Liver, pancreatic secretions and jaundice

Question 1

What is the name of food when it exits the stomach?

Answer 1

Chyme

Question 1

At what level must blood bilirubin by at for jaundice to occur?

Answer 1

35 micromolar - 3x the normal amount

Question 2

What does colipase do?

Answer 2

Activates lipase

Prevents bile acids inhibiting the lipase

Question 2

What population gets pancreatitis the most?

Answer 2

Females >50

Question 2

Why do a high proportion of babies get jaundice?

Answer 2

Is there is a lot of haemolysis during the switch from foetal to adult Hb and the liver it’s yet developed enough to deal with the extra load.

Question 3

What happens when fatty acids enter to intestinal mucosa?

Answer 3

Reform triglycerides

Question 4

Which pancreatic cells release bicarbonate?

Answer 4

Duct cells

Question 4

What drug can be used to decrease fat absorption?

Answer 4

Orlistat

Question 5

What are bile salts made from?

Answer 5

Cholesterol

Question 6

What does CCK do to the gallbladder?

Answer 6

Stimulates contraction

Question 6

Which pancreatic cells release enzymes?

Answer 6

Acinar

Question 6

What serum markers are indicative of pancreatitis?

Answer 6

Lipase (most characteristic)

Amylase

Question 6

Is Gilbert’s syndrome severe? What goes wrong?

Answer 6

No, usually subclinical

Decreased conjugation of bilirubin

Question 8

What are zymogens?

Answer 8

Inactivated precursor forms of enzymes

Question 9

What happens to faeces after a fatty meal?

Answer 9

It’s darker due to more bile

Question 10

What is a hepatic cause of jaundice?

Answer 10

Intrahepatic obstruction - cirrhosis

Question 11

What activates colipase?

Answer 11

Trypsin

Question 12

How much bile can the liver produce per day?

Answer 12

Up to 1L

Question 13

What is the function of the taurine and glycine groups on bile salts?

Answer 13

Increase solubility

Question 14

What is cyst a general term for?

Answer 14

A Bladder-like structure

Question 15

What structure does bile acids form in digested lipids?

Answer 15

Micelles

Question 15

What happens in Dubin-Johnson syndrome? Is it severe?

Answer 15

Impaired secretion of conjugated bilirubin

Mild symptoms

Question 16

What does secretin enhance the secretion of?

Answer 16

Bicarbonate in the acinar cells of pancreas

Question 17

What happens when you have a deficiency in glucose-6-phosphate dehydrogenase?

Answer 17

You can’t produce as much glutathione (glutathione protects against ROSs) > More ROS > RBCs damaged

Question 18

What percentage of bilirubin comes from the breakdown of old RBCs?

Answer 18

80%

Question 19

What endocrine hormones do islets of Langerhan make?

Answer 19

Insulin Glucagon

Question 20

How does increasing the fat cotent of faeces affect its appearance?

Answer 20

Paler, whiter Greasy Foul smelling

Question 22

What is enterohepatic circulation?

Answer 22

Where bile salts are absorbed in the terminal ileum for recycling

Question 23

What happens when you go on chloroquine when you have a deficiency in G6PD?

Answer 23

ROS from chloroquine aren't removed by glutathione \> membrane destruction and globin precipitation \> haemolytic jaundice, Heinz bodies

Question 25

What type of agents are bile salts?

Answer 25

Detergents

Question 26

What are two other names for bile?

Answer 26

Gall Chole

Question 28

What percentage of bile salts are recycled?

Answer 28

95%

Question 28

What happens in Crigler-Najjar syndrome? Is it severe?

Answer 28

UDP glucuronyl transferase deficiency Yes, transplant required

Question 29

Describe the structure of bile salts

Answer 29

Steroid structure with a carboxylic acid group that is commonly amide linked to taurine or glycine

Question 31

In what form are lipids that lipases breakdown?

Answer 31

Triglycerides

Question 32

What does a deficiency in galatose--6-phosphate uridylyl transferase result in?

Answer 32

Hypergalatosaemia \> jaundice, cataracts

Question 33

Why to premature babies get jaundice more?

Answer 33

Ligandin and UDP glucuronyl transferase takes longer to reach normal levels

Question 34

What are the most important bile salts?

Answer 34

Cholic acid Deoxycholic acid Chenodeoxycholic acid

Question 35

What gives gallstones their colour?

Answer 35

Bilirubin derivatives

Question 36

What are gallstones predominantly made of?

Answer 36

Cholesterol

Question 37

What is the function of the trypsin inhibitor?

Answer 37

Binds in the active zone of trypsin so that it isn't inappropriately activated in the pancreas

Question 39

Which cells make insulin?

Answer 39

Beta cells

Question 41

What does a loss of K cause?

Answer 41

Feeling of weariness

Question 42

What is a pre-hepatic cause of jaundice?

Answer 42

Haemolysis

Question 43

Where is cholecystokinin produced?

Answer 43

Walls of the duodenum

Question 44

What does carboxypeptidase do?

Answer 44

Cleaves the C-terminus of proteins

Question 46

What is occuring in pancreatitis?

Answer 46

Pancreatic enzymes are self digesting

Question 47

What is good about having a glucose-6-phosphate dehydrogenase deficiency?

Answer 47

Confer resistence to malaria

Question 49

Is bilirubin in haemolytic jaundice conjugated or unconjugated?

Answer 49

It's not that white and black - there is a mix

Question 50

What is post hepatic cause of jaundice?

Answer 50

Gallstone

Question 51

What are the effects of CCK?

Answer 51

Gallbladder contraction Digestive enzyme secretion from pancreas Insulin secretion Satiation in CNS

Question 52

What are some causes of greater or prolonged hyperbilirubinaemia in babies?

Answer 52

Haemolytic disorder Glucose-6-phosphate dehydrogenase deficiency Birth trauma

Question 53

How do natural plant steroids reduce cholesterol?

Answer 53

Block bile salt receptors \> new cholesterol must be used to make bile