Questions and Answers
What is the primary source of nutrients for the liver?
Which components constitute the portal triad in the liver?
Which area of the liver has the lowest oxygen concentration?
In what direction does blood flow in the liver compared to bile?
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Which of the following is NOT a function of the liver?
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What is a clinical sign of liver disease that affects the brain?
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Which classification of liver disease is characterized by hemolysis?
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What is a consequence of decreased urea production in liver disease?
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What is the primary cause of hepatic encephalopathy?
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Which diagnostic test is NOT typically used to assess liver disease?
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What does an increase in cholesterol levels typically indicate?
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What does a normocytic, normochromic anemia indicate?
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What do changes in albumin levels primarily reflect?
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What does a decrease in glucose levels typically suggest?
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An increased ALP level in a cat is more significant due to what reason?
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What does an increase in both GGT and ALP likely indicate?
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Study Notes
Liver Functions and Anatomy
- Nutrients predominantly enter the liver via the portal vein.
- The portal triad consists of the portal vein, bile duct, and hepatic artery.
- Centrilobular (zone 3) is the area of the liver with the lowest oxygen concentration.
- Blood flow in the liver moves in the opposite direction to bile flow.
Functions of the Liver
- Synthesizes amino acids and converts glucose to glycogen and vice versa.
- Produces bile and deactivates poisons and toxins.
- Decomposes red blood cells and synthesizes cholesterol.
- Regulates blood composition and hormone production and metabolism.
- Assists in vitamin absorption, metabolism, and production.
Clinical Signs of Liver Disease
- Secondary gastrointestinal symptoms: vomiting, diarrhea, hypo/anorexia.
- Icterus/jaundice due to bilirubin accumulation.
- Hepatic encephalopathy: signs include head pressing, seizures, behavioral changes (e.g., fly biting, blind, aggression).
- Polyuria/polydipsia (PU/PD) from decreased urea production, leading to excessive urination and drinking.
- Hemorrhagic tendencies due to decreased coagulation factors (2, 7, 9, 10 affected) and thrombocytopenia.
- Ascites due to low albumin levels impacting oncotic pressure and increased portal pressure.
- Bile peritonitis resulting from gallbladder rupture.
- Increased drug sensitivity due to low albumin and reduced metabolic function.
Classifications of Liver Disease
- Pre-hepatic: typically involves hemolysis.
- Hepatic: related to direct liver issues.
- Post-hepatic: often involves bile obstruction.
Hepatic Encephalopathy and Diagnostics
- Hepatic encephalopathy caused by elevated ammonia and other toxins not processed by the liver.
- Diagnostics for liver disease: CBC, pseudo function tests (total bilirubin, glucose, BUN, cholesterol, albumin), ammonia, bile acids, imaging, and biopsy.
Hematology Insights
- Normocytic, normochromic anemia suggests chronic inflammatory disease.
- Macrocytic, hypochromic anemia indicates blood loss anemia.
- Microcytic, hypochromic anemia points to iron deficiency or portosystemic shunts.
- Thrombocytopenia is linked with gastrointestinal blood loss or disseminated intravascular coagulation (DIC).
- Reactive thrombocytosis may occur with GI blood loss.
Albumin and Globulin Changes
- Increased albumin indicates dehydration or GI fluid loss.
- Decreased albumin suggests liver dysfunction or GI loss (protein-losing nephropathy).
- Increased globulin indicates chronic inflammation or neoplasia; decreased globulin with low albumin indicates gut loss (protein-losing enteropathy).
Cholesterol, BUN, and Glucose Levels
- Decreased cholesterol reflects reduced liver production or GI loss and absorption issues.
- Increased BUN may indicate dehydration or GI blood loss; decreased BUN points to liver dysfunction.
- Low glucose levels may signal liver dysfunction since the liver and kidneys contribute to gluconeogenesis.
Bilirubin and Enzyme Indicators
- Increased bilirubin is indicative of liver disease and can lead to jaundice and neurological complications.
- Elevated alkaline phosphatase (ALP) reflects biliary stasis/cholestatic disease; it has a shorter half-life in cats.
- Increased gamma-glutamyl transferase (GGT) suggests cholestatic disease; elevated GGT and ALP together likely indicate cholestatic disease.
- Elevated alanine aminotransferase (ALT) suggests liver damage or disease.
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Description
Test your knowledge on the anatomy and functions of the liver. This quiz covers the liver's role in metabolism, synthesis, and the clinical signs of liver disease. A comprehensive assessment for students and health professionals alike.
