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Flashcards in Liver Deck (68):
1

what do hepatocytes(60%) do

perform metabolic functions- removal of toxic substances(alcohol)

2

what do kupffer cells(30%) do

tissue macrophage - et RBC, bacteria, viruses

3

what is the functional unit of the liver

hepatic lobule

4

what is the hepatic lobule made of

hepatocytes and a central hepatic venule

5

at each corner of hepatic lobule what does the triad consist of

hepatic artery (75%)
portal vein (25%)
bile duct

6

the blood travels from the corner to the central vein by small channels called what

sinusoids

7

what are the sinusoids lined by

hepatocytes

8

what secretes bile

hepatocytes

9

where does the hepatocytes secrete bile into

channels- canaliculi

10

biliary system ducts (6)

canaliculi
ductule
left/right hepatic duct
common hepatic duct
cystic duct
common bile duct

11

where are kupffer cells found

in sinusoids

12

what do kupffer cells do

remove gut bacteria/ antigens

13

what is the first step of bile seceretion

by hepatocytes:
bile acids
bilirubin
cholesterol
phospholipids

14

what is the second step of bile secretion stimulated by

hormone secretin

15

what is the second step of bile seceretion

epithelial cells secreting water and electrolytes such as Na+ and bicarbonates

16

normally cholesterol is soluble in

bile

17

how are gall stones formed

due to precipitation of gall stones in bile

18

what are two types of gall stones

pigment (80%)
cholesterol (20%)

19

what are the 3 factors in increased risk of gall stone formation

- high fat diet
- women- estrogen
- inflammation of epithelial cells

20

what are the two things that cholestrol gets broken down into (acids)

cholic acids
chenodeoxycholic acid

21

what are these two acids conjugated with

amino acids to make more soluable

22

what is the conjugated form released into

cannaliculi

23

how much of bile is reabsorbed at the terminal ileum

95%

24

what vein returns the blood to hepatocytes from ileum

portal vein

25

what happens to the 5% of bile

lost in faeces

26

how many times a day is the same pool of bile circulated

6-8

27

what other purpose does bile serve other than fat emulsification

removal of waste: bilirubin and cholesterol

28

what is bilirubin the product of

breakdown of haemoglobin

29

what is haem converted to

free bilirubin

30

what is free bilirubin bound to

albumin

31

what is the bilirubin bound to albumin conjugated with

amino acid (glucoronic acid)

32

what is the conjugated form of free bilirubin with amino acid secreted into and then metabolised by

bile
intestinal bacteria

33

what is the major metabolite of bilirubin in urine

urobilin
urobilinogen

34

what is the major metabolite of bilirubin in faeces

stercobilin

35

what is jaundice

either free or conjugated bilirubin in ECF

36

what is the sclera

white part of the eye

37

where does yellow appear in jaundice patients

skin
sclera
mucosal membrane

38

what is the normal concentration of bilirubin in the plasma

0.5mg/dL

39

what is the abnormal concentration of bilirubin in the plasma

1.5mg/dL

40

when do you get green discolouration

mutation of biliverdin reductase gene

41

what does biliverdin reductase gene convert

biliverdin to bilirubin

42

what causes the green colour jaudice

biliverdin

43

3 types of jaundice

pre hepatic
hepatic
post hepatic

44

what is pre hepatic jaundice

too much haemolysis
neonates

45

what is hepatic

problems with hepatocytes due to cirrhosis, hepatitis, drugs
inc in serum bilirubin

46

what is post hepatic

passage of conjugated bilirubin into duodenum blocked, leak out into circulation and urine

47

what happens to excess proteins

-keto group converted to glucose or lipids
-urea cycle
-synthesis of plasmaproteins

48

what can ammonia do

depress cerebral blood flow and cerebral oxygen consumption
-interferes with GABA and dopamine

49

what does interference with GABA and dopamine lead to

hepatic encephalopathy

50

what enzyme catalyses redox reactions in phase 1 of drug metabolism

cytochrome P450

51

where does phase 1 of drug metabolism take place

smooth ER

52

what happens in phase 2 of drug metabolism

-conjugation with glucuronyl to make water soluble
-removal using ATPase pumps

53

what three pathways for paracetamol metabolism

1. glucoronidation
2. sulfation
3. N-hydroxylation and dehydration

54

with the N-hydroxylation and dehydration pathway for paracetamol metabolism what is the intermediate formed

NAPQI- toxic

55

what detoxifies NAPQI

glutathione conjugation

56

in paracetamol overdose what is the treatment

N-acetyl cysteine which is precursor of glutathione

57

what does reactions with NAPQI and nucleic acids/ proteins lead to

liver necrosis and kidney damage

58

what is the first step of alcohol metabolism

ethanol to acetaldehyde catalysed by alcohol dehydrogenase

59

what is reduced in the first step of alcohol metabolism

NAD+ to NADH

60

what does NADH and H+ react with

pyruvate

61

this depleted supply of pyruvate will inhibit what and lead to what

gluconeogenesis
hypoglycemia

62

what will the build of lactic acid lead to

acidosis

63

what are the three stages of liver damage due to drinking

fatty liver
alcohol hepatitis
cirrhosis

64

what does vit B12 deficiency lead to

pernicious anaemia

65

what enzyme indicates a obstruction to bile flow

ALP- alkaline phosphatase
GGT

66

what does albumin in blood test tell us

decreased in chronic liver disease

67

what does bilirubin in blood say

jaundice

68

what does alanine amino transferase(ALT) suggest

alcohol induced damage- leak out of hepatocytes