16. Structure and Function of Liver Flashcards

1
Q

What vessels enter and leave the liver?

A

Enter:
hepatic portal vein
hepatic artery

Leave:
hepatic vein

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2
Q
What is the livers internal structure?
stratified squamous
lobular
columnar
stratified cuboidal
A

lobular

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3
Q

What is the portal triad?

A

hepatic artery
hepatic portal vein
bile duct

(present at each vertex of a lobule)

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4
Q

Where is bile produced my hepatocytes collected?

A

Bile canaliculi

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5
Q

What cell types are found in the liver?

A
  1. Hepatocytes
  2. Endothelial cells
  3. Kupffer cells (macrophages)
  4. Pit cells (natural killer cells)
  5. Hepatic stellate cells
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6
Q

What are the functions of the liver?

A

Factory:
carbohydrate, lipid, protein metabolism.
bile formation.
storage e.g. glycogen, vit A, minerals

Waste Management:
detoxification of xenobiotics.
removal of waste e.g. bilirubin breakdown, drugs, toxins.

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7
Q

Which of these functions does the liver not do?

  1. store vitamin A,D, K, B12, iron, copper
  2. nitrogen metabolism
  3. vitamin D activation
  4. lipid metabolism
  5. synthesis of albumin + clotting factors
A
  1. activate vitamin D
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8
Q

What are bile salts in the liver formed from?

A

Cholesterol

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9
Q

How does increasing dietary fibre and drugs like cholestyramine reduce cholesterol levels?

A

They bind to bile acid in the gut and prevent it recirculating.
Therefore more bile acid needs to be made from cholesterol, thus reducing blood cholesterol levels.

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10
Q

How to gall stones develop?

A

↑ cholesterol levels.
bile contains free cholesterol and bile salts, if too much cholesterol enters the bile, it cannot be solubilised by the bile salts and therefore cholesterol precipitates.

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11
Q

What is phase 1 of xenobiotic metabolism mainly performed by?

A

Cytochrome P450 enzymes (CYP)

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12
Q
Which of these is not a xenobiotic metabolism phase 2 reaction?
oxidation
conjugation
glucuronidation
sulphation
hydroxylation
reduction
hydrolysis
A

oxidation
hydroxylation
hydrolysis
reduction

these are all phase 1 reactions.

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13
Q

What is a prodrug?

Why can they be useful?

A

Inactive (or less active) compound which is metabolised in the body to produce a therapeutically active form.
e.g tamoxifen

Improve absorption of the drug in the gut.
Allow for an alternative route of administration e.g. skin patch.

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14
Q

In a paracetamol overdose, the phase 2 pathway it is mainly metabolised by becomes overloaded, resulting in the build up of a toxic molecule which leads to liver failure.
What is this molecule?

A

NAPQI

N-acetyl-p-benzo-quinoneimine

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15
Q

Outline the steps in the metabolism of alcohol and the enzymes.

A

ethanol > acetylaldehyde
(alcohol dehydrogenase)

acetylaldehyde > acetate
(acetylealdehyde dehydrogenase)

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16
Q

Chronic alcohol use depletes cytochrome P450 enzyme levels.

True or False?

A

FALSE
chronic alcohol use induces the synthesis of MORE CYP enzymes, since they metabolise alcohol when levels are high.

Causes dosage issue when prescribing drugs.

17
Q

Red blood cells are mainly phagocytosed by Kupffer cells in the liver.
True or False?

A

TRUE

18
Q

The globin protein in haemoglobin is degraded.

How is the haem metabolised and removed?

A

Haem > biliverdin > bilirubin

bilirubin transported to liver hepatocytes attached to albumin.
Here it is conjugated and secreted into bile.

Further metabolised by bacteria in the gut > urobilinogen

urobilinogen > urobilin/stercobilin
Both are excreted.

19
Q

What is prehepatic jaundice?

A

Jaundice caused by haemolytic anaemia e.g. sickle cell

RBC are being abnormally broken down

20
Q

What is intrahepatic jaundice?

A

Jaundice caused by liver damage (infection, inflammation, cirrhosis) or is inherited (Gilbert’s syndrome).

21
Q

What is extrahepatic jaundice?

A

Jaundice caused by a blockage (gallstones, pancreatic carcinoma)