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Flashcards in Week 6 Deck (117)
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1

List some of the major functions of the liver

Hormone metabolism
Glycogen storage
Synthesis of albumin
Detoxification

2

When is the sphincter of oddi open and when does it close?

The sphincter of oddi is closed between meals and opens during a meal

3

What does bile contain?

Bile acids
Water and electrolytes
Cholesterol
IgA
Bilirubin

4

What is meant by enterohepatic recycling?

The reabsorption of bile salts in the terminal ileum, which are then transported back to the liver

5

Drug metabolism often proceeds in two phases. Describe what happens in each of these phases

Phase 1 - Drugs are activated by oxidation/ reduction/ hydrolysis - this makes the drug more polar to allow for conjugation
Phase 2 - An endogenous compound is added to the drug to make it more polar

6

The cytochrome P450 superfamily are haem proteins. Where are these located and what is their function?

Located in the endoplasmic reticulum of liver hepatocytes
Mediate oxidation reactions in phase 1 of drug metabolism

7

What is meant by hepatic encephalopathy?

A hepatic coma in which there is an altered level of consciousness as a result of liver failure

8

In severe hepatic failure, detoxification of which substance can't occur, causing it to accumulate?

NH3

9

Which membrane does HC03- and Cl- exchange occur at?

The duct cell apical membrane

10

How does hepatic portal blood concentration of bile salts affect their synthesis?

A low concentration stimulates synthesis of bile salts
A high concentration inhibits synthesis

11

Which 2 hormones affect bile secretion?

Cholecystokinin
Secretin

12

Which hormone causes gall bladder contraction and relaxation of the sphincter of oddi?

Cholecystokinin

13

What is meant by 'Glucuronidation'

the transfer of glucuronic acid to the substrate.
(forms either; amide/ ester or thiol bonds)

14

Explain the blood supply to the liver

The liver has a dual blood supply, from the hepatic arteries and from the hepatic portal vein.
The liver has single drainage, via the hepatic vein.

15

Which 3 cell types are contained within sinusoidal spaces?

Endothelial cells
Kuppfer cells
Stellate cells

16

How is acute liver failure defined?

The rapid development of hepatic dysfunction in a previously healthy liver

17

Give some examples of 'LFTs' and 'True liver function tests'

LFTs;

ALT
AST
ALP
GGT

True liver function tests;

Bilirubin
Albumin
Prothrombin time

18

List some of the clinical features of acute liver disease

Jaundice
Lethargy
Nausea
Itch
Pain

19

list some of the causes of acute liver disease

Hepatitis
Drugs
Cholangitis
Alcohol
Malignancy

20

What are the suitable investigations for acute liver disease?

History and examination
LFTs
Ultrasound
Virology

21

How is acute liver disease treated?

Supportive
Fluids
Increased calorie intake
Sodium bicarbonate bath, Cholestyramine or Uresodeoxycholic acid (for the itch)

22

Why is adequate nutrition important in patients with acute liver disease?

Acute liver disease is a hypermetabolic state meaning that there is increased energy requirements

23

Which drugs can potentially cause acute liver failure?

PARACETAMOL
ANTIBIOTICS

24

Which toxic metabolite can paracetamol accumulate as?

NAPQI

25

List the possible causes of fulminant hepatic failure

Paracetamol
Drugs
Viral Hepatitis

26

What are the possible worrying clinical complications of FHF?

Encephalopathy
Hypoglycaemia

27

How is FHF managed?

Referral should happen quickly and patients show due in ITU with supportive care and fluids. Transplantation should be considered.

28

What are antimicrobials?

All agents that act against microorganisms ( Bacteria, fungi, viruses and protozoa)

29

How is antimicrobial resistance (AMR) defined?

When microbes are resistant to one or more antimicrobial agents used to treat infection

30

What is the difference between vertical and horizontal transmission in terms of antibiotic resistance?

Vertical transmission- A bacterium accumulates errors during its replication
Horizontal transmission - Resistant genes are swapped from one microbe to another