toxicosis causes what type of damage to the liver?
DNA damage
Acute or chronic
High doses of xylitol can cause what type of damage to the liver?
Acute
What are four causes of uniformly enlarged pale livers?
Lipidosis, glycogen accumulation, amyloidosis, and lymphoma/leukemia
What is a common lesion seen in old dogs in the liver?
Benign hepatocellular proliferations
Hepatocellular carinomas are (common/rare) and metastasis is (common/rare)
rare
rare
Benign biliary proliferations are most common in what species?
Older cats
Examples of biliary carcinomas
Often metastasizes
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