Science Quiz / Alimentary systems path part 1 (liver and pancreas)

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Can you name the Alimentary systems path part 1

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What are the three main mechanisms of increased enzyme presence in the serum?
 
 
 
Which of the following is not one of the top 3 most important leakage enzymes?
a)Alanine aminotransferase (ALT) b)lactate dehydrogenase (LDH) c)Aspartate aminotransferase (AST) d)glutamate dehydrogenase (GLDH)  
What is the only other tissue (aside from the liver) that may leak Alanine Aminotransferase?
This enzyme may be induced by glucocorticoids and phenobarbital, but may also leak from this tissue. 
Which of the three most important enzymes occurs in most cells, and is used more commonly in large animals?
Activity is highest in liver and muscle, but the myocardium, pancreas and hemolysed RBCs may also release it. 
GLDH is mainly used in what group of animals to assess hepatocyte injury?
 
LDH is a non-specific indicator of ______ ________, due to its wide distribution.
 
What is the standard measuring unit for enzyme activity in serum, in _ per _ format?
 
Which of the following enzymes is NOT a leakage enzyme at all?
a)GLDH b)AST c)ALT d)GGT e)ARG 
TLI (trypsin like immunoreactivity) would be increased with ________ and decreased with ____ _____ ______
 
 
The most specific test for pancreatitis measures _____ _______ _______
 
This diagnostic enzyme of the induced variety tends to increase more dramatically in dogs than cats?
It is also less sensitive in large animals due to wide variation, and due to the presence in many tissues including liver, bone, intestine, kidney, placenta and leukocyte, it is not very specific. 
What substance is added in the liver to unconjugated bilirubin to conjugate it?
 
A hyperbilirubinemia rich in unconjugated bilirubin would be indicative of ___-_______ hyperbilirubinemia, most likely caused by _______
 
 
Aside from liver disease, you may see a mild increase of this enzyme (2-4x) in adults with pathologic osteoblastic activity?
Most serum activity is still due to the hepatic isoenzyme, which is indicative of cholestasis, intra- or extra-hepatic.. 
Which of the following drugs is not induced by exogenous steroids in dogs??
a)ARG b)ALT, c) ALP d)GGT e) none of the above 
If you were to perform a screening test for cholestasis, you'd test ___. With a positive, you'd measure ____ to confirm?
Base your thinking purely on which of the two enzymes has the appropriate sensitivity or specificity. Ignore that you'd likely measure both from the outset. 
This enzyme's properties make it more useful in large animals as well. 
If neurological signs have developed and the owner reports preceeding icterus in their history, what is likely occuring?
 
Which of the following is not a type of hepatic injury or disease?
a)hepatocellular disease b)cholestatic disease c)increased hepatic uptake, conjugation or secretion d)abnormal hepatic blood flow e)decreased synthetic and Kupffer cell functions 
An animal with elevation of steroidal ALP is not on immunosuppressant therapy. This could be a false positive, but the animal will quite likely show this change with?
 
The only hepatic leakage enzyme which only tends to be useful in small animals is?
 
80-90% of the blood inflow to the liver is provided by the _____ ____, and the remainder by the _______ ______
 
 
This leakage enzyme may be used in large animals, but will be artifactually decreased after a short time due to short halflife.
 
What specifically is the trigger for increased synthesis of induction enzymes?
 
If halflives vary between enzymes between the dog and the cat, which one tends to have them last longer?
 
When heme is broken down in macrophages the end result before modification is ______ ______, which, being water insoluble, will bind to _____ to get to the liver
 
 
Conjugated bilirbin is converted into _______ and reabsorbed for excretion in urine, or lost in the feces as _______
It may also be reabsorbed and returned to the liver for further degradation (enterohepatic circulation) 
 
Which of the following is the least likely explanation for a dog presenting with an elevation in ALP (any isoform)
a)Osteosarcoma b)intrahepatic cholestasis c)chronic renal illness d)a healing bone fracture e)hyperparathyroidism f)Cushing's disease (hyperadrenocortcism) 
With intrahepatic hyperbilirubinemia, the ______ ______ increases due to decreased secretion, when at least ___ of bile flow inside liver is obstructed.
 
 
When the common bile duct is blocked, and the conjugated bilirubin rises, this is ___-______ ________
 
Which species breaks the rules and almost always has elevations of unconjugated bilirubin, even with intrahepatic disease?
 
If you already know the patient has hepatobiliary disease and increased conjugated bilirubin, ordering ____ _____ analysis adds no new info.
 
