5604654
Description
Flashcards by Hayley Pfeffer, updated more than 1 year ago
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Created by Hayley Pfeffer
almost 8 years ago
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| Question | Answer |
| What colour top should you use for haematology? Biochemistry? | purple top red top |
| What are the three leakage enzymes? why are they called leakage enzymes? How long does it take them to appear? | ALT, AST, GLDH leak from cells when cells damaged seen in serum within hours of damage |
| What are the two induction enzymes? Why are they called induction enzymes? How long does it take them to appear? | ALP, GGT made by cells in response to cell damage days |
| What kind of enzyme is ALT What does an increase in ALT mean? when does increase occur? | Liver specific leakage enzyme Acute hepatocellular damage <12 hours after damage |
| How do you interpret ALT Mild increase Marked increase (400) | -may be underlying cause, not just primary liver dz- liver neoplasia, endocrine disease, pancreatitis, aenamia, dehydration -infection, toxin, trauma |
| What kind of enzyme is AST? what does an increase in AST mean? | non liver specific leakage enzyme Acute hepatocellular damage or muscle injury |
| To interpret what an increase in AST is due to, what do you need to know? | CK |
| What kind of enzyme is GLDH? What does an increase mean? | liver specfic leakage enzyme acute hepatocellular injury |
| What kind of enzyme is ALP? what may an increase in ALP indicate? when would you see an increase in ALP? | non specific induction enzyme Choleostasis, bone disease, young growing animal, chronic stress, steroids tx 1-2 days after damage |
| Why is ALP difficult to interpret? | Multiple different ALP isoforms- hepatic isoform Bone isoform Corticosteroids isoform routine blood testing does not distinguish between the different isotopes |
| What kind of enzyme is GGT? what does an increase indicate? | fairly liver specific induction enzyme of largies Choleostasis, corticosteroids, colostrum |
| What may cause an increase in GGT in largies (specific diseases) | facial eczema ragwart liver fluke colostrum intake |
| What do liver function tests evaluate? | The livers ability to perform normal functions measure serum levels of compounds that are normally removed or made by the liver |
| What level must serum bilirubin be at before you see jaundice? | 50 micromols/L |
| What are the 5 causes of hyperbilirubinaemia? | fasting pre hepatic-haemolytic hepatic post hepatic- Choleostatic sepsis |
| When may fasting hyperbilirubinaemia occur? Who does it affect? How severe is it/do you see jaundice? | After a period of anorexia- decreased uptake of bilirubin by hepatocytes Horses mild- no jaundice |
| When may pre-hepatic hyperbilirubinaemia occur? How severe is it/do you see jaundice? | Animals with haemolytic anaemia -IMHA, lepto pomona, paracetemol marked- with jaundice |
| When may you see hepatic hyperbilirubinaemia? How severe is it/do you see jaundice? | Animals with significant liver disease- impaired bilirubin uptake Often mild with variable jaundice |
| What may cause post hepatic hyperbilirubinaemia? How severe is it/ do you see jaundice? | Animals with choleostasis- bile is regurgitate back into circulation marked with jaundice |
| What may cause septic hyperbilirubinaemia? what animal does it affect? | severe bacterial septicemia- increased inflam mediators reduce bilirubin transport into the liver, get decreased bilirubin excretion dogs |
| In which species is seeing hyperbilirubinaemia and bilirubinuira significant? what does it suggest? | cats significant hepatobiliary disease and cholestasis |
| Is seeing bilirubinuria significant in dogs? why? | No low renal threshold for bilirubin so can pass out easily |
| Describe entero-heptic re circulation of bile acids | Bile acids made in liver- excreted into intestine- re-absorbed into portal vein- re-circulated back to liver- removed from blood in liver- reused to make more bile |
| What may cause an increase in serum BA's | 1. decreased BA clearance from portal blood- PPS, severe liver damage 2. Decreased BA excretion- cholestasis |
| Explain portosystemic shunt | Where the portal vein does not carry blood back to the liver and shunts the blood straight into the circulation |
| When and when not should BA levels be tested? | DO- liver disease suspected but routine biochemistry results equivocal Don't- you have ruled out non hepatobiliary causes and animal has jaundice- BA gives no additional info |
| How do you test Bile acids? | Need 2 samples -pre-prandial serum sample (after 12 hour fast) -post-prandial serum sample (2 hours after eating) |
| How do you interpret a BA test? | pre-prandial low and post prandial mildly increased = normal Pre prandial increased and post prandial markedly increased =abnormal |
| What does it mean if BAs are increased? | Damaged liver PSS Choleostasis |
| What are some compounds the liver usually makes | albumin urea cholesterol glucose coagulation factors |
| Do you see low albumin in acute or chronic liver disease? why? | chronic long 1/2 life |
| What CS might you expect to see 2ndary to hypoalbuminaemia? | oedema- mostly ascites |
| In what animal won't you see low albumin in chronic renal failure? | Horses |
| Why do you get decreased urea in liver failure? | Liver normally converts ammonia into urea, can't do this if there is significant loss of liver function |
| What are the two things may you see in terms of cholesterol and liver failure? why? | hypocholsteraemia-Decreased cholesterol synthesis by liver Normal cholesterol- because biliary excretion of cholesterol also decresed cholesterol appears normal or even increased |
| What may you see in terms of glucose and liver failure? | Hypoglycaemia- decreased liver synthesis by liver Normal or hyperglycaemia- decreased glucose uptake by liver post eating |
| What may you see in terms of clotting factors with liver failure? | reduced production of clotting factors -increased coagulation times- APTT, ACT, PT -2dry haemostasis effects- bleeding into joints, cavities, muscles |
| Besides bloods, what are some other methods to sample the liver? | Cytology Histology PM |
| Name some advantages and disadvantages ofdoing a FNA for cytology | -good for diffuse dz process -cheap, quick, patient conscious -less diagnostic than histology -individual cells- no architecture, can miss if a focal lesion |
| What are some advantages and disadvantages of doing a liver biopsy for histology | -good for focal or diffuse lesions more diagnostic then cytology- tissue architecture + cells -slower, expensive, GA needed |
| If taking a PM liver sample, how thick should the sample be and what is the ration of tissue: formulin | <1cm 1:10 |
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