ILA 6 - Liver SBA Flashcards

1
Q

Bilirubin is the by-product of Haemoglobin breakdown.
Microsomal enzyme uridine diphosphoglucoronosyl transferase (glucuronyl transferase) catalyses the formation of what?

A. Conjugated bilirubin
B. Free bilirubin
C. Stercobilinogen
D. Unconjugated bilirubin
E. Urobilinogen

A

A. Conjugated bilirubin

Bilirubin is essentially insoluble.
Conjugated bilirubin is soluble and therefore more easily excreted in the urine and bile.

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2
Q

Bilirubin is the by-product of Haemoglobin breakdown.
Bacterial enzyme hydrolysis in the gut produces this compound which is excreted in faeces.

A. Conjugated bilirubin
B. Free bilirubin
C. Stercobilinogen
D. Unconjugated bilirubin
E. Urobilinogen

A

C. Stercobilinogen

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3
Q

Bilirubin is the by-product of Haemoglobin breakdown.
Which compound is returned to the liver by the enterohepatic circulation?

A. Conjugated bilirubin
B. Free bilirubin
C. Stercobilinogen
D. Unconjugated bilirubin
E. Urobilinogen

A

E. Urobilinogen

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4
Q

The duodenum lies between the stomach and Ileum.

What structure is situated within the duodenal loop?
A. Common bile duct
B. Cystic duct
C. Gall bladder
D. Pancreas
E. right hepatic duct

A

D. Pancreas

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5
Q

A 53 year old patient is admitted with jaundice.
Which of the following causes an increased serum unconjugated (free) bilirubin and increased faecal urobilinogen?

A. Hepatocellular cause of jaundice
B. Mixed picture cause of jaundice
C.Post-hepatic (obstructive) cause of jaundice
D. Pre-hepatic cause of jaundice

A

D. Pre-hepatic cause of jaundice

Pre hepatic has both raised.

Hepatocellular causes have increased free bilirubin but decreased faecal urobilinogen.

Post hepatic causes have normal free bilirubin and absent faecal urobilinogen.

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6
Q

The hepatic lobule is a hexagonal shaped unit.

What is the structure in the middle of the hepatic lobule?

A. Bile duct
B. Central vein
C. Hepatic artery
D. Portal triad
E. Portal vein

A

B. Central vein

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7
Q

The reticuloendothelial system plays an important role in the liver.
Which one of these cells is part of the reticuloendothelial system in the liver?
A. Fibroblast
B. Hepatocyte
C. Ito cell (Hepatic stellate cell)
D. Kupffer cell
E. Sinusoidal endothelial cell

A

D. Kupffer cell

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8
Q

The liver is the body’s largest internal organ.
Which of the following best describes its attributes?

A.The hepatic blood supply is 25% of the cardiac output.
B. The liver is divided into 5 segments
C. The liver lies in the left hypochondrium.
D.The portal vein supplies 25% of hepatic blood flow.
E. The segment is the functional hepatic unit.

A

A.The hepatic blood supply is 25% of the cardiac output.

The hepatic blood supply is 25% of cardiac output. The liver lies in the right hypochondrium and receives 75% of its blood flow via the portal vein. It has 8 segments, and the lobule is the functional hepatic unit.

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9
Q

A 45 year old patient complains of their eyes and skin becoming yellow in colour. A diagnosis of obstructive jaundice is made.
Obstructive jaundice is commonly caused by gall stones within what structure?
A. Common bile duct
B. Cystic duct
C. Gall bladder
D. Pancreas
E. right hepatic duct

A

A. Common bile duct

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10
Q

The pancreas is responsible for secreting a number of essential substances.
Which of the following describes its secretory function?
A. Glucagon inhibits the breakdown of glycogen
B.Glucagon is secreted by the alpha (B) islet cells.
C. Insulin is secreted by the beta (A) islet cells.
D.Pancreatic polypeptide is secreted by the G islet cell.
E. Somatostatin is secreted by the delta (D) islet cells

A

E. Somatostatin is secreted by the delta (D) islet cells

Glucagon is secreted by the alpha (A) islet cells.
Insulin is secreted by the beta (B) islet cells.
Somatostatin is secreted by the Delta (D) islet cells
Glucagon stimulates the breakdown of glycogen
Pancreatic polypeptide is secreted by the F islet cell.
Somatostatin is a peptide hormone that includes amongst its actions the inhibition of insulin and glucagon secretion

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11
Q

A newborn baby is noticed to have a yellowish discoloration of the sclera.
What is the cause of physiological jaundice of the newborn?
A. Diversion of portal blood flow into the umbilical vein
B. Excess breakdown of foetal haemoglobin
C. Horizontal alignment of the common bile duct as it enters the duodenum
D. Immaturity of conjugation enzyme mechanisms in the liver

A

B.
Excess breakdown of foetal haemoglobin

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12
Q

The liver has many different functions.
Which of the following best describes a function of the liver?

A. Conversion of thyroxine (T4) into triiodothyronine (T3)
B. Glucagon synthesis
C. Production of renin
D. Production of Urobilinogen
E. Storing Vitamins A C D E

A

A. Conversion of thyroxine (T4) into triiodothyronine (T3)

The liver stores glycogen, glucagon is synthesised in the alpha cells of the pancreas. Vitamin C is water soluble and is not stored in the liver unlike Vit A D E and K. Renin and Urobilinogen are not produced in the liver (see diagram).

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13
Q

The gallbladder plays an important role in digestion.
Which of the following best describes the control of its function?

A. Cholecystokinin is released in response to the presence of amino acids in the gut.
B. Cholecystokinin is released in response to the presence of carbohydrates in the gut.
C. The entero-pancreatic reflex is mediated by the sympathetic system.
D. The gall bladder synthesizes 50 mls of bile per day.
E. The sympathetic nervous system releases Acetylcholine causing the gallbladder to contract.

A

A. Cholecystokinin is released in response to the presence of amino acids in the gut.

The Vagus nerve (parasympathetic) releases Acetylcholine causing the gallbladder to contract.
Cholecystokinin is released in response to the presence of amino acids in the gut as well as lipids, free fatty acids, peptides but not carbohydrates or HCl.
The gall bladder stores up to 50 mls of bile.
The entero-pancreatic reflex is mediated by the parasympathetic system.

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14
Q

A 78 year old patient is admitted with obstructive jaundice.
Which of these is not a cause of Obstructive Jaundice?
A. Cirrhosis
B. Gallstones
C. Gilbert’s Syndrome
D. Hepatitis
E. Pancreatic Carcinoma

A

C. Gilbert’s Syndrome

Gilbert’s syndrome is a genetic disorder.
People with the syndrome have a faulty gene which causes the liver to have problems removing bilirubin from the blood.
There is no obstructive element in Gilbert’s syndrome

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