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Digestion > 3B-Physiology of the LIVer > Flashcards

3B-Physiology of the LIVer Flashcards

1
Q

You ready for the BOOM?! How bad do you want that A?! WHAT ARE THE 13 MAJOR LIVER FUNCTIONS? This is a mastery type flashcard..

A

1.GlycogenoLYSIS 2.Glycogenesis 3.Protein Metabolism 4.Urea Synthesis 5.Lipid Metabolism 6.Hormone Metabolism 7.Iron Metabolism/Storage 8.Vitamin Storage 9. Drug Detoxification 10. Vitamin D Activation 11. Plasma Protein Synthesis 12. Clotting Factor Synthesis 13. Bile Synthesis

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2
Q

Liver cells can typically store up to ___% of their weight as glycogen (____-____ g in an adult).

A

8%…100-120g

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3
Q

Which tissue stores more TOTAL glycogen: liver or skeletal muscle? In the muscles, glycogen is found in a much lower concentration then the liver (___-____% of the muscle mass).

A

Skeletal Muscle….1-3%

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4
Q

What is the first step to amino acid degradation?

A

DEAMINATION! Remove the AMINE group from the AA

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5
Q

What 2 enzymes are required for the first step in amino acid degradation?

A

1.Aspartate TransAminase (AST) 2.Alanine TransAminase (ALT)

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6
Q

What are the 2 roles of the enzymes AST and ALT?

A
  1. Deaminate Amino Acids 2.Synthesize non-essential AA’s in the liver
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7
Q

High blood levels of ____ (SGPT) and ____ (SGOT) can be indicative of liver disease.

A

AST & ALT

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8
Q

Ultimately, the amine groups cleaved from the amino acids are converted into _______ (___) or ________ (____), which are then converted into ____.

A

ammonia (NH3) or ammonium ions (NH4+)…..urea

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9
Q

Where does Urea synthesis occur?

A

the liver

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10
Q

What is the name of the cycle where ammonia is converted into urea?

A

the Anders ÖRN-ith-ine Cycle!

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11
Q

What is the diseased liver STATE caused by accumulation of AMMONIA in the blood? (two names)

A

Hepatic Coma or Hepatic Encephalopathy

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12
Q

What is the diseased liver STATE caused by accumulation of UREA in the blood? (two names)

A

AZ-O-temia or Uremia

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13
Q

What can be the result of a build up of urea in the body and it precipitates on the Pt’s skin?

A

Uremic Frost…Interesting!

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14
Q

What is a BUN? What is a normal BUN range?

A

Blood Urea Nitrogen…5-26 mg/dL in adults

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15
Q

What are the 4 ways BUN can be elevated? Whats the most common?

A

1.Impared Renal Function (MOST COMMON) 2.Increased Protein intake/catabolism 3. G.I. Bleeding (bacteria make Nitrogenous waste) 4. Dehydration

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16
Q

Where are chylomicrons made? Where are most of them absorbed?

A

the Small Intestine…absorbed into the Lymph

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17
Q

Which lipoproteins are carrying cholesterol/fats from the liver to the body? (2 types)

A

VLDLs and LDLs

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18
Q

Which lipoproteins carry cholesterol/fats from the body and bring it to the liver?

A

HDL

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19
Q

Which lipoprotein is the deflated beach ball?

A

HDL!

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20
Q

WHAT IS THE CATALINA WINE MIXER of endogenous cholesterol synthesis?

A

HMG-CoA REDUCTASE!!

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21
Q

What is the ONLY WAY the body gets rid of excess Cholesterol?

A

VIA the BILE (HDLs pick it up and bring it to the limbs)

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22
Q

What is the main cause of Gall Stones?

A

TOO much Cholesterol in the Bile solution

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23
Q

What are the two main causes of KetoGenesis?

A

1.Fasting State 2.Type I Diabetes

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24
Q

REVIEW: What are the three Ketone Bodies?

A

1.Acetone 2.Beta-Hy-droxy-but-yric Acid 3.Aceto-Acetic Acid

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25
Q

What are the three main types of hormones the liver degrades?

A

1.Steroid Hormones 2.T3 3.T4

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26
Q

What is the difference between T3 and T4?

A

An extra Iodine!

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27
Q

What molecule STORES iron in the liver?

A

Ferritin

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28
Q

What is the classic sign of Hema-Chromo-Cytosis?(high ferratin)

A

Bronzing of the Skin (not addison’s disease)

29
Q

What is the form of iron in the blood?

A

Transferrin

30
Q

What does iron bind to in the liver to make its final storage complex (ferratin)? (we didn’t discuss this)

A

Apo-ferritin + iron =ferritin, final storage form

31
Q

What three vitamins are stored in LARGE quantities in the liver?

A

Vitamins A, B12, and D

32
Q

What is the most important enzyme system in the liver for DRUG metabolism?

A

Cytochrome P450

33
Q

The basic purpose of drug metabolism in the body is to make drugs less _______ and more _______ and thus more readily excreted in the _____ or _____.

A

less active….more water soluble…..urine or bile

34
Q

Which enzymes are associated with Phase I in drug metabolism?

A

CytoChrome P450 enzymes

35
Q

Which enzymes are associated with Phase II in drug metabolism?

A

Conjugate Enzymes

36
Q

What can the drug possibly be split into in Phase 1 of drug metabolism?

A

1.A metabolite with modified activity 2.A metabolite that is inactive

37
Q

The Cytochrome P450 enzymes are most predominant in the liver but can also be found in the ______, ______ and other organs.

A

intestines, lungs and other organs

38
Q

Each CYP enzyme is termed an _____ since each derives from a different gene.

