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BioScience II > Hepatobillary PPT-Josh > Flashcards

Hepatobillary PPT-Josh Flashcards

(77 cards)

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1
Q

this is my last ppt for this test I am going to go through it and only grab the highlights!!!

A

I cant look at this shit anymore

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2
Q

what is the largest solid organ in the body?

A

liver

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3
Q

Liver:

is made up of 50,000-100,000 discrete anatomic units called what?

A

lobules

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4
Q

Liver:

how many portal tracts are there?

A

4-5

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5
Q

what are the 2 types of cells that line the sinusoids?

A

endothelial

kupffer cells (macrophages)

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6
Q

Hepatic blood flow:

dual afferent blood supply equal to __% of CO

A

25%

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7
Q

Hepatic blood flow:

70% of blood is spplied via the ____

A

Portal vein

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8
Q

Hepatic blood flow:

30% suppied via the _______

A

hepatic artery

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9
Q

Hepatic blood flow:

is how many ml/min

A

1500 mL/min

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10
Q

Hepatic blood flow:

arterial flow is autoregulated based on what?

A

O2 consumption

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11
Q

Hepatic blood flow:

a decrease in either hepatic arterial or portal venous flow results in what?

A

compensatory increases in the other

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12
Q

what is teh normal hepatic blood volume?

A

450 mL

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13
Q

Fuctions of LIver?

A

Reservoir

Blood cleansing

metabolic

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14
Q

Blood cleansing fx:

blood from the gut contains large amounts of colonic bacilli, cleansing is performed by the ___ cells that line the hepatic sinus

A

Kupffer cells

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15
Q

____ cells lint the hepatic sinuc and permit diffusion of large plasma proteins and other substances into extravascular spaces in the liver, resulting in a large quanity of lymph that is nearly equal in protein concentration to plasma

A

endothelial

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16
Q

Metabolic Functions of liver

what re the 4 main metabolic fxns?

A
  1. Carbohydrate metabolism
  2. Fat metabolism
  3. Protein metabolism
  4. Drug metabolism
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17
Q

Metabolic Functions of liver

what are the 3 ways the liver does carbohydrate metabolism

A
  1. Gylcogenesis
    • process of glycogen synthesis
  2. Glycogenolysis
    • Release of glucose form glycogen
  3. Gluconeogenesis
    • Conversion of fats/proteins to glucose
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18
Q

Metabolic Functions of liver

what are the final products of Carbohydrate metabolism

A

glucose

frutose

galactose

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19
Q

Metabolic Functions of liver

what are the 2 ways of fat metabolism

A
  1. Lipogenesis
    • synthesis of cholesterol and proteins and carbs from fat
  2. Lipolysis
    • breakdown of lipids
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20
Q

Metabolic Functions of liver

how does it do protein metabolism

A
  • Deamination of proteins
  • Deamination of excess amino acids
  • Synthesis of lipoproteins
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21
Q

Metabolic Functions of liver

how does it do Drug metabolism

A

phase I and II biotransformation

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22
Q

Metabolic Functions of liver

what are the vitamins it stores?

A

A,D,E,K

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23
Q

Metabolic Functions of liver

the liver does synthesis of coagulation factors and inhibitors, in fact it does most all clotting factors except???

A

Factor VIII

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24
Q

Metabolic Functions of liver

how it is responsible for phagocytosis?

