Liver/Pancreatic Secretions & Jaundice

Question 1

what regulates gall bladder function?

Answer 1

CCK

Question 2

how much bile can human liver make per day?

Answer 2

1 L

Question 3

3 most important human bile acids?

Answer 3

cholic acid
deoxycholic acid
chenodeoxycholic acid

Question 4

how much of bile is recycled? from where?

Answer 4

95% from terminal ileum

Question 5

which cells does bicarb and enzymes come from in the pancreas?

Answer 5

bicarb: duct cells
enzymes: acinar cells

Question 6

what are the inactive form of enzymes?

Answer 6

zymogens

Question 7

What regulates pancreatic secretions? where does it come from?

Answer 7

CCK and secretin

from the walls of duodenum

Question 8

cholesterol is soluble? insoluble?

Answer 8

insoluble, will precipitate if not enough bile salts

Question 9

bile salts from what?

bile pigment from what?

Answer 9

salts: cholesterol
pigment: bilirubin

Question 10

Lecithin is generic name for?

Answer 10

phospholipid

Question 11

unconjugated bile acids are more or less acidic that tauroconjugates?

Answer 11

less acidic

Question 12

what is a detergent?

Answer 12

micelles to capture grease

Question 13

example of a detergent?

Answer 13

bile acid

Question 14

any reserve for bile salts to keep cholesterol in micelles?

Answer 14

Nope right at limit, why gall stones are so easily form if over limit

Question 15

What does lipase need to be activated

Answer 15

colipase

Question 16

what is fatty stool called?

Answer 16

steatorrhea

Question 17

What drug makes steatorrhea?

Answer 17

Orlistat

Question 18

What is the total bile salt pool?

Answer 18

3-5g

Question 19

how does margarine lower cholesterol?

Answer 19

plant sterols compete with bile salt absorption receptors

Question 20

How does cholestryamine affect cholesterol:

Answer 20

disrupts negative feedback to make up for excreted cholesterol

Question 21

3 important intestinal secretions:

Answer 21

secretin
Gastrin
Cholescystokinin

Question 22

What does secretin do?

Answer 22

enhances bicarbonate content in pancreatic secretions

Question 23

where is CCK produced?

Answer 23

duodenum

Question 24

CCK does what neurally?

Answer 24

give you satiation feeling

Question 25

what does CCK stimulate? 3 things

Answer 25

gall bladder contraction pancreas digestive enzyme promote insulin release

Question 26

what does Trehalase digest?

Answer 26

mushrooms

Question 27

how is Trypsinogen activated?

Answer 27

cleaves a sequence to activate once in the intestine by enteropeptidases

Question 28

how to prevent trypsinogen activation in pancreas?

Answer 28

trypsin inhibitor in small amount in pancreas

Question 29

Amino peptidase carboxy peptidase which side break down protein?

Answer 29

Amino: N side Carboxy: C side

Question 30

two main causes of pancreatitis?

Answer 30

alcohol abuse | Gallstones (women older than 50)

Question 31

decreased pain in a chornic alcoholic could mean?

Answer 31

advanced pancreas destruction

Question 32

Serum lipase or amylase is more sensitive in dx of pancreatitis?

Answer 32

serum lipase

Question 33

what is the most energy expensive thing to digest? carbs? fats or proteins?

Answer 33

proteins

Question 34

how many micromolar bilirubin needed for it to show up in eyes

Answer 34

35 micromolar

Question 35

jaundice categorized into 4?

Answer 35

pre-hepatic hepatocellular post-hepatic neonatal

Question 36

heme oxygenase in macrophages makes what from heme?

Answer 36

biliverdin, iron, CO

Question 37

What does biliverdin reductase do?

Answer 37

reduces biliverdin to unconjugated bilirubin

Question 38

Sources of heme besides old RBCs? 3 things

Answer 38

failed erythropoieses myoglobin cytochromes

Question 39

What will patients with jaundice present with re: ALT, AST, GGT, ALP?

Answer 39

All raised

Question 40

what does UDP-glucuronyl transferase do?

Answer 40

adds glucoronic acid to bilirubin twice to conjugate it and make it soluble

Question 41

when bilirubin-albumin enters hepatocyte, first thing that happens?

Answer 41

bilirubin attaches to LIGANDIN

Question 42

Dubin-Johnson syndrome is problem with?

Answer 42

cMOAT

Question 43

which big drug interferes with bilirubin reuptake?

Answer 43

Rifampicin

Question 44

What heavy metal bad for liver?

Answer 44

Copper (wilson's disease)

Question 45

classic pre-hepatic jaundice is caused by?

Answer 45

haemolysis and increase unconjugated plasma bilirubin

Question 46

prevalence of neonatal jaundice?

Answer 46

1:3

Question 47

what usually causes neonatal jaundice?

Answer 47

immature liver need time to build up LIGANDIN and UDP | change over from foetal to adult haemoglobin Hby to HbB

Question 48

other pathological causes of neonatal jaundice?

Answer 48

ABO-RH incompatibility birth trauma premature glucose-6-phosphate dehydrogenase deficiency

Question 49

Gilbert's Disease?

Answer 49

1:20 | decreased conjugation of bilirubin with fasting (normal biopsy and lifespan)

Question 50

Why are fava beans bad for someone with glucose-6-phosphate dehydrogenase deficiency?

Answer 50

fava beans has divicin and causes oxidative stress and leads to haemolytic anaemia

Question 51

glucose-6-phosphate dehydrogenase deficiency confers resistance to?

Answer 51

Malaria

Question 52

what is the most common human enzyme deficiency? 400 million ppl

Answer 52

glucose-6-phosphate dehydrogenase deficiency

Question 53

What does glutathione do?

Answer 53

antioxidants

Question 54

Who shouldn't take chloroquine?

Answer 54

glucose-6-phosphate dehydrogenase deficiency people

Question 55

what is cholroquine?

Answer 55

oldest of antimalarials

Question 56

jaundice in newborn with bilateral cataracts?

Answer 56

galactosaemia