A

isoform

39
Q

During Drug Metabolism, Conjugation reactions are designed to make metabolites more _____/_______, sometimes after they’ve been created by P450 enzymes.

A

polar/hydrophilic

40
Q

What are the 4 endogenous substrates added to a metabolite during the conjugation phase? What is the most common one?

A

1.Glu-Cur-Onic Acid (AKA Glu-cur-on-idation= most common) 2.Gluta-thi-one 3.Acetyl-CoA 4. An Amino Acid

41
Q

What DDI results in DECREASED metabolic activity of CP450 enzymes, leading to DECREASED metabolism of drugs?

A

CP450 INHIBITION…Grapefruit juice inhibits the metabolism of cocaine!

42
Q

Which DDI results in INCREASED activity of CP450 enzymes leading to INCREASED metabolism of the drugs?

A

CP450 INDUCTION…Ethanol speeds up the metabolism of tylenol or BROCCOLI speeds up the metabolism of caffeine!

43
Q

What is the final, active product of Vit D activation? What hormone stimulates the final steps?

A

1,25-Di-Hydroxy-chol-e-cal-ciferol…PTH

44
Q

REVIEW: What are the three MAIN types of plasma proteins? Are these the only proteins found in the blood?

A
  1. Albumin 2.Globulin 3.Fibrinogen…HELL NAW, not the only proteins found in the blood!
45
Q

___-___% of the globulins are formed in the liver. The remainder of the globulins are formed almost entirely in the __________. They are mainly ______ globulins that constitute the antibodies used in the immune system.

A

50-80%…lymphoid tissues…Gamma

46
Q

BOOM GO TIME: What are the 5 main functions of Plasma Proteins?

A

1.Oncotic Pressure(prevents edema) 2.Buffer 3. Transport(hydrophobic stuff, metals, what not) 4.Clotting 5.Immune response

47
Q

WHAT ARE THE 9 clotting factors synthesized in the liver?

A

1,2—–5——7, 8, 9, 10, 11, 12…EASY as PIE!

48
Q

What are the 6 constituents of bile? How much of bile is technically waste?

A
  1. Bile Salts (50%) 2. Phospholipids (40%) 3.Cholesterol (4%) 4.Bile Pigments-Biliruben(2%) 5.Electrolytes 6.Water…50% is technically waste!!
49
Q

What are the two PRIMARY Bile Acids? What are they synthesized by?

A

Cho-Lic Acid and Chen-o-deoxy-Cho-Lic Acid…Synthesized by the liver

50
Q

What are the two SECONDARY bile acids? What are they synthesized by?

A

Deoxy-Cho-Lic Acid and Litho-Cho-Lic Acid… Synthesized by intestinal bacteria

51
Q

What are the two AA’s used to turn bile acid into bile salt?

A

GLYCINE or TAURINE

52
Q

What is the purpose of conjugating bile acids into bile salts?

A

Makes them AMPHIPATHIC!

53
Q

Which class of bile acid is found in the gall bladder? Which class gets converted to bile salts?

A

PRIMARY…cholic acid and chenodeoxycholic acid have not been exposed to the intestinal bacteria yet….Secondary get converted to the bile salt

54
Q

What is the most common phospholipid found in bile?

A

Lecithin “LESS-EH-THIN”

55
Q

Hepatic synthesis of ____ _____ accounts for the majority of cholesterol breakdown in the body.

A

bile acids

56
Q

In humans, roughly ____ mg of cholesterol are converted to bile acids and eliminated in bile every day.

A

500 mg

57
Q

Bilirubin is a waste product of _______ degradation.

A

Hemoglobin

58
Q

What are the two types of bilirubin? (With ALL their names :))

A

1.Free/Unconjugated/Indirect Bilirubin and 2.Conjugated/Direct Bilirubin

59
Q

_____ bilirubin is transported in the BLOOD attached to ALBUMIN.

A

Free/Unconjugated. Indirect

60
Q

What are the three steps that a hepatocyte must do to turn free bilirubin to conjugated biliruben?

A

1.Uptake from circulation 2.Conjucation of the bilirubin 3.Excretion of bilirubin in bile

61
Q

WHAT IS ATTACHED to bilirubin in order to CONJUGATE it?? What is the ENZYME that catylizes this RXN?

A

GLU-CUR-ONIC ACID…Glu-cur-onyl Transferase

62
Q

Which is more water soluble: conjugated or free bilirubin?

A

Conjugated bilirubin is much more water soluble then free bilirubin.

63
Q

What is the form of bilirubin in feces?

A

Sterobilin

64
Q

What are the three steps to bile synthesis?

A

1.hepatocytes secrete bile into CANALICULI 2. water and HCO3 added to bile by CHOL-ANGIO-CYTES 3. 50% gets Stored inGall Bladder

65
Q

The first two steps of bile synthesis may produce ___ ml/day of “_______”

A

900 ml/day of “hepatic bile”

66
Q

What is the extremely aggressive form of cancer in the CholAngioCytes?

A

“bile duct” cancer

67
Q

Between meals, approx. ____% the hepatic bile is
diverted to the ________, which stores the bile and removes _____ and _____. Here the contents are increased __-___ fold.

A

50%….gall bladder….salts and water..10-20fold increase

68
Q

So, during meals, the bile that reaches the duodenum is a mixture of relatively “dilute” _____ bile and “concentrated” ________ bile.

A

hepatic bile….gall bladder bile

69
Q

What are the 2 important functions of Bile?

A

1.Excrete things the kidney can’t 2.Lipid Digestion/Absorption

Digestion (16 decks)

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