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GI System Final I > Liver and Gallbladder Function - Lopez > Flashcards

Liver and Gallbladder Function - Lopez Flashcards

1
Q

Function of liver

A

bile production and secretion, metabolism of carb/protein/lipid, bilirubin production, detoxification

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2
Q

Carb metabolism by liver

A

gluconeogenesis, storage of glucose as glycogen, release of glucose

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3
Q

Protein metabolism by liver (4)

A

synthesize nonessential amino acids, modify amino acids, synthesize plasma protein, convert ammonia to urea

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4
Q

Liver failure can result in…

A

hypoalbuminemia –> edema

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5
Q

Lipid metabolism by liver

A

fatty acid oxidation, synthesis of lipoproteins, cholesterol, and phospholipids

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6
Q

Majority of bile is….

A

bile salts

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7
Q

Where is bile produced and secreted

A

liver

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8
Q

Cirrhosis

A

chronic liver disease where normal liver cells are damaged and replaced by scar tissue

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9
Q

How can cirrhosis occur

A

excessive alcohol intake

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10
Q

Why does alcohol lead to cirrhosis

A

alcohol abuse causes accumulation of fat in hepatocytes causing fatty liver and steatohepatitis

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11
Q

Steatohepatitis

A

fatty liver with inflammation leading to scarring

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12
Q

Relative amounts of the four bile acids

A

cholic acid > chemodeoxycholic acid > deoxycholic acid > lithocholic acid

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13
Q

Location of primary bile acids

A

hepatocytes

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14
Q

Location of secondary bile acids

A

lumen of small intestine

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15
Q

Location of bile salt conjugation

A

liver

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16
Q

Bile salt structure

A

amphiphathic

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17
Q

Role of bile salts

A

emulsify lipids and form micelles

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18
Q

Phospholipid structure

A

amphipathic molecules but not soluble in H2O

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19
Q

How are micelles formed?

