L2: Liver Medicine I

What are the main consequences when hepatocytes malfunction?

-functional changes (metabolic, detoxification, coagulation)

-neoplastic changes (tumors)

-clinical signs (vomiting, jaundice, ascites, etc.)

What are some functional changes seen in liver disease?

-disruption in carbohydrate, lipid, protein, vitamin/iron metabolism

-detoxification

-hemostasis

-blood storage

-filtration

-bilirubin metabolism

What are neoplastic changes in the liver?

-tumor development

• lymphoma

• hepatic adenocarcinoma

common clinical signs of liver disease? (9)

-vomiting

-anorexia

-ptyalism

-polyuria/polydipsia

-jaundice

-ascites

-fever

-behavioral changes

-seizures

What are the main diagnostic principles for liver disease?

-anatomical diagnostics (imaging, biopsy)

-functional diagnostics (pseudofunction and function tests)

-assessment of liver enzyme activity

definition:

pseudofunction tests

-tests that assess what the liver makes, processes, or regulates

• glucose

• cholesterol

• urea

• coagulation factors

• albumin

• bilirubin

examples of function tests for the liver?

-bile acids test (assesses hepatocellular function)

-ammonia test (measures liver's ability to remove ammonia from the gut)

Which enzymes are used to assess liver cell injury?

-ALT and AST (hepatocellular/cytosolic)

-ALP and GGT (biliary epithelium

What are some representative diseases affecting the liver? (6)

-inflammatory (immune-mediated, cholangiohepatitis, chronic hepatitis)

-intoxications (drugs, toxins)

-neoplasia (lymphoma, adenocarcinoma)

-metabolic (hepatic lipidosis)

-breed-associated (copper storage)

-infections (bacterial, toxoplasmosis)