[2] Hepatic Physiology Flashcards
Why is low blood glucose commonly seen during liver failure?
Liver acts as a Glucose-Buffer and maintains the stability of blood glucose levels in post prandial periods
What enzymes in the liver act as Biochemical detoxifiers?
Cytochrome P450
Most significant plasma protein made in the liver?
Albumin
How much bile produced in a day?
600-1200 mL/day
Most potent stimulus for bile?
CCK
Function: Bile Salt
Absorption of Lipids
Function: Bile Acids
Excretion of Cholesterol
[Potential Exam Question]
Primary Bile Acids
Cholic Acid
Chenodeoxycholic Acid
What phase has the highest rate of Gallbladder emptying?
Intestinal Phase
Gallstones are usually made of?
85% are Cholesterol Stones
Functional Unit of the Liver
Hepatic Lobule
3 Models of the Microarchitecture of the Liver
- Classical Lobule
- Portal Lobule
- Hepatic Acinus
Describe: Classical Lobule
Shape: Hexagonal
Center- Central Vein
Corners - Portal Triad
Perspective: Anatomical
Describe: Portal Lobule
Shape: Triangular
Center: Portal Triad
Corners: Central Vein
Perspective: Bile Secretion
Describe: Hepatic Acinus
Shape: Elliptical/Diamond
Short-Axis: 2 Portal Triads
Long axis: 2 Central Veins
Perspective: Metabolic
When is Jaundice evident?
Total Plasma Bilirubin > 2mg/dL
What is the only organ capable of completing the Urea Cycle?
Liver
Location: Urea Cycle
Mitochondria and Cytosol of Hepatocytes
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
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
After complete hepatectomy, a rise would be expected in the blood level of
a. Glucose
b. Clotting factors
c. Conjugated Bilirubin
d. Estrogen
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
