B3 Physiology of Liver and Spleen

Question 1

What does the spleen primarily do?

Answer 1

Filters the blood for damaged RBCs

Question 2

What are primary liver cells called?

Answer 2

Hepatocytes

Question 3

What is the role of hepatocytes?

Answer 3

Remove toxic substances (including alcohol) from the blood

Question 4

How do toxic substances leave the liver?

Answer 4

Out of the lobules via the hepatic venule

Question 5

What is the hepatic venule?

Answer 5

The central vein of all the lobules

Question 6

Why does the blood leaving the lobule contain low levels of oxygen?

Answer 6

Hepatocytes along the sinusoids have used up much of the available oxygen

Question 7

What are sinusoids?

Answer 7

Little sinuses that the carry blood from the hepatic portal vein and hepatic artery, through hepatocytes where it will eventually reach the hepatic venule

Question 8

What is the periportal zone I?

Answer 8

The region of liver lobules nearest to the entering vascular supply

Question 9

What is clinically important about the periportal zone I?

Answer 9

Least sensitive to ischaemic injury but very susceptible to viral hepatitis

Question 10

What region will have the poorest oxygenation and will be most affected in ischaemia?

Answer 10

Centrilobular Zone III

Question 11

What are zone I hepatocytes specialised for?

Answer 11

Oxidative liver functions including:
Gluconeogenesis
Beta oxidation of fatty acids
Cholesterol synthesis

Question 12

What are zone III cells important for?

Answer 12

Glycolysis
Ketogenesis
Lipogenesis

Question 13

Which cells would be most specialised for cytochrome P450 based drug detoxification?

Answer 13

Zone III

Question 14

What is the consequence of cholestasis?

Answer 14

Bile can’t get out of the liver

Question 15

What is the major protein of the liver?

Answer 15

Albumin

Question 16

What is hypoalbuminaemia?

Answer 16

A feature of chronic liver disease though can also occur in severe acute liver damage

Question 17

What is a major enzyme in amino acid deamination?

Answer 17

Glutamate dehydrogenase

Question 18

What does the liver do with ammonia?

Answer 18

Via the portal vein, it can be incorporated into amino acids

Question 19

What is the liver’s effect on glycogen synthesis?

Answer 19

Increases it

Question 20

What is glucagon’s effect on gluconeogenesis?

Answer 20

Increases it

Question 21

What is phase 1 of drug metabolism?

Answer 21

Leads to polar, more reactive chemicals.

Question 22

What is phase 2 conjugation

Answer 22

Leads to more polar but less reactive chemicals

Question 23

What are the main points in aspirin metabolism?

Answer 23

Attaching hydroxyl group to aspirin and conjugation

Question 24

What is the most common cause of liver dysfunction in the UK?

Answer 24

Non-alcoholic fatty liver disease (NAFLD)

Question 25

What does NADH to when it accumulates?

Answer 25

Conversion from pyruvate to lactate instead of glucose

Question 26

True or false? People who have drunk a lot of alcohol can become hypoglycaemic?

Answer 26

True- trying to produce glucose via gluconeogenesis but NADH drives pyruvate conversion to lactate