 
In which species might bilirubinuria present before hyperbilirubinemia with bile duct obstruction?
 
What are two scenarios that justify ordering bile acid analysis?
 
 
When bile acids are increased, it can indicate:
a)decreased functional liver mass b)cholestasis c)shunting d)diffuse illeal disease e)a, b and c f)all of the above 
What percentage of newly synthesized urea tends to go for renal excretion?
 
Which of the following is not likely a cause of increased ammonia?
A)hepatic insufficency B)portosystemic venous shunting C) congenital enzyme deficiency D) urea toxicosis of ruminants E) none of the above 
The building block that is molded into bile acids by the liver is _______.
 
What percentage of bile acids are reabsorbed in the ileum, bind albumin and hitch hike back to the liver?
 
Microbial deamination of amino acids and urea results in most production of ______ in the body.
This is the chemical where increase will be primarily responsible for hepatic encephalopathy 
Ammonia is the most sensitive indicator of hepatic disease in this species above others.
 
True or false: hypoglycemia can occur due to lack of functional liver mass?
 
What is the purpose of bicarbonate secreted by the pancreas?
 
Which of the following would you not likely associate with pancreatitis?
a)high fat diets b)dogs and cats c)horses d)sulfa drugs or corticosteroids e)trauma or ischemia 
Which of the following is not a differential for increased serum amylase activity?
a)heart disease b)renal disease c)pancreatitis d)intestinal perforation e) A and B are not differentials f)all of A-D are differentials 
Which of the following is not a differential for increased serum lipase activity?
a)pancreatitis b)renal disease c)pancreatic neoplasia d)corticosteroid administration e)hepatic neoplasia f)D and E are not differentials g)A-E are all differentials 
In ___ the serum pancreatic enzymes are often not increased, and clinical signs are vague, making diagnosis difficult.
 
When serum ___ is increased, it's very suggestive of pancreatitis, but renal disease can decrease clearance and raise it.
It takes a week or more to get a result back. 
Why might liver enzymes be elevated during pancreatitis?
 
Due to functional damage from proteases or mechanical obstruction of the bile duct by an inflammed pancreas, you may see:
 
What two diseases may develop as a result of chronic or recurrent acute bouts of pancreatitis?
Potatoes sure are delicious eh? Shouldn't wash them down with four cans of soda though... 
 
Chronic diarrhea and weight loss are the main clinical signs of this illness.
German shepherds are especially prone to this, and it may be a sequela of pancreatitis. 
PLI is better for _______ and when TLI is decreased it indicates _______
 
 
Zone 3 hepatocytes ar closest to the ______ _____, whereas zone 1 hepatocytes rae nearest the ______ _____
 
 
Of the following list, please pick a function that is NOT performed by the liver?
Excretion of bile, conjugation of bilirubin, bile acid metabolism, glycolysis, gluconeogenesis, lipid metabolism, xenobiotic metabolism, synthesis of albumin, synthesis of clotting factors, synthesis of complement, synthesis of zymogens, innate immune function through Kupffer and NK cells 
Name a sign of sublethal energy to hepatocytes or biliary epithelium?
Think about pale swollen cell without fragmented nuclei- those ones would be dead. 
If there are many tiny distinct foci of hepatic injury, thousands of them, this is called?
 
Centrilobular or periacinar zonal necrosis affects zone _ hepatocytes, whereas periportal or centroacinar affects zone _
 
 
Centrilobular hepatocytes are susceptible to toxins processed by _____ ______ ______ and to conditions which cause ______.
 
 
Toxins are most likely to cause the rare midzonal necrosis pattern in ____ and ______
 
Name an example of a common that would cause the uncommon periportal pattern of zonal hepatic necrosis?
 
_______ _______ is a disease that results from vitamin E or selenium deficiency, and causes entire hepatic lobules to necrose, which is referred to as ______ necrosis.
 
 
The stem cells of the hepatobiliary area are _____-shaped.
 
Regeneration of hepatic injuries occurs without scarring only if the _____-_____ _______ is intact.
 
Random focal fibrosis is likely indicative of?
 
Chronic inflammation or cholestasis is most likely associated with _____ fibrosis.
 
Chronic toxicity or passive congestion is likely associated with _____ necrosis.
 
The final and irreversible end-stage of toxicity, cholangitis/obstruction, congestion, metabolic disease, hepatitis and idiopathic liver disease is?
 
Cows that are kept outdoors with hepatic failure may suffer from?
 
Nutmeg liver, with centrilobular atrophy and fibrosis and portal lipidosis is characteristic of?
 
