[2] Hepatic Physiology

Question 1

Why is low blood glucose commonly seen during liver failure?

Answer 1

Liver acts as a Glucose-Buffer and maintains the stability of blood glucose levels in post prandial periods

Question 2

What enzymes in the liver act as Biochemical detoxifiers?

Answer 2

Cytochrome P450

Question 3

Most significant plasma protein made in the liver?

Answer 3

Albumin

Question 4

How much bile produced in a day?

Answer 4

600-1200 mL/day

Question 5

Most potent stimulus for bile?

Answer 5

CCK

Question 6

Function: Bile Salt

Answer 6

Absorption of Lipids

Question 7

Function: Bile Acids

Answer 7

Excretion of Cholesterol

Question 8

[Potential Exam Question]

Primary Bile Acids

Answer 8

Cholic Acid

Chenodeoxycholic Acid

Question 9

What phase has the highest rate of Gallbladder emptying?

Answer 9

Intestinal Phase

Question 10

Gallstones are usually made of?

Answer 10

85% are Cholesterol Stones

Question 11

Functional Unit of the Liver

Answer 11

Hepatic Lobule

Question 12

3 Models of the Microarchitecture of the Liver

Answer 12

1. Classical Lobule
2. Portal Lobule
3. Hepatic Acinus

Question 13

Describe: Classical Lobule

Answer 13

Shape: Hexagonal
Center- Central Vein
Corners - Portal Triad
Perspective: Anatomical

Question 14

Describe: Portal Lobule

Answer 14

Shape: Triangular
Center: Portal Triad
Corners: Central Vein
Perspective: Bile Secretion

Question 15

Describe: Hepatic Acinus

Answer 15

Shape: Elliptical/Diamond
Short-Axis: 2 Portal Triads
Long axis: 2 Central Veins
Perspective: Metabolic

Question 16

When is Jaundice evident?

Answer 16

Total Plasma Bilirubin > 2mg/dL

Question 17

What is the only organ capable of completing the Urea Cycle?

Answer 17

Liver

Question 18

Location: Urea Cycle

Answer 18

Mitochondria and Cytosol of Hepatocytes

Question 19

The following will result to increased unconjugated bilirubin in the plasma EXCEPT?

a. Decreased uptake of bilirubin in hepatic cells
b. Disturbed secretion of bilirubin into the bile canaliculi
c. Excess production of bilirubin
d. Disturbed binding of bilirubin with albumin

Answer 19

D

A. Decreased uptake of bilirubin in hepatic cells
- decreased uptake = less conjugation

B. Disturbed secretion of bilirubin into the bile canaliculi
- conjugated bilirubin will be forced to be refluxed
into the plasma

C. Excess production of bilirubin
- excess production = unconjugated bilirubin in
plasma

D. Disturbed binding of bilirubin with albumin
- bilirubin cannot be transported into the hepatocyte (and will therefore remain unconjugated) if it is not bound to albumin

Question 20

After complete hepatectomy, a rise would be expected in the blood level of

a. Glucose
b. Clotting factors
c. Conjugated Bilirubin
d. Estrogen

Answer 20

D

a. Glucose
- blood glucose level is not expected to rise because it is the liver’s function to synthesize glucose (gluconeogenesis) when no sources are available
b. Clotting factors
- the liver synthesizes clotting factors
c. Conjugated Bilirubin
- bilirubin is conjugated in the hepatocytes
d. Estrogen
- a rise in levels of steroid hormones (such as estrogen) in the blood is expected since there is no liver to metabolize such substances