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liver Flashcards

1
Q

what is liver inflammation often due to

A

obesity

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2
Q

pathway to cirrhosis

A
  1. progressive fibrosis
  2. portal hypertension
  3. deterioration of liver §
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3
Q

what is the body largest internal organ

A

liver

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4
Q

where is the liver situated

A

right hypochondrium

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5
Q

how many segments

A

8

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6
Q

what does each segment have

A

portal pedicle

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7
Q

what two vessels enter the liver

A
  • hepatic artery

- portal vein

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8
Q

what is the hepatic artery

A

branch of the coeliac axis

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9
Q

what does the portal vein do

A

drain most of the GI tract and the spleen

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10
Q

where does blood go after it leaves the sinusoids

A
  1. enter branches of the hepatic vein

2. enters inferior vena cava

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11
Q

what is special about the caudate lobe

A
  • receives independent blood supply from portal vein and hepatic artery
  • drains directly into inferior vena cava
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12
Q

do sinusoids have a basement membrane

A

no

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13
Q

what are Kupffer cells

A

phagocytic cells

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14
Q

what is the subendothelial space between the sinusoids and hepatocytes

A

space of Disse

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15
Q

what do stellate cells store

A

retinoids in their resting state

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16
Q

what happens to stellate cells when activated

A

are contractile and regulate sinusoidal blood flow

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17
Q

what do stellate cells generate

A

collagen eventually leading to cirrhosis

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18
Q

what do bile canaliculi form

A

a network between the hepatocytes

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19
Q

where do the hepatic ducts join

A

at the porta hepatis

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20
Q

what does the cystic duct connect

A

the gall bladder to the lower end of the common hepatic duct

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21
Q

where does the gall bladder lie

A

under the right lobe of the liver

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22
Q

what does the gall bladder do

A

stores and concentrated hepatic bile

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23
Q

where does the bile duct and pancreatic duct open into

A

second part of duodenum

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24
Q

what does the liver synthesise

A
  • all circulating proteins
  • all coagulation factors
  • complement system
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25
Q

what does the liver control

A

the rate of gluconeogenesis

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26
Q

functions of albumin

A
  • maintain intravascular oncotic pressure

- transport water-insoluble substances such as bilirubin, hormones, fatty acids and drugs

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27
Q

examples of coagulation factors

A
  • fibrinogen
  • prothrombin
  • antithrombin
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28
Q

what does the liver store

A
  • large amounts of certain proteins and minerals

- glycogen

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29
Q

how are amino acids degraded

A

by transamination and oxidative deamination

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30
Q

what does oxidative deamination of amino acid produce

A

ammonia

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31
Q

what is ammonia converted to

A

urea

32
Q

where is urea excreted

A

kidneys

33
Q

what organ controls glucose homeostasis

A

liver

34
Q

what is glycogenolysis

A

glycogen breakdown

35
Q

what is gluconeogenesis

A

synthesis of new glucose

36
Q

what are the sources of gluconeogenesis

A
  • lactate
  • pyruvate
  • amino acids
  • glycerol
37
Q

where is glycerol from

A

lipolysis of fat

38
Q

what is used in prolonged starvation as a source of fuel

A
  • ketone bodies

- fatty acids

39
Q

are fats soluble in water

A

no

40
Q

how are fats transported

A

by lipoproteins

41
Q

what organ metabolises lipoproteins

A

liver

42
Q

where are triglycerides from

A

dietary origin

43
Q

where is most cholesterol synthesised from

A

acetyl-CoA

44
Q

what does bile consist of

A
  • water
  • electrolytes
  • bile acids
  • cholesterol
  • phospholipids
  • conjugated bilirubin
45
Q

what does bile formation require

A

uptake of bile acids

46
Q

what does bile acid receptor farnesoid X do

A

block bile acid formation from cholesterol

47
Q

what are water channels

A

aquaporins

48
Q

where are bile acids excreted to

A

into bile and pass via the common bile duct into the duodenum

49
Q

what are the 2 primary bile acids

A
  • cholic acid

- chenodeoxycholic acid

50
Q

what do I cells of duodenum secrete

A

cholecystokinin

51
Q

what does cholecystokinin do

A

stimulate contraction of gall bladder and relax sphincter of Oddi this allows bile to enter the duodenum

52
Q

what does bile acids act as

A

detergents - lipid solubilisation

53
Q

what do bile acids form in aqueous solution

A

micelles

54
Q

how is bilirubin produced

A

from breakdown of mature red cells by Kupffer cells in the liver

55
Q

what is bilverdin formed from

A

haem and reduced to form bilirubin

56
Q

how is bilirubin transported

A

bound to albumin

57
Q

is conjugated bilirubin water soluble

A

yes

58
Q

what is bilirubin reduced to

A

urobilinogen

59
Q

where is the main site of drug metabolism

A

liver

60
Q

what are viral markers good for diagnosing

A

Hep A, B, C, D, E

61
Q

what is serum iron and ferritin used to diagnose

A

haemochromatosis

62
Q

what is serum copper used for

A

Wilson’s disease

63
Q

what is anti-nuclear cytoplasmic antibodies used for

A

primary sclerosing cholangitis

64
Q

what are markers of liver fibrosis used for

A

NAFLD

hepatitis C

65
Q

what is serum albumin useful for

A

determining severity of liver disease

66
Q

is bilirubin mostly conjugated or unconjugated

A

unconjugated

67
Q

what is prothrombin time a marker of

A

synthetic function

68
Q

when is genetic analysis done

A
  • haemochromatosis

- alpha1-antitrypsin deficiency

69
Q

what do dipsticks test sense

A

bilirubin and urobilinogen

70
Q

what is ultrasound useful for

A
  • extraheptic obstruction
  • assessing jaundice
  • assessment of hepatomegaly
  • assessing hepatic parenchyma
  • cirrhosis
  • lymph node enlargement
71
Q

what does fatty infiltration look like on ultrasound

A

bright appearance

72
Q

what does CT provide guidance for

A

biopsy

73
Q

what does X-ray for

A
  • gallstones
  • air in biliary tree
  • pancreatic calcification
  • calcification of gall bladder
74
Q

what is upper GI endoscopy used for

A

diagnosis and treatment of varices, peptic ulcers

75
Q

what does ERCP outline

A

biliary and pancreatic ducts

76
Q

what is skin like in haemochromatosis

A

slate-grey appearance

77
Q

what does splenomegaly occur with

A

portal hypertension

GI (50 decks)

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