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Chem II exam 2 > Liver > Flashcards

Liver Flashcards

(55 cards)

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1
Q

Liver functions

A

Metabolize carbs, lipids, proteins, bilirubin
Detox
storage of essential compounds
clearing waste products into bile

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2
Q

Liver anatomy

A

extremely cascular
bi-lobal (connected by falciform ligament)
Right lobe 6x larger

Blood supplied by: hepatic artery (25%) Portal vein (75%)

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3
Q

Liver micro anatomy

A

Lobules:
Functional units
extretory/metabolic funtions
6 sided
portal triad each corner

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4
Q

Liver cell types

A

Hepatocytes: 80% of the volume
Kupffer cells: fancy location specific macrocytes

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5
Q

Death in liver failure

A

24 hours due to hypoglycemia

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6
Q

Liver
Excretion and secretion

A

Endogenous and exogenous substances in bile or urine
Only organ that gets rid of heme waste

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7
Q

Bile

A

Bilirubin principle pigment
made of bile salts, pigments, cholesterol, other substances from the blood

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8
Q

Unconjugated bilirubin

A

Also called indirect
Bound by albumin
insoluble

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9
Q

Conjugated bilirubin

A

Soluable
Hepatocyte into bile

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10
Q

Urobilinogen

A

colorless byproduct of bilirubin made by bacteria

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11
Q

Bilirubin processing

A

RBC -> heme -> unconj bilirubin -> +albumin makes indirect bilirubin -> conjugated bilirubin -> urobilinogen -> excreted in feces, urine, or recirculated

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12
Q

Glycogenesis

A

storing glucose as glycogen

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13
Q

Glucogenolysis

A

break down glycogen

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14
Q

Gluconeogenesis

A

Generate glucose from non carb sources

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15
Q

Lipid metabilism in the liver

A

Both lipids and lipoproteins
70% daily lipids come from liver and not diet
fatty acids -> Acytal CoA -> triglycerides, phospholipids, Cholesterol

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16
Q

Liver proteins

A

Almost all synth in liver
Dev Hgb in infants
most important: Albumin
Syth pos/neg acute phase reactants

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17
Q

Liver detox

A

Gate keeper to the GI tract
First pass effect
Drug detox major function

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18
Q

Pre hepatic Jaundice

A

Increased bili sent to liver
hemolytic anemias
unconjugated hyperbilirubinemia

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19
Q

Post hepatic Jaundice

A

Biliary obstruction disease
Gallstones or tumors
conjugated bili can’t be eliminated
bile not brought to intestines - grey poop

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20
Q

Hepatic jaundice

A

primary problem in liver
bili metabolism and transport defects

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21
Q

Gilbert’s syndrome

A

autosomal recessive disorder
hepatic jaundice
no clinical consequences
intermittent unconjugated hyperbilirubinemia

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22
Q

Crigler-Najjar

A

Hepatic jaundice
chronic unconj. hyperbilirubinemia
inherited
type 1: complete abcense of enzymatic conjug
type 2: severe deficiency

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23
Q

Dublin Johnson

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A

Obstructive in nature
can’t remove conj. bili
Dark stain granules on liver
mild, no treatment needed

24
Q

physiologic Jaundice

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A

Kernicterus - unconj. bili in the neonate, deposited in brain
Treated with phototherapy, IVIG, metalloporphryrins

25
Cirrhosis
Scar tissue replaces normal tissues poor prognosis alcoholism
26
Liver tumors Benign
Hepatocellular adenoma
27
Liver tumors Malignant
Hepatocellular carcinoma Continues to rise
28
Reye's Syndrom
Don't give kids asprin Encephalopathy follows a viral syndrome 3x increase in ammonia, AST,ALT
29
Drug and alcohol related liver disorders
Ethanol - most important drug Long term consumption can result in a number of disorders
30
Fatty liver
sl. elevation in ALT, AST, GGT Very mild
31
Alcoholic Hepatitis
Fever, Ascites, proximal muscle loss Elevated AST, ALT, GGT, ALP Serum protein decrease (albumin) Creatinine increase = kidney dmg
32
alcoholic cirrhosis
more common in males. 60% survival rate if alcohol is stopped increased AST, ALT, GGT, ALP
33
3 fractions of bilirubin
Delta conj unconj
34
Remembering bilirubin
Vowels: Indirect, unconj, insoluble Consonants: direct, conj, water soluble
35
Bili collection for testing
Serum or plasma Mallory Evelyn prefers serum (alcohol can precip. proteins) fasting avoid hemolysis sensitive to light
36
Bilirubin methods
Jendrassik-Grof procedure more complicated than Malloy-Evelyn
37
Mallory Evelyn procedure
Diazo reagent 1.2 pH red-purple pigment Methanol accelerator
38
Jendrassik-Grof procedure
diazo reagent Diazo only gives conj. bili caffeine-benzoate gives tot. bili
39
Liver enzymes
most useful LFTs ALT, AST, ALP, 5' nucleotidase, GGT, LD
40
ALT/AST
Aminotransferases AST: Heart, Skeletal muscle, liver ALT: mainly in liver
41
ALP/5NT
ALP: Bone, Liver. Hepatobiliary vs. bone disease 5NT: rarely ordered. no bone source, use for differentiation w/ ALP
42
GGT/LD
GGT: Used for detection of alcoholism. Hepatic Neoplasms. LD: widely distributed. released from cellular destruction
43
Hepatitis
Inflam of the liver Most common cause - Viral Chronic hepatitis seen in HBV and HCV
44
Hep A
HAV. Infectious or short incubation Most common Non-envoloped RNA From contaminated food - fecal -> oral route Self limiting
45
Hep A clinical markers
IgM anti-HAV IgG Anti-HAV if IgM = and IgG +, then past infection indicated Vaccine availible.
46
Hep B
HBV. "serum Hepatitis" Ubiquitous Can live in environ. for 7 days detected in all body fluids
47
Hep B routes
Parenteral Perinatal Sexual
48
Hep B Sero markers
DNA virus Replicates in liver HBcAg - Core antigen HBsAg - Surface antigen HBeAg - envelope antigen
49
HBsAg - Surface antigen
Testing all donated blood not infectious indicated possible infection can be positive 10-20 days post-vaccination Anti-HBs + mean acquired immunity
50
Chronic infection with HBV
90% recover in 6 months 4 phases : Tolerance Clearance Non-replication Reactivation
51
Hep C
Non-A. Non-B hepatitis RNA genome Parentally xmitted High rate of progress to chronic hep, cirrhosis, carcinoma Leading cause of liver xplants
52
HCV tests
Anti-HCV PCR for serum HCV RNA
53
Hep D
Super infects with Hep B Requires HBsAg to replicate
54
Hep E
nonenveloped RNA 21-42 day incubation simlar to HAV Anti-HEV IgM testing
55
Hepatitis routes of infection
Hep A/E: Fecal Oral B/C/D: parenteral, sexual

Chem II exam 2 (6 decks)

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