liver

Question 1

what is liver inflammation often due to

Answer 1

obesity

Question 2

pathway to cirrhosis

Answer 2

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

Question 3

what is the body largest internal organ

Answer 3

liver

Question 4

where is the liver situated

Answer 4

right hypochondrium

Question 5

how many segments

Answer 5

8

Question 6

what does each segment have

Answer 6

portal pedicle

Question 7

what two vessels enter the liver

Answer 7

• hepatic artery

- portal vein

Question 8

what is the hepatic artery

Answer 8

branch of the coeliac axis

Question 9

what does the portal vein do

Answer 9

drain most of the GI tract and the spleen

Question 10

where does blood go after it leaves the sinusoids

Answer 10

1. enter branches of the hepatic vein

2. enters inferior vena cava

Question 11

what is special about the caudate lobe

Answer 11

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

Question 12

do sinusoids have a basement membrane

Answer 12

no

Question 13

what are Kupffer cells

Answer 13

phagocytic cells

Question 14

what is the subendothelial space between the sinusoids and hepatocytes

Answer 14

space of Disse

Question 15

what do stellate cells store

Answer 15

retinoids in their resting state

Question 16

what happens to stellate cells when activated

Answer 16

are contractile and regulate sinusoidal blood flow

Question 17

what do stellate cells generate

Answer 17

collagen eventually leading to cirrhosis

Question 18

what do bile canaliculi form

Answer 18

a network between the hepatocytes

Question 19

where do the hepatic ducts join

Answer 19

at the porta hepatis

Question 20

what does the cystic duct connect

Answer 20

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

Question 21

where does the gall bladder lie

Answer 21

under the right lobe of the liver

Question 22

what does the gall bladder do

Answer 22

stores and concentrated hepatic bile

Question 23

where does the bile duct and pancreatic duct open into

Answer 23

second part of duodenum

Question 24

what does the liver synthesise

Answer 24

• all circulating proteins
• all coagulation factors
• complement system

Question 25

what does the liver control

Answer 25

the rate of gluconeogenesis

Question 26

functions of albumin

Answer 26

- maintain intravascular oncotic pressure | - transport water-insoluble substances such as bilirubin, hormones, fatty acids and drugs

Question 27

examples of coagulation factors

Answer 27

- fibrinogen - prothrombin - antithrombin

Question 28

what does the liver store

Answer 28

- large amounts of certain proteins and minerals | - glycogen

Question 29

how are amino acids degraded

Answer 29

by transamination and oxidative deamination

Question 30

what does oxidative deamination of amino acid produce

Answer 30

ammonia

Question 31

what is ammonia converted to

Answer 31

urea

Question 32

where is urea excreted

Answer 32

kidneys

Question 33

what organ controls glucose homeostasis

Answer 33

liver

Question 34

what is glycogenolysis

Answer 34

glycogen breakdown

Question 35

what is gluconeogenesis

Answer 35

synthesis of new glucose

Question 36

what are the sources of gluconeogenesis

Answer 36

- lactate - pyruvate - amino acids - glycerol

Question 37

where is glycerol from

Answer 37

lipolysis of fat

Question 38

what is used in prolonged starvation as a source of fuel

Answer 38

- ketone bodies | - fatty acids

Question 39

are fats soluble in water

Answer 39

no

Question 40

how are fats transported

Answer 40

by lipoproteins

Question 41

what organ metabolises lipoproteins

Answer 41

liver

Question 42

where are triglycerides from

Answer 42

dietary origin

Question 43

where is most cholesterol synthesised from

Answer 43

acetyl-CoA

Question 44

what does bile consist of

Answer 44

- water - electrolytes - bile acids - cholesterol - phospholipids - conjugated bilirubin

Question 45

what does bile formation require

Answer 45

uptake of bile acids

Question 46

what does bile acid receptor farnesoid X do

Answer 46

block bile acid formation from cholesterol

Question 47

what are water channels

Answer 47

aquaporins

Question 48

where are bile acids excreted to

Answer 48

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

Question 49

what are the 2 primary bile acids

Answer 49

- cholic acid | - chenodeoxycholic acid

Question 50

what do I cells of duodenum secrete

Answer 50

cholecystokinin

Question 51

what does cholecystokinin do

Answer 51

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

Question 52

what does bile acids act as

Answer 52

detergents - lipid solubilisation

Question 53

what do bile acids form in aqueous solution

Answer 53

micelles

Question 54

how is bilirubin produced

Answer 54

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

Question 55

what is bilverdin formed from

Answer 55

haem and reduced to form bilirubin

Question 56

how is bilirubin transported

Answer 56

bound to albumin

Question 57

is conjugated bilirubin water soluble

Answer 57

yes

Question 58

what is bilirubin reduced to

Answer 58

urobilinogen

Question 59

where is the main site of drug metabolism

Answer 59

liver

Question 60

what are viral markers good for diagnosing

Answer 60

Hep A, B, C, D, E

Question 61

what is serum iron and ferritin used to diagnose

Answer 61

haemochromatosis

Question 62

what is serum copper used for

Answer 62

Wilson's disease

Question 63

what is anti-nuclear cytoplasmic antibodies used for

Answer 63

primary sclerosing cholangitis

Question 64

what are markers of liver fibrosis used for

Answer 64

NAFLD | hepatitis C

Question 65

what is serum albumin useful for

Answer 65

determining severity of liver disease

Question 66

is bilirubin mostly conjugated or unconjugated

Answer 66

unconjugated

Question 67

what is prothrombin time a marker of

Answer 67

synthetic function

Question 68

when is genetic analysis done

Answer 68

- haemochromatosis | - alpha1-antitrypsin deficiency

Question 69

what do dipsticks test sense

Answer 69

bilirubin and urobilinogen

Question 70

what is ultrasound useful for

Answer 70

- extraheptic obstruction - assessing jaundice - assessment of hepatomegaly - assessing hepatic parenchyma - cirrhosis - lymph node enlargement

Question 71

what does fatty infiltration look like on ultrasound

Answer 71

bright appearance

Question 72

what does CT provide guidance for

Answer 72

biopsy

Question 73

what does X-ray for

Answer 73

- gallstones - air in biliary tree - pancreatic calcification - calcification of gall bladder

Question 74

what is upper GI endoscopy used for

Answer 74

diagnosis and treatment of varices, peptic ulcers

Question 75

what does ERCP outline

Answer 75

biliary and pancreatic ducts

Question 76

what is skin like in haemochromatosis

Answer 76

slate-grey appearance

Question 77

what does splenomegaly occur with

Answer 77

portal hypertension