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What are made in the liver by oxidation of cholesterol?
bile acids
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Bile acids can facilitate absorption of what?
lipid soluble vitamins (ADEK)
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What is it called when excess glucose following a meal, becomes glycogen?
glycogenesis
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What is glycogen as source of glucose between meals, is short term?
glycogenolysis
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What is glucose production when glycogen stores exhausted, is long term, and is important in herbivores?
gluconeogenesis
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What clotting factors does the liver NOT produce?
VIII
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What produces endogenous cholesterol?
hepatocytes
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What is used in the formation of cholic acids, portion of bile acids, used in the production of hormones (progesterone, estrogen, testosterone)?
cholesterol
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Cholesterol is precipitated in the stratum corneum, what does this do?
provides protection, prevents absorption of water-soluble compounds and prevents evaporation of water
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What does the liver store?
glycogen, vitamins A, D, B12
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What does failure to excrete bilirubin lead to?
icterus/jaundice
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What does failure to excrete nitrogenous wastes lead to?
hyperammoniemia which is toxic to the CNS and leads to neurologic disease.
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What are the symptoms of hepatic encephalopathy?
cortical dysfunction, altered mentation, circling, yawning (horses), and head pressing
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If the liver fails, this leads to phylloerythrin entering systemic blood, skin, which is activated by UV light, this leads to what?
tissue peroxidation and dermatitis, skin necrosis, photosensitization
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Failure to secrete/recirculate bile acids leads to what?
poor digestion of fat, diarrhea
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What are the clinical signs to hypoalbuminemia?
ventral/peripheral edema, ascites
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How will failure to produce clotting factors affect the patient?
prolonged extrinsic, prolonged intrinsic, potentiates bleeding diathesis, typically end stage clinical signs in horses
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What does failure to produce/store glycogen mean?
no glycogen reserves
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What does failure of gluconeogenic function lead to?
inability to provide glucose from non-CHO precursors
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What does failure of FA/ lipid metabolism lead to?
elevated triglycerides in blood, fatty liver syndrome.
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In UA what is indicative of liver failure in small animals?
dilute urine sg, ammonium biurate crystals, bilirubinuria (NOT in cats), no urobilinogen present
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What tests indicate hepatocellular injury?
ALT (dogs), SDH, AST
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What are tests that show liver function?
albumin, glucose, cholesterol, BUN, bilirubin
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Elevated bile acids are highly specific for liver disease, but are not specific for what?
type of liver disease
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What may elevated NH3+ in blood indicate?
reduced hepatic mass, failure of liver to produce urea, shunting of blood around the liver
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Does the degree of elevation of ammonia level correlate with clinical signs?
no
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What is ultrasound guided, useful to confirm diagnosis, useful to determine prognosis?
liver biopsy
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What are methods of airway protection?
nasal passages filter large particles, bronchial epithelium provides a mucociliary escalator, alveolar macrophages, important in pulmonary disease prevention
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What cells are responsible for surfactant production?
type II cells
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Horses are obligate nasal breathers, to increase oxygen delivery to the alveolus, they must dilate their what?
nares, nasal passages, and nasopharynx
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What is included in the extrathoracic airway?
nasal cavity, nasopharynx, larynx, trachea
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What is included in the intrathoracic airway?
trachea, bronchi, bronchioles, terminal bronchioles
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What can alter the amount of O2 delivered to the alveolus and pulmonary capillary?
airway disease, alveolar/pulmonary capillary disease, parenchymal disease, pleural disease, CNS disease
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What involves thickening of alveolar epithelium, capillary endothelium or interstitium, affects transport of O2/CO2 for gas exchange, diffusion impairment?
alveolar/capillary/interstitial disease
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What are the different types of pneumonia?
infectious, inflammatory, viral, fungal
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What are different ways in which pneumonia can be acquired?
hematogenous spread, aerosolized particles, foreign body
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Auscultation of the respiratory tract always includes what?
the trachea
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What determines the effective ability of respiratory gas exchange?
arterial blood gas
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What diagnostic test is very useful for pleural disease, visualization of pleura/superficial parenchymal disease, may assist in collection of pleural fluid for evaluation?
thoracic ultrasonography
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What is indicated in plerual disease, may guide antimicrobial therapy, auscult fluid line?
pleurocentesis/chest tube
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What is considered representative sample of both right and left lung?
transtracheal wash
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What samples fluid from localized region of lung, performed standing sedation in horses, GA in small animals, performed via endoscopy?
bronchoalveolar lavage
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What is indicated in poor performance/noise. Allows visualization of nasal passages, pharynx, larynx, trachea, performed standing in horses, GA in small animals?
endoscopy: URT
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Despite the cause, decreased oxygen delivery through alveolus into the pulmonary capillary results in one primary problem?
hypoxemia
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What is necessary for oxygen exchange?
breathing, 20% oxygen available, have ventilated alveoli, have lung capillaries, have a matching pair of alveolus/capillary, have a healthy lung
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