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FHB > GI 10 and 11: Liver and bile > Flashcards

GI 10 and 11: Liver and bile Flashcards

1
Q

Wht are the 3 main functions of the liver

A

metabolism, detoxification, excretion

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2
Q

What is the portal circulation?

A

Blood from GI organs goes to portal vein instead of straight to vena cava –> allows liver to have a first “look over” of blood from GI tract (detox!!)

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3
Q

Hepatocyte

A

liver cell

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4
Q

Organizing structure hepatocytes are in

A

plates

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5
Q

what kinds of vessels supply hepatocytes

A

sinusoids (low resistance cavities that are supplied by portal vein and hepatic artery)

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6
Q

Hepatic triad

A

Branches of hepatic artery, portal vein and bile duct

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7
Q

Zone 1

A

Periportal cells - cells closest to triad, very sensitive to oxidative injury and hve largest O2 and nutrient supply. These are most active in detoxiication

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8
Q

Zone 2

A

intermediate zone between zones 1 and 3

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9
Q

Zone 3

A

Pericentral cells - closest to hepatic vein, mmost sensitive to ischemia and very active in bile synthesis

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10
Q

where does biliary system start?

A

Hepatocytes

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11
Q

Canaliculi in liver connect what?

A

apical membranes of adjacent hepatocytes

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12
Q

Cholangiocytes

A

Canaliculi drain bile from liver and transport to biliary ductules - these ductules are lined by cholangiocytes which are a kind of columnar epithelial cell

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13
Q

Zones 1-3 in level of oxygenation

A

Zone 1 > zone 2 > zone 3

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14
Q

Biliary ductules drain into what

A

bile ducts - which coalesse into right and left hepatic ducts, and then into hepatic duct and go to either gall bladder (via cystic duct) or small intestine via common bile duct

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15
Q

What metabolism do hepatocytes play a role in

A

carbohydrates
lipids
proteins

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16
Q

what do heptocytes do for carb metabolism

A

gluconeogenesis
glycogenolysis

Impaired liver fxn results in hyperglycemia during and after meals, and hypoglycemia between meals

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17
Q

Hepatocyte fxn in lipid metabolism

A

Rich store of enzymes for FA oxidation - contributes to generating energy
convert carbs to lipids - synthesis of lipoproteins, cholesterol, phospholipids (metabolism classes will cover this gain)
Convert cholesterol to bile acids

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18
Q

Role ofl liver in protein metabolism

A

synthesize non-essential AA’s nd modifies these so they can go into biosynthetic pathways for carb synthesis
synthesizes plasma proteins (including albumin)
converts ammonia to urea

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19
Q

How does liver protect body from toxins

A

Senses endogenous or exogenous toxic molecules (so anything cells produce and are in blood, but also any drugs or bacterial toxins), done in 2 phases

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20
Q

phase 1 of liver detoxification

A

oxidation, hydroxylation - catalyzed by cytochrome p450 enzymes

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21
Q

phase 2 of liver detoxification

A

cnjugate substances with glucuronide sulfate, AA’s, or GSH to make the m water soluble, then excrete products in feces via bile or in urine via kidney

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22
Q

Wht role does liver play in excretion?

A

Large water soluble catabolites and molecules can be excreted via bile –> go to feces

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23
Q

Constituents of bile

A 
bile salts
phospholipids
proteins
cholesterol
bile pigments (bilirubin) 
electrolytes (isotonic to plasma)
24
Q

2 primary bile acids synthesized by hepatocytes

A

cholic acid and chenodeoxycholic acid

25
Q

Secondary bile acids and how are they synthesized

A

Colonic bacterial enzymes act on primary bile acids to form secondray ones, whch are ursodeoxycholic acid, deoxycholic acid, and lithocholic acid)

26
Q

how are bile salts made / how are bile acids made more soluble

A

in hepatocytes, primary and secondary bile cids are conugated with glycine nd taurine with exception of lithocholic cid which is sulfated instead

27
Q

Conjugated bile acids are absorbed __ by ____

Deconjugated bile acids are absorbed ___ by ____

A

in ileum by ASBT

In colon by passive diffusion

28
Q

How are bile acids brought back to liver

A

entoerhepatic circulation

29
Q

If you have an ileal resection what happens to bile circulation

A

you lose a shit ton of bile recycling

30
Q

What can cholangiocytes do to bile

A

modify it - Glucose, AAs are reclaimed by transporters, and chloride is exchanged for HCO3- so bile is slightly alkaline

31
Q

where is bile stored

A

gallbladder

32
Q

in between meals, outflow of bile is blocked by what

A

constriction of sphincter of oddi

33
Q

How does bile concentrate

A

unknown mechanism but Na/H exchanger plays a role, sodium is absorbed which will bring water with

34
Q

What hormone is the main player in getting bile to be secreted from GB into duodenum

A

CCK

Ach can also be dumped on GB to get it to squeeze from neural reflexes

35
Q

What are gallstones

A

precipitated bile constituents

36
Q

What comprises gallstones

A

cholesterol or calciu-biliruinate pigment stores

37
Q

What usually prohibits gallstone generating

A

anti nucleating proteins

38
Q

If you skip breakfast what might happen

A

gallstones

39
Q

What is bilirubin a consequence of

A

heme degeneration

40
Q

What does bilirubin bind to in blood

A

albumin

41
Q

what takes bilirubin into hepatocytes

A

organic anion transporting polypeptide transporter (OATP)

42
Q

in microsomes of hepatocytes, bilirubin is conjugated to what via what enzyme

A

Glucoronic acid by UDP glucuronyl transferase

43
Q

Why do some newborns develop jaundice

A

UDP glucunoryl transferase is not synthesized quickly after birth

44
Q

Conjugated bilirubin is water soluble or insoluble

A

soluble and part of it is xcreted in urine (remainder is secreted in bile nd travels to small intestine to do so)

45
Q

In terminal ileum, what happens to biliruben

A

deconjugated by bacterial enzymes and metabolized to urobilinogen

46
Q

Can bilirubin cross BBB?

A

yes and it can cause neurological damage and be fatal if it isn’t yeeted

47
Q

Increase in unconjugated bilirubin would be a reflection of what

A

loss/absence of UGT
sudden oversupply of heme
liver failure

48
Q

High conjugated bilirubinemia would be do to

A

defect in OATP , blockage of bile flow

49
Q

Jaundice

A

yellow color of skin and conjunctiva due to accumulation of bilirubin due to hemolysis, hepatic dysfunction, or gallbladder duct issues

50
Q

What is a product of protein catabolism the liver must deal with to safely excrete

A

ammonia - turns to urea via urea cycle

51
Q

What are the 2 main generators of ammonia for us

A

protein catabolism and colonic bacteria

52
Q

Is urea ammonia membrane permeable

A

yes

53
Q

What happens to ammonium and urea

A

excreted in stool and urine

54
Q

Hepatic encephalopathy

A

Chronic liver disease –> declining mental fxn, caused by detox function being fucked –> this is fatal

55
Q

Liver cirrhosis

A

irreversible scarration and destrution of liver, caused by injury, fibrosis, and tissue degeneration from dugs, poisons, and hepatitis

56
Q

Portal hypertension

A

Increased BP in sinusoids reflects to portal vein –> results in splenomegaly , ascites, and other complications

caused by increased vscular resistance in lier

FHB (54 decks)

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