A

filtration and destruction of bacteria and debris in blood

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25
Metabolic Functions of liver what minerals is it responsible for?
iron hemostasis copper regulation
26
LFTs: normal Albumin
3.5-5.5 g/dL
27
LFTs: normal AST
10-40 U.mL
28
LFTs: normal ALT
5-35 U.mL
29
LFTs: normal Alk phosphate
45-115 u/L
30
what is an inflammatory disease of the liver parenchyma
Hepatitis
31
Hepatitis: what is teh most common form?
A (50%)
32
Hepatitis: how are each form transmitted? 1. A 2. B 3. C 4. D
1. fecal-oral (sewage)/ shellfish 2. Percutaneous/ sex 3. Percutaneous 4. percutaneous Reacap B by sex A by shit
33
what is hepatic inflammation due to idiosyncratic reaction, dose related toxicity, or a combination of the 2
Drug induced hepatitis
34
Drug induced hepatitis what is teh most common type?
Alcoholic hepatitis
35
Drug induced hepatitis acetamiinophen ingestion of \>\_\_\_\_\_ can cause this
25G
36
Drug induced hepatitis the onset is ___ weeks post exposure but can be up to six months
2-6 weeks
37
what are the stages of alcohol induced liver damage?
* fatty liver * Liver fibrosis * Cirrhosis
38
which VAA can cause hepatitis?
halothane called halothane hepatisis
39
what is it called when normal liver parenchyma is replaced w/ fibrous and nodular tissie
Cirrhosis
40
Cirrhosis: what are early S/S
fatique Malaise jaundice
41
Cirrhosis:w hata re late S/S
spider angiomata gynecomastia testicular atrophy ascites
42
Cirrhosis: why is hypogycemia common?
due ti inadequate gluconeogenesis
43
Manisestations of Cirrhosis: GI
* PORTAL HTN * ascites * esophageal varies * Hemorrhoids * GI bleeding
44
Manisestations of Cirrhosis: circulatory
* High CO * Systemic ateriovenous shunts * Low SVR * cirrhotic cardiomyopathy
45
Manifestations of Cirrhosis: Pulmonary
* increased intrapulmonary shunting * Decreased FRC * Pleural effusion * Restrictive ventilatory defect * Resp alkolosis
46
Manifestations of Cirrhosis Renal
* Increased reabsorption of Na+ * Impaired free water clearance
47
Manifestations of Cirrhosis: Hematological
* Anemia * Coagulopathy
48
Manifestations of Cirrhosis: infections
spontaneous bacterial peritonitis
49
Manifestations of Cirrhosis: Metabolic
* HYPO Na+ * HYPO K+ * HYPO Mg++ * HYPO albumin * HYPOglycemia
50
Manifestations of Cirrhosis: neuro
encephalopathy
51
what disease is caused by obesity when there is an excess of intraheptic triglycerides, impaired insulin activity, and additional release of inflammatory cytokines
Non-alcoholic Fatty liver disease (NAFLD) also called Nonalcoholic steatohepatitis
52
NAFLD \_\_\_% of severly obese adults have this?
85%
53
Anesthesia for pts w/ decreased liver function: they are increased rick of what?
bleeding infection hepatic decompensation death
54
Anesthesia for pts w/ decreased liver function: intraop what should you monitoe
BGL
55
Anesthesia for pts w/ decreased liver function: why to they get hypotensive?
low SVR and relative hypovolemia
56
Anesthesia for pts w/ decreased liver function: what do u need to do with NDMBD?
increase dose
57
Anesthesia for pts w/ decreased liver function: what do u need to do w/ propofol dose?
decrease
58
Anesthesia for pts w/ decreased liver function: why may SCh be prolonged?
b/c plasma cholinesterase is produced in the liver and may also be deficient
59
Anesthesia for pts w/ decreased liver function: VAAS and regional both decrease HBF by \_\_\_\_% in absence of stimulation
30%
60
Anesthesia for pts w/ decreased liver function: what 3 VAAs undergo minimal hepatic metabolism and can be regarded as safe
Iso sevo des
61
Anesthesia for the drunk: do they need more or less anesthesia
less (additive depressant effect)
62
Anesthesia for the drunk: why do u need aspiration precautions?
slowed gastric emptying decreased LES tone
63
Anesthesia for the drunk: why may there be increased surgical bleeding
interferance w/ plt aggrigation
64
Anesthesia for the drunk: is the brain more or less tolerant to hypoxia?
less
65
Anesthesia for the drunk: what happens to circulating catecholamines
increased (labile VS and exaggerated responses to drugs and stimuli)
66
Gallbladder: capable of holding how much fluid
30-50 ml
67
Gallbladder: how is the common bile duct formed?
* Bile ducts from hepatic Lobules join eventually forming the RIGHT and LEFT HEPATIC DUCTS * which combine to form the HEPATIC DUCT * which together with the CYSTIC DUCT from gallbladder become the COMMON BILE DUCT
68
Gallbladder: ## Footnote At the termination of these ducts is an envolope of smooth muscle called what, which provides a barrier to intestinal bacteria
Sphinter of Oddi
69
Both the billary and pancreatic tracts empty into the duodenum via what?
ampulla of vater
70
Gallbladder: what provides the blood supply?
Cystic artery
71
What is bile made of?
* 97% water * \<1% bile salts * inorganic salts * Lipids * Lecithin * Alkaline phosphate * Conjugated Bilirubin
72
what is the functions of bile?
* emulsify and enhance absorption of ingested fats and fat-soluble vitamins * provide excretatory pathway for drugs and toxins * maintain duodenal alkalization
73
Bile: hepatocytes in each lobule continuolsly secrete bile into bile canaliculi at a rate of ___ L/day
1
74
what causes constraction of the gallbladder, relaxation of the sphinter of oddi, and propulsion of bile into the duodenum
CHOLECYSTOKIN
75
what is the primary end product of Hgb metabolism and is formed from the degradation of the heme ring in the kupffer cells?
bilirubin
76
Anesthesia for Billary Disease: what opiod is most associated w/ spasms of the sphincter of oddi
morphine
77
by far the award for the worst PPT goes to AMY WTF this shit was retarded and not to mention she filled up every single inch of the fucking ppt slides
really what the fuck????

BioScience II (39 decks)

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