B3 W2/W3

Question 1

Hepatic jaundice

Answer 1

Caused by liver cirrhosis which disrupts conjugation of bilirubin and leads to both unconjugated and unconjugated bilirubin. Liver cirrhosis will also cause haemhorrage, oedema and jaundice symptoms such as pale urine and dark stool

Question 2

Formation of mature HDL?

Answer 2

HDL carrying cholesterol which is esterified

Question 3

Space of disse

Answer 3

Space between sinusoidal endothelium and hepatocytes

Question 4

Coronary ligament

Answer 4

Peritoneal reflection between the liver and the diaphragm which demarcate the bare area

Question 5

Ammonia excretion?

Answer 5

Occurs in the liver. Nitrogen is incoportated into glutamine and alanine. Glutamine is deaminated by glutaminase enzyme to form glutamate and NH3. Ammonia (NH3) undergoes ornithine cycle in heaptocyte mitchondira to form urea. Alanine yields more glutamate via transamination with 2-oxoglutarate.

Question 6

Alanine cycle

Answer 6

Degradation of muscle protein to form glucose for ATP production for muscle contraction. Alanine is transported from the skeletal muscle to the liver to undergo transamination with 2-oxoglutarate and form glutamate. Glutamate will generate pyruvate and urea.

Question 7

What is 2-oxoglutarate?

Answer 7

An intermediate in Krebs which undergoes transamination with alanine to form glutamate

Question 8

post-resorptive state

Answer 8

Fasting state where fatty acids enter the liver undergo beta oxidation to form acetylcoA to enter Krebs or ketogenesis .

Question 9

Compound lipid

Answer 9

Phospholipid

Question 10

Hepatic artery proper

Answer 10

Branches into left and right hepatic artery to supply the L and R liver lobes

Question 11

What is a single unit of the liver?

Answer 11

Lobe

Question 12

How is phase I metabolism induced?

Answer 12

Decrease in plasma conc/ drug Cp caused by alcohol, contraceptives, sterols or rifampicin (antibiotics which treat mycobacterium)

Question 13

What is the role of the liver on amino acids?

Answer 13

BIosynthesis, conversion and degradation

Question 13

What is the importance of a-ketoglutarate?

Answer 13

Intermediate which is part of the citric acid cycle. It is a source of glutamate via the enzyme glutamate dehydrogenase

Question 14

What is the transport form of ammonia in the liver?

Answer 14

Glutamine

Question 15

Phrenic lymph nodes

Answer 15

Part of the lymphatic system which drains the bare area

Question 16

How does the liver act on carbohydrates?

Answer 16

Biosynthesis, conversion and degradation, storage

Question 17

Triangular ligaments

Answer 17

Peritoenal reflections form the coronary ligaments. Coronary ligaments join together to form the triangular ligaments.

Question 18

What is the composition of bile?

Answer 18

Bile salts (from bile acid), conjugated bilirubin, proteins, fatty acids and phospholipids and antibodies. It is produced via the accessory digestive gland of the liver

Question 19

Liver storage

Answer 19

Iron, copper, glycogen, fat soluble Vitamin A, vitamin D, E and K and vitamin B12

Question 20

ERCP

Answer 20

Examines disease of liver, bile duct and pancreas

Question 21

How is inhibition of Cytochrome P450 occur?

Answer 21

Ketaconazole and terfenadine

Question 22

Cholesterol is a progenitor for…

Answer 22

Steroid hormones, bile salts and vitamin D

Question 23

Subphrenic recess

Answer 23

Potential space between the inferior surface diaphragm and the liver

Question 24

Where does gluconeogenesis occur?

Answer 24

In higher oxygen regions in the liver in the periportal region

Question 25

What is the area of the deepest part of the abdominal cavity when a patient is in a supine position?

Answer 25

Hepatorenal recess

Question 26

How are fatty acids and cholesterol synthesised?

Answer 26

From acetate units

Question 27

Absorptive state

Answer 27

Glucose is converted into acetyl coA via glycolysis and link. It then is converted into fatty acids for storage. This occurs in the liver

Question 28

What does the ventral mesogastrium become?

Answer 28

Falciform ligament and lesser omentum