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HOS Unit 4 > 13 Liver I > Flashcards

13 Liver I Flashcards

1
Q

How much cardiac output is devoted to the liver?

A

25%

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2
Q

Does the portal vein or hepatic artery supply more blood to the liver?

A

Portal

[portal= 60-80% and hepatic= 20-40%]

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3
Q

How does pancreatic hormones get to the liver?

A

pancreatic venous drainage is into portal system

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4
Q

T-F– portal blood may contain gut derived antigens, bacteria products, and other cells?

A

True

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5
Q

What does the lobule of the liver comprise?

A

central vein with plates(cords) of hepatocytes arrayed radially from it [hexagonal]

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6
Q

What is located at the corners of the hexagonal lobules?

A

portal triad [hepatic artery, portal vein, small bile duct]

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7
Q

Are the portal triad vessels inflow or outflow?

A

inflow

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8
Q

What is the functional unit of the alternative view of the liver with the central view around the portal triads?

A

liver acinus [more sense physiologically due to focusing on where blood enters the parenchyma]

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9
Q

What is larger to draw in 2 dimensions- the acinus or the lobule?

A

acinus

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10
Q

What are the hepatic cords lined by?

A

sinusoids- sinusoidal endothelial cells [special capillary]

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11
Q

are liver sinusoidal epithelial cells fenestrated? adhere closely to one another? have a complete basement membrane?

A

yes fenestrated, no adhere closely, no complete basement

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12
Q

Where does the exchange of substances take place in the liver?

A

across the space of disse

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13
Q

characteristics of sinusoidal epithelial cells in the liver offer what 2 important things?

A
  1. porous–>nutrient exchange

2. maintain low pressure

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14
Q

What occurs during chronic liver disease?What does this eventually lead to?

A
  1. scar tissue in space of disse
    decreased caliber of the sinusoids
  2. portal hypertension
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15
Q

What are the macrophages of the liver? where are they located?

A

kupffer- reside in lumen of the sinusoids

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16
Q

What glucose metabolism processes take place in the liver?

A

glycogenesis, glycogenolysis, gluconeogenesis

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17
Q

What can happen in an acetaminophen overdose?

A

acute liver injury leading to hypoglycemia

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18
Q

Does the liver have a major role in lipid metabolism? What roles?

A

yes [synthesizes cholesterol and lipoprotein, trafficking of lipoprotein particles, everything to do with triglycerides]

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19
Q

What is the primary organs for amino acid transformations?

A

liver

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20
Q

What amino acid altering enzymes are only used by hepatocytes and are therefore used as an indicator for liver damage?

A 
alanine aminotransferase (ALT)
aspartate aminotransferase (AST)
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21
Q

What can occur in cirrhosis and contribute to hepatic encephalopathy?

A

Impaired detox of ammonia

22
Q

What is the replacement of liver tissue with fibrosis?

A

cirrhosis

23
Q

What regulates oncotic pressure and carries many diff. ligands?

A

albumin- produced in liver

24
Q

What is made in liver and is a strong protease inhibitor?

A

alpha1- antitrypsin

25
Q

What is made in liver and precursor for angiotensin II?

A

angiotensinogen

26
Q

What is made in liver and is an inhibitor of intrinsic coagulation system?

A

antithrombin III

27
Q

what is made in liver and an assembly of lipoprotein particles?

A

apo-B

28
Q

What is made in the liver and is a copper transporter?

A

ceruloplasmin

29
Q

What coagulation factors are made in the liver?

A

II, VII, IX, X

30
Q

Is fibrinogen made in the kidney?

A

NO—liver

31
Q

What is made in the liver and binds and transports cell-free hemoglobin?

A

haptoglobin

32
Q

What is made in liver and is a carrier for thyroid hormone in the bloodstream?

A

thyroxine binding globulin

33
Q

What is made in the liver for iron transport?

A

transferrin

34
Q

What is the principal organ for drug metabolism?

A

liver

35
Q

In the liver is polar compounds converted to more lipophilic substrates during drug metabolism?

A

No- lipophilic —> more polar [allows excretion in the bile]

36
Q
  • What type of reaction is mainly catalyzed by cytochrome P450 in the ER and involved in ox-red reactions where the oxygen group is inserted into the compound?-
  • Is the product more or less reactive?
A

Phase I-often produces a more reactive intermediate

37
Q

Are the substrate specificities of the cytochrome P450 enzymes narrow and singular?

A

No- broad and overlapping

38
Q

What type of reaction usually involve conjugation of the compound to a group that increases water solubility?

A

Phase II

39
Q

If too much acetaminophen is taken, what shift takes place?

A

shift to cytochrome p450 pathway—>reactive intermediate—>glutathione can’t keep detoxing and damage ensues

40
Q

What is the effective treatment for acetaminophen overdose?

A

N-acetylcysteine

41
Q

Can alcohol ingestion induce p450 pathway and allow acetaminophen toxicity at lower levels?

A

yes

42
Q

What makes up bile?

A

water, electrolytes, bile acids, cholesterols, phospholipids and bilirubin

43
Q

Is bile concentrated during fasting?

A

yes

44
Q

What cells make bile?

A

hepatocytes

45
Q

What does bile do?

A

emulsifies fat

46
Q

What results from many types of liver injury and can cause malabsorption and deficiencies in fat soluble vitamins?

A

cholestasis

47
Q

T-F—bile is important for the elimination of cholesterol?

A

yes- conversion of cholesterol to bile acids

48
Q

What creates gall stones?

A

precipitation of cholesterol out of bile

49
Q

What drug can be used to decrease enterohepatic recirculation of bile ?

A

cholestyramine

50
Q

bilirubin is a breakdown of what?

A

heme porphyrin—-> metabolized by bacteria [calcium bilirubinate gallstones can occur in patients with accelerated turnover of RBCs]

HOS Unit 4 (18 decks)

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