A

bile salts solubilize phospholipids

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20
Q

Cholesterol structure

A

weakly polar molecule on interior micelle

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21
Q

Most important bile pigment

A

bilirubin

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22
Q

T/F Bile pigments play a major rile in micellar formation

A

F- do not take part in micellar formation

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23
Q

What is the predominant cation of bile

A

Na+

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24
Q

Predominant anion of bile

A

Cl- and HCO3-

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25
What does the behavior of bile salts depends on...
bile salt concentration
26
Decreased concentration of bile salts
no aggregation of bile salts
27
Increased concentration of bile salts
increased concentration of micelle formation
28
Critical micellar concentration
hydrophobic portion of bile salt, phospholipds, and fatty acids interact in interior of micelles
29
5 components of biliary system
liver, gallbladder and bile duct, duodenum, ileum, portal circulation
30
What is secreted into the bile canaliculi
the returning bile salts
31
What secretes canalicular bile
ductule cells in response to osmotic effects of anion transport
32
What happens via enterohepatic circulation
bile salts are recirculated to the liver
33
3 steps of enterohepatic circulation
1bile salts transported from ileum to portal blood 2. bile salts back to liver 3. Synthesis of bile salts to replace amount that was lost
34
What membrane do the bile salts get taken up through
basolateral membrane of hepatocytes
35
2 systems of bile salt uptake by liver
1Na+ dependent transport protein, sodium taurocholate cotransporting polypeptide, 2. Na+ independent transport protein, organic anion transport protein
36
Ileal transport process
highly efficient at carrying bile acids to portal blood
37
Effect of increase in bile secretion on returning rate of bile acids
increase bile acid to liver via portal blood
38
What is inhibited by bile salts
cholesterol 7a-hydroxylase
39
Secretin effect on bile salts
stimulates HCO3 secretion and H2O from ductile cells cause an increase in bile formation and decrease in bile salt concentration
40
Secretion of bile acids in relation to cations
accompanied by passive movement of cations into conaliculus
41
What is canalicular bile
ultrafiltrate of plasma
42
Bile flow between periods of digestion: gallbladder
relaxed gallbladder, sphincter of Oddi closed
43
Interdigestive period
between periods of digestion
44
CCK mediated when...
eating
45
CCK function on gallbladder
contraction of gallbladder and relaxation of sphincter of Oddi
46
UDP glucuronyl transferase
synthesized slowly after birth | - can potentially cause jaundice
47
Conjugated bilirubin is called..
bilirubin glucuronide
48
What accounts for the urine's yellow color
conjugated bilirubin
49
What causes stool dark color
Urobilin and stercobilin
50
Physiological neonatal jaundice
increase level on unconjugated bilirubin in blood during first week of life
51
Two main causes of physiological neonatal jaundice
1bilirubin production is elevated 2. Low activity of UDP glucuronyl transferase
52
Why would bilirubin be elevated
increased breakdown of fetal erythrocytes
53
UDP glucuronyl transferase
enzyme responsible for binding bilirubin to glucuonic acid to mae bilirubin more soluble
54
Jaundice
yellowing of skin beginning at face
55
Crigler-Najjar syndromes
can't conjugate bilirubin
56
Gilbert's syndrome
can't uptake unconjugated bilirubin in liver
57
Dubin-Johnson syndrome
can't secrete conjugated bilirubin into bile
58
Rotor syndrome
can't secrete conjugated bilirubin into bile | *same as Dubin-Johnson*
59
Hemolytic anemia
form of anemia due to hemoylsis
60
Hemolytic anemia affect on bilirubin
increase bilirubin production
61
T/F Hemolytic anemia is related to both unconjugated bilirubin and conjugated bilirubin
F- Hemolytic anemia is related to conjugated bilirubin
62
Constitutional hepatic dysfunction/familial nonhemolytic jaundice
aka Gilbert's syndrome
63
Level of unconjugated bilirubin for Gilbert's syndrome
increased in blood ( unconjugated hyperbilirubinemia)
64
What causes Gilbert's syndrome
mutation in gene that codes for UDP glucuronyl transferase
65
Level of unconjugated bilirubin for Crigler-Najjar syndrome
increased in blood (unconjugated hyperbilirubinemia)
66
Type I Crigler-Najjar syndrome
early in life - no function of UDP glucuronyl transferase - with kernicterus
67
Kernicterus
form of brain damage caused by accumulation of unconjugated bilirubin in brain
68
Babies with kernicterus
lethargic and weak muscle tone
69
Type II Crigler-Najjar syndrome
starts later in life - less that 2-5 function of UDP glucuronyl transferase - less likely to develop ketnicterus
70
Treatment for Crigler-Najjar
- light treatment (phototherapy) but doesn't work after the age of 4 due to thickening of skin - blood transfusions - oral calcium
71
Treatment for only Type I CN
liver transplant
72
Treatment for only Type II CN
phenobarbitol drug
73
Level of unconjugated bilirubin for Dubin-Johnson syndrome
increase of unconjugated bilirubin IN SERUM without liver enzyme elevation
74
Cause of Dubin-Johnson
defect in ability of hepatocytes to secrete conjugated biliruin
75
Mutation in Dubin-Johnson
multidrug resistance protein 2 (MRP2)
76
Function of MRP2
transport bilirubin out of liver cells into bile
77
Staple sign of Dubin-Johnson
liver has black pigmentation
78
Dubin-Johnson incidence rate
more common among iranian and moroccan jews living in Israel
79
Rotor syndrome bilirubin levels
build up of both unconjugated con conjugated bilirubin in blood
80
Gene associated with Rotor syndrome
abnormally short OATP1B1 and OATP1B3
81
Function of OATP1B1 and OATP1B3
transport bilirubin from blood to liver to be cleared from body
82
Liver appearance with Rotor syndrome
not pigmented
83
How does phototherapy work
transformation of trans-bilirubin into cis-bilirubin allowing the newborn to excrete bilirubin in urine and stools
84
Cholelithiasis
excess of pigmented bilirubin breakdown or cholesterol
85
Choledocholithiasis
small gallstomes pass to biliary duct and get stuck leading to inflammation and crampy pain
86
How can jaundice form from gallstone
if stone passes to common bile duct and obstructs it
87
How can pancreatitis form from gallstone
if stone pass to entrance of duct at duodenum and obstruct pancreatic duct
88
Gallstone ileus
stone pass into duodenum and obstruct it
89
Phase I of drug metabolism by liver
cytochrome P450 enzyme oxidation
90
Phase II of drug metabolism by liver
conjugation phase

GI System Final I (7 decks)

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