Clin Path- Liver Evaluation.txt
Card Set Information
Clin Path- Liver Evaluation.txt
clin path liver
Liver disease can occur from... (5)
trauma, hypoxia, toxicity, neoplasia, or obstruction of the bile duct
4 broad categories of diseases of the liver.
hepatocellular damage, decreased hepatic functional mass, cholestasis/ enzyme induction, alterations in portal blood flow
Generally, __________ of hepatic function is necessary before clinical signs of liver failure are observed.
a loss of 70%
We detect the activity of leakage enzymes by providing a specific _________ for _________ and then measuring the known _______.
substrate; enzyme interaction; by-product
Enzymes located in the ________ require more cellular damage for release than those located in the ________.
ALT is located in the _____ of...
cytosol; hepatocytes and muscle cells
ALT is NOT useful in... (3)
horses, ruminants, and pigs (low conc in hepatocytes)
Because serum ALT activity is proportional to the number of injured hepatocytes, increased ALT activity may not be detected with...
liver failure where the number of hepatocytes is markedly reduced
Muscle leakage should be considered a potential source of increased serum ALT if...
there is significant muscle damage
AST is located in the _________ and _________ of...
cytosol; mitochondria; hepatocytes, muscle, and erythrocytes
Increased serum AST activity may be due to... (3)
hepatocellular damage, muscle damage, or hemolysis
Elevated AST suggests more severe hepatocelluar damage than ALT because...
it is mostly present in the mitochondria
SDH is located in the _______ of ________; therefore it is...
cytosol; hepatocytes; liver-specific in all species
GLDH is located in the ________ of _________, but is it not widely used because the assay is difficult.
Obstruction of bile flow or excretion.
Cholestasis can present as _______.
Hepatocyte injury may result in cell swelling, causing...
obstruction of bile canaliculi, leading to cholestasis
Post-hepatic cholestasis often occurs in patients with ___________ due to...
pancreatitis; inflammation of the pancreatic duct that spreads to affect the biliary duct
ALP- liver and steroid isoforms increase
T. bilirubin- pre-hepatic, hepatic, or post-hepatic increases
ALP is a ___________ protein that increases by _________.
What are the isoforms of ALP?
Liver, bone, corticosteroids (dogs only)
The hepatic isoform of ALP is increased with...
cholestatic disorders or significant hepatocyte swelling (lipidosis)
ALP is typically increased in cats with _________.
In cats ALP>>GGT is consistent with __________; GGT>ALP is more consistent with ________.
hepatic lipidosis; cholangiohepatitis
In dogs, corticosteroids can simultaneously induce...
liver and corticosteroid ALP isoforms
The ALP bone isoform is associated with....
increased osteoblastic activity (growing animals, osteosarcoma, bone healing)
GGT is a ____________ protein that is elevated by ________.
Most serum GGT is of _________ origin.
Elevated serum GGT occurs with ________ and _________.
cholestatic disease; steroid induction
How is GGT used in neonates?
used as a marker of colostral absorption
Bilirubin and bile acids are markers of... (2)
cholestasis and hepatic function
Bilirubin is increased with... (3)
hemolysis, biliary obstruction (decreased clearance), or defect in processing
Bile acids are produced by the _______, and they are increased with...
liver; reduced clearance by the liver
Unconjugated bilirubin in the blood is tightly bound to ________.
Pre-hepatic hyperbilirubinemia is caused by... (2)
hemolysis, internal hemorrhage
Hepatic hyperbilirubinemia i caused by... (4)
lipidosis, cirrhosis, hepatitis (biliary obstruction due to hepatocellular swelling), neoplasia
Post-hepatic hyperbilirubinemia is caused by... (2)
Hyperbilirubinemia can be a sign of ________ in horses and ruminants because...
anorexia; fatty acids compete with unconjugated bililrubin for binding on hepatocyte surface receptors
Miid bilirubinuria is ________ in dogs.
In horses and ruminants, ___________ bilirubin predominates.
Measurement of bile acids in _________ animals is redundant.
Increased bile acids concentrations are seen when there is ________________________, which can be due to...
decreased clearance by the liver; reduced functional hepatic mass or cholestasis
Increased serum bile acids due to reduced functional hepatic mass may be caused by... (4)
cirrhosis, nodular fibrosis, massive necrosis, portosystemic shunts
Decreased bile acid concentrations occur with ________.
What is measured to analyze hepatic synthesis? (5) Do they increase or decrease?
glucose, cholesterol, BUN, albumin, clotting factors; decreased
Insufficient Vitamin K can be associated with ________ due to decreased fat digestion and absorption (Vit K is fat soluble).
Hepatic macrophage in reticuloendothelial cells in the body that do not stimulate an antibody response against the majority of antigens they remove; affect globulin concentration.
If portal blood flow i shunted to bypass Kupffer cells, antigens normally removed in the liver would...
stimulate an antibody response in other tissues of the body; thus, increase globulins
Hyperammonianemia is seen with... (5...3 are species specific)
hepatic insufficiency (reduced functional mass), portosystemic shunts, congenital enzyme deficiency in dogs, urea toxicosis in ruminants, intestinal bacterial overgrowth in horses
5 functions of the kidneys.
excretion of waste products, retention/reabsorption, water and electrolyte balance, urine concentration, hormone production