Liver Detox & Alcohol Flashcards Preview

Jason's GI Block > Liver Detox & Alcohol > Flashcards

Flashcards in Liver Detox & Alcohol Deck (84):
1

Cytochrome P450 oxidises all foreing chemicals with MW of?

<5000

2

Which Cytochrome P450 metabolises paracetomol?

Cytochrome P450 2E1
CYP2E1

3

Where do you find Cytochrome P450 enzymes in the cell?

Endoplasmic reticulum
mitochondria

4

What is the formula for Cytochrome P450 monoxygenase catalyse?

RH + NADPH + H+ + O2 --> ROH + H2O + NADP+

5

What happens if CYP 2D6 is deficient?

failure to convert codeine to morphine

6

What does the initial alternation in Cytochrome P450 involve?

addition of -OH group and then a sugar to make it soluble

7

where is Cytochrome P450 located on the ER?

Microsomes

8

Cytochrome P450 is an enzyme? or a pigment?

Enzyme

9

P450 is in the microsomes? or the ER?

ER

10

What colour are Microsomes?

PInk

11

What are the P450 in mitochondria used for?

oxidising steroids esp. in adrenals

12

Cytochromes (not P450) also function in what?

oxidative phosphorylation

13

Food toxins do what to your P450?

promotes variants of P450, can train your liver to metabolize more toxins slowly

14

how many P450 genes in humans?

57

15

CYP 2A6
What is CYP, 2, A, 6?

CYP: P450
2: family
A: subfamily
6: Form

16

Each family in P450 share ___% same sequence?

40%

17

Each subfamily in P450 share ___% same sequence?

>55%

18

what does the hydrophobic protein foot of P450 enzymes do?

anchors P450 to a membrane eg. ER

19

are P450s inducible?

yes if substrates are persistently present

20

what makes P450 pink?

haem prosthetic group

21

What anchors the haem to the protein in P450?

cysteine anchor

22

P450 is a mono or di or tri-oxygenase?

mono-oxygenase

23

how does P450 get collateral damage during oxidation?

reactive O2 species don't always hit their mark, since they are immediately next to substrate, it may damage P450 in process

24

peroxide usually attacks substate to form R-OH but when it doesn't, what does it create?

epoxide

25

epoxides from P450 reaction gone awry does what?

highly reactive with DNA

26

imipramine is a tricyclic what? discovered how?

antidepressant, from a TB drug trial

27

What is the Ames test?

to see if your product has dioxins which are carcinogenic

28

aflatoxin from corn and nuts fungus contributes what severity of ?

kwashiorkor

29

kwashiorkor children have low what?

low albumin and high oedema

30

Drugs what induce P450 can do 3 things:

activate the gene dioxin/phenobarbital
stabilise mRNA
protect P450 from turnover

31

dioxin induces CYP ____ leading to what?

CYP 1A1
cancer, birth defects, immunocompromise

32

how much dioxins needed to cause problems?

picogram quantities

33

What was agent orange?

dioxins and benzopyrenes

34

Phenobarbital used for? acts where?

anesthetic by vets
acts on DNA

35

Some drugs where poor metabolisers have adverse reactions due to P450 polymorphisms include?

warfarin
opioids
fluorouracil
diazepam

36

If CYP 2D6 is inactive what happens?

poor metabolism of codeine = no analgesic action

37

test for CYP 2D6 in patients how?

PCR with a kit

38

Is cirrhosis reversible?

Nope

39

how many Australians have health problems related to risky alcohol intake?

2-3 million

40

Aldehyde dehydrogenase converts acetaldehyde to acetate, what is acetate used for? 2 things

oxidised for energy or converted into fat

41

how fast to most people clear alcohol from their system?

1 standard drink per hour

42

should we completely abstain from alcohol?

no. moderate amounts confers better health and longevity

43

Fermenting to make alcohol was univeral to all civilisations except"

aboriginal australians

44

compare ethanol to fat

almost identical in energy content

45

how does alcohol depress nervous function?

ethanol disrupts membrane fats and make them more leaky and harder to fire properly

46

High risk to health, how many drinks for men and women?

