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GI > Physiology and Pharmacology of the Liver > Flashcards

Physiology and Pharmacology of the Liver Flashcards

1
Q

How is carbohydrate metabolism regulated

A

Hormonally

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2
Q

Glycolysis

A

Breakdown of Glucose to pyruvate –> lactate (anaerobic) + acetly coA (aerobic)

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3
Q

Gluconeogenesis

A

AA –> Glucose

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4
Q

Glycogenesis

A

Store glucose as glycogen

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5
Q

Glycogenolysis

A

Releasing glucose as required

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6
Q

fat Metabolism of the Liver

A

Ketogenesis
Processing chylomicrons
Synthesis of lipoproteins and cholesterol

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7
Q

Horomones deactivated by liver

A

Insulin
Glucagon
ADH
Steroid hormones

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8
Q

Hormones activated by the liver

A

Thyroid Hormone

Vit D hormone

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9
Q

What does the liver store

A 
Fat soluble vitamins - vit A (in cell), D, E, K (hepatocytes)
Water solumble vitamin D
Iron
copper
Glycogen
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10
Q

Detoxification

A

Exogenous
- ethanol and drugs
Endogenous
- bilirubin (haem breakdown)

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11
Q

Protection

A 
Kuppfer Cells
Immune Factors (acute phase protein)
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12
Q

Synthesis of proteins

A 
Clotting factor 2, 7, 9, 10
Protein S and C
Albumin
Carrier proteins
Apoliproteins
Complement proteins
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13
Q

What is the role of bile

A

Digestion and absorption of fats

Excretion of metabolism product

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14
Q

What is bile produced by

A

Bile duct cells

Hepatocytes

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15
Q

Bile action between meals

A

Stored and concentrated in the gallbladder

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16
Q

Bile during a meal

A

Chyme in duodenum stimulates gallbladder to contract via CCK and vagal impulse
Sphincter of Oddi opens via CCK
Bile spurts into duodenum via cystic and common bile duct

17
Q

How do heapatocytes secrete bile

A

Secrete primary juice into caniculi which drains into biliary ductules and ducts

18
Q

What are secretions from hepatocytes made up of

A 
Bilirubin
Bile salts
Bile Acids
Lipids and phospholipids
Cholesteral
Na, K, Cl, HCO3, Ca
IgA
19
Q

Excessive cholesterol in comparison to bile may lead to

A

Acids + Lectin –> Microcystals –> gallstones

20
Q

What is the ost common pathology of the biliary tree

A

Choleliathiathis

21
Q

What is the gold standard treatment for symptomatic gallstones

A

Laparascoipc cholecystectomy

22
Q

What is given to patients with unimpaired gallbladder function who have small to medium sized gallstones

A

Ursodeoxycholic acids

23
Q

What may be given for biliary colic

A

Strong analgesic

- however morphine can block sphincter of Oddi

24
Q

What can biliary spasm be relieved by

A

GTN

Atropine

25
Q

Where do bile salts entering the duodenum go

A

Only a small amount is lost in faeces

Most reabsorbed by active transport in terminal ileum and undergoes enterohepatic recycling

26
Q

A fraction of bile salts are dehydroxylated to what

A

Secondary bile acids then go to liver then conjugated with glycine or taurine to form bile salts

27
Q

What provides the majority of cholesterol excretion

A

Bile salts

28
Q

What is the mechanism of colveselam

A

Binds to bile acids preventing cholesterol from binding and causes its excretion out the body
Cholesterol must form more bile acid and will therefore not gather in plaques causes blockages

29
Q

What is colveselam used for

A

Lipid lowering
Cholestatic jaundice
Bile acid diarrhoea

30
Q

Drugs are described as xenobiotic what does this mean

A

Not produced normally by the body

31
Q

What do drug metabolism facilitate

A

Converts parent drugs to more polar metabolites that are not readily excreted by the kidney and therefore allows excretion

32
Q

Phase 1 involves

A

Oxidation
Reduction
Hydrolysis
Makes the drug more polar

33
Q

CYP450

A

Group of haem proteins located in the endoplasmic reticulum mediating oxidation reactions

34
Q

Phase 2 involves

A

Conjugation of a chemically reactive group resulting in inactive proteins

35
Q

What is a common phase 2 reaction

A

Glucocordination

36
Q

Hepatic Enchepalopathy caused by

A

Hepatic Failure prevents urea cycle converting NH3 to urea
Blood levels of NH3 increase exerting a toxic effect on the CNS
Incoordination, coma, drowsiness due to cerebral oedema

GI (25 decks)

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