Metabolic function of the liver

Question 1

what produces bile

Answer 1

hepatocytes and bile duct

Question 2

where is bile stored between meals

Answer 2

gall bladder

Question 3

during a meal what causes gallbladder to contract opening sphincter of oddi for bile to enter duodenum

Answer 3

chyme

Question 4

4 functions of bile

Answer 4

micelle formation
neutralisation of chyme
pH adjustment for digestive enzyme action
protects mucosa

Question 5

what ducts does bile travel through to enter the duodenum

Answer 5

cystic duct

common bile duct

Question 6

where do hepatocytes secrete primary juice to

Answer 6

canaliculi

Question 7

what is in primary juice secreted by hepatocytes

Answer 7

bile acids
water
electrolytes 
lipids 
cholesterol 
IgA
bilirubin 
metabolic wastes

Question 8

what is cholelithiasis

Answer 8

pathology of the bile duct due to concentration of bile in gallbladder that causes cholesterol to crystallise into gall stone

Question 9

how is symptomatic cholelithiasis treated

Answer 9

laparoscopic cholecystomy

Question 10

how is cholelithiasis treated if liver does work

Answer 10

ursodeoxycholic acid

Question 11

what should you give to help Biliary colic pain

Answer 11

Buprenorphone or pethidine

NOT MORPHINE

Question 12

what can relieve biliary spasm

Answer 12

atropine

glycerytitrate

Question 13

what happens to bile salts

Answer 13

some is lost in faeces

majority is reabsorbed by active transport in the terminal ileum where it undergoes enterohepatic recycling

Question 14

what happens to primary acids

Answer 14

dehydroxylated by gut bacteria to form secondary bile acids which are returned to the ileum and conjugated with glycine/taurine and recycled as bile salts

Question 15

when are bile acid sequestrants used

Answer 15

hyperlipidaemia
cholestatic jaundice
bile acid diarrhoea

Question 16

examples of bile acid sequestrants

Answer 16

colveselam
colestipol
colestyramine

Question 17

side effects of bile acid sequestrants

Answer 17

diarrhoea
reduced absorption of fat soluble vitamins and thiazide diuretics
unpalatable

Question 18

what do xenobiotics facilitate

Answer 18

excretion

Question 19

main organ of drug metabolism

Answer 19

liver

Question 20

phase 1 metabolism reactions

Answer 20

oxidation, reduction, hydrolysis

Question 21

phase 2 metabolism reactions

Answer 21

add endogenous substance

conjugation

Question 22

where do phase 2 reactions usually occur

Answer 22

liver

Question 23

what happens in hepatic encephalopathy

Answer 23

severe hepatic failure where detoxification of ammonia to urea fails causing a toxic effect on CNS

Question 24

what can be used in severe hepatic failure

Answer 24

lactulose to convert NH3 to NH4+ which is not absorbed

antibiotics to inhibit NH3 generation

Question 25

which antibiotics are used to inhibit NH3 generation in hepatic encephalopathy

Answer 25

neomycin | rifamixin