Hepatic and Renal Flashcards
Hepatic Blood Flow
20% of CO
Hepatic Blood Flow: Intrinsic Controls
- HABR (hepatic arterial buffer response)
- Metabolic
- Autoregulation
Hepatic Blood Flow: Extrinsic Controls
- Neural
- Humoral
What is HABR?
Hepatic Arterial Buffer Response:
The hepatic arterial buffer response (HABR) is a self-regulating mechanism that helps maintain hepatic perfusion during times of reduced portal venous blood flow, such as during acute occlusion or in cirrhosis
What 4 things does the liver metabolize?
Proteins
Carbohydrates
Lipids
Bile
What does the liver make?
Coagulation factors
Proteins for coagulation
List some protein regulators in coagulation
Protein S
Protein C
Protein Z
Plasminogen Activator Inhibitor
Antithrombin III
How much of heme produciton is done by the liver?
20%
Where is Bilirubin, Angiotensinogen, and Thrombopoietin made?
Liver
How does the liver and thyroid interact?
The liver activates T4 to T3
How do the liver and kidneys interact?
Inactivates aldosterone and ADH
How does the liver and pancreas interact?
Inactivates insulin
What are kupffer cells?
Liver cells that filter toxins and contaminates from splanchnic blood
Hepatic Drug Metabolism: Phases
- Phase 1: CYP increases drug polarity
- Phase 2: conjugating drugs with H2O soluable substrate
- Phase 3: excrete into bile
Liver Function Tests
SLAAPS
Serum Albumin
LDH
ALT
AST
PT
Serum Bilirubin
Normal Albumin
3.5-5.5 g/dL
Normal Prothrombin Time
12-14secs
Normal Bilirubin
0.2-1.1 mg/dL
Which inhaled agent is the worse for hepatic blood flow?
Halothane
Which inhaled agent is associated with Hepatitis?
Halothane
What is ESLD?
End Stage Liver Disease
ESLD: CNS complications
Hepatic Encepalopathy
ESLD: Cardiovascular complications
Hyperdynamic State
Cardiomyopathy
Altered Blood Flow
Portal Hypertension
ESLD: Pulmonary complications
Hypoxemia
Portopulmoary Syndrome
Hepatorpulmonary Syndrome
ESLD: Renal complications
Hepatorenal Syndrome
Edema
Ascities
ESLD: Hematological complications
Coagulopathy / Hypercoagulable
Thrombocytopenia
ESLD: Endocrine complications
Abnormal glucose use