Men = 6+
Women = 4+

47

FAS features?

small irreversibly shrunken brains affecting their entire lives

48

Alcoholic signs include? from head to toe

neuro
jaundice
altered breath
esophageal varices
gynecomastia
Heart disease and arrythmia
scarred liver
portal hypertension
capat medusa
ascites
hand tremor
hypogonadism
bruisibility
muscle wasting
osteoporosis
edema

49

How fast does fatty liver develop? reversible or irreversible?

rapid development and reversible

50

3 presentations of alcohol induced liver damage?

fatty liver
alcoholic hepatitis with inflamm
alcoholic cirrhosis

51

50% of heavy drinkers present with fever and jaundice and abdo pain, what is the likely diagnosis?

alcoholic hepatitis with widespread inflamm

52

15-30% of heavy drinkers with extensive fibrosis and distorted internal liver structure are diagnosed with?

alcoholic cirrhosis

53

How much of your liver do you need to function normally?

40%

54

How much alcohol entered system through stomach vs. gut?

stomach: 30%
Gut: 70%

55

how much of the alcohol is metabolized in liver? in lungs and kidneys? the rest?

90%
<2% in lungs and kidneys
rest by stomach

56

what percentage of alcohol do you lose consciousness?

0.3%

57

ethanol>acetylaldehyde>Acetate gets converted to what and then fed where?

acetyl CoA then into Krebs cycle

58

why do you feel faint if you have alcohol on an empty stomach?

Alcohol Dehydrogenase makes NADH which represses gluconeogenesis and leads to hypoglycemia = faintness

59

what is MEOS? how do it get activated?

microsomal ethanol oxidising system.
due to chronic alcohol: induces CYP2E1 four fold
Catalase is minor pathway

60

why are women affected by alcohol more?

alcohol does not distribute into fat as in men

61

three quick drinks raises you alcohol to?

0.05%

62

How much alcohol in % can your liver clear per hour?

0.015

63

Why is alcohol clearance so slow?

alcohol dehydrogenase kinetics maxes out very fast

64

alcohol breath tests over or underestimates?

underestimates

65

alcohol has 2 effects on drugs?

prevents drug clearance due to competition
promotes drug clearance due to elevated CYP 2E1

66

one really important drug alcohol affects

warfarin

67

warfarin + alcohol =

a bad day.....

68

Hepatocytes are damaged via alcohol because 4 reasons

1 more free-radical damage due to decrease glutathione
2 dietary neglect
3. MEOS increases free radicals
4. increase iron catalyst for free radicals

69

Wernicke Korsakoff syndrome cause? and symptoms?

thiamine deficiency
wide step, nystagmus, confusion, hypothermia, amnesia, confabulation

70

what is ALDH2?

acetylaldehyde dehydrogenase II in the mitochondrias and most important

71

acetylaldehyde dehydrogenase II inherited as recessive or dominant?

dominant

72

acetylaldehyde dehydrogenase II missing in ____% of Asians?

40%

73

What is disulfiram/antabuse used for

inhibites aldehyde dehydrogenase = nausea, vomiting with alcohol consumption

74

Which could be a reward centre in the brain for alcohol?

Dopamine D2 receptor regulates reward reinforcement

75

What are Naltrexone, Nalmefene, Tiapride, Acamprosate used for?

neurological Rx to decrease craving and ease withdrawal with alcohol

76

Physical signs during examination for alcoholism?

spider naevi, palmar erythema, gynecomastia, change in body hair, peripheral neuropathy

77

Gamma-glutamyltranspeptidase (GGT) is what?

elevated in almost any liver disease, but could be increased in heavy drinkers even without liver damage or inflamm

78

is ALT elevated in alcohol liver damage?

yes

79

what is carbohydrate deficient transferrin? when is it elevated?

marker for alcohol consumption greater than 4-5 drinks per day

80

why does alcohol cause dehydration

alcohol interferes with pituitary, less vasopression>less reabsorption of water>more peeing>dehydration

81

Alcohol causes most problems when in pregnancy?

in utero, first trimester

82

FAS features?

small irreversibly shrunken brains affecting their entire lives

83

definition of binge drinking?

more than 10 standard drinks in one sitting

84

alcohol help with cancer?

NOPE.