Failure of closure of the ____ ______ results in congenital intrahepatic PSS.
 
Congenital extrahepatic PSS involves connection of the portal vein to the ____ ____ ____ or _____ _____
 
 
With PSS, these vessels tend to atrophy?
 
With PSS these vessels tendt o become hyperplastic?
 
Hepatic portal hypertension would be due to increased resistance to flow within ______.
Prehepatic is due to portal vein obstruction, posthepatic hypertension would be due to hepatic vein or vena cava obstruction. 
Which of the following is not a mechanism of hepatic lipidosis development?
a)endocrine disorder b)toxic or anoxic injury to hepatocytes c)low fat diet d)none of the above 
Name a potential cause of hepatic glycogenosis?
 
What breed of dogs is most prone to copper toxicosis?
 
In sheep, copper accumulation occurs chronically, but presents as ______ ______ _____ after stressors prompt sudden release.
 
Oriental cats and this breed of dog are most prone to inherited amyloidosis.
Presents as enlarged, waxy pale liver. Will stain green with congo-red stain. 
If a dog has chronic liver disease which develops into cirrhosis, which increases resistance to intrahepatic blood flow, what may develop?
 
If the nucleus is pushed aside by vacuoles on hepatic histology, this is ______. If not, if the nucleus stays put and vacuoles are not clean and crisp, it's ____.
 
 
On histology, pink material along the hepatic sinusoids int he space of disse is?
Can be primary due to plasma cell neoplasms (AL type) or secondary (AA type) due to acute phase proteins. 
Inflammation of the gall bladder= _____. If the biliary duct system and hepatic parenchyma are both inflammed= ______.
 
 
Multifocal random hepatocellular necrosis is characteristic of what type of virus in most species?
 
What Flavivirus is often associated with acute diffuse hepatitis in horses that have received equine serum injections?
 
A dog presents with signs of liver necrosis and hemorrhage, and blue eye immune complex uveitis. What is this?
Antigen-antibody complex formation, type III reaction in the eye. 
Which of the following bacteria would you associate with young, immunocompromised animals, especially foals?
a)Nocardia b)actinobacillus equuli c)Clostridium piliforme d)Yersinia e)Salmonella f)actionmyces 
Which bacteria is most associated iwth grain overload hepatic abscesses in cattle?
Raised lesions full of necrotic debris and neutrophils, can shower the lungs through the hepatic vein. 
This bacteria would be associated with acute hemolytic crisis and/or chronic hepatitis.
Present in contaminated water, bedding or soil, enters through skin or mucous membrane. 
These two bacteria cause similar disease involving spores in Kupffer cells, proliferating in low oxygen tension, causing necrosis, hemolsis and hemoglobinuria.
Most likely in ruminants, the diseases are bacillary hemoglobinuria and infectious necrotic hepatitis respectively. 
Milk spotting affecting 40-50% of a pig liver is likely caused by?
If in an equine liver it would be probably due to Strongylus edentatus, and referred to as perihepatitis filamentosa 
A small liver in ad og, with an accentuated lobular pattenr, cirrhosis and chronic inflammation is referred to as?
 
Ascending bacterial infection would be associated with ______ cholangitis or cholangiohepatitis?
 
Acetaminophin or pyrrolizidine alkaloid toxicity would cause ______ necrosis.
Pyrrolizidine alkaloids are converted by p450 to pyrrolic esters which result in necrosis and megalocytosis by preventing cell division but not DNA synthesis. 
TMS and the mycotoxin sporodesmin would likely cause hyperplasia or necrosis of the _____ _______.
 
This toxin, commonly ingested by large animals from ponds is associated with centrilobular or massive hepatocellualr necrosis and hemorrhagic gastroenteritis?
 
Umbilicated pale nodules are likely what kind of liver neoplasia?
 
Multifocal depressions in the hepatic surface, darker than the surounding tissue are characteristic of this hepatic neoplasm?
 
Cholecystitis may be associated with this strain of salmonella enteritidis?
Top o' the mornin' teh yeh, haff yerself a guiness an' an inflammed gallbladder! 
Carcinomas of the pancreas are _____, and adenomas are _____.
Both answers refer to frequency of occurence. 
 
If when looking at a bovine liver, fusobacterum necrophorum is your primary differential, this bacteria should also be on your list but lower down.
 
Focal hepatic necrosis together with diffuse cortical hemoglobin staining in the bovine kidney is most likely caused by this clostridium.
Associated with the migration of fasciola hepatica. 
Fat necrosis in the pancreas results in this process.
 

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