Basics

Question 1

functions of CCK

Answer 1

1. gallbladder contraction and emptying
2. relaxation of Sphincter of Oddi
3. acts on pancreas to produce digestive enzymes

Question 2

functions of secretin

Answer 2

acts on biliary and pancreatic epithelium to produce bicarbonate-rich solution (pancreatic enzymes can only work in alkaline environments)

Question 3

role of ligandins

Answer 3

keeps bilirubin (both conjugated and unconjugated) in solution within hepatocytes to prevent efflux back into the circulation

Question 4

what type of hyperbilirubemia is neonatal jaundince?

Answer 4

unconjugated (low activity of UGT)

Question 5

what is kernicterus?

Answer 5

accumulation of unconjugated bilirubin in brain, causing cerebral palsy and hearing loss in newborns (seen in Crigler Najjar syndrome Type 1)

Question 6

what type of hyperbilirubemia is Gilbert’s syndrome?

Answer 6

unconjugated (low activity of UGT)

Question 7

MOAT defect

Answer 7

Dubin-Johnson syndrome (conjugated hyperbilirubinemia)

Question 8

dual role of the LDL-R in decreasing LDL

Answer 8

1. removal of precursor, IDL

2. uptake of LDL

Question 9

type of epithelium lining bile duct

Answer 9

simple cuboidal

Question 10

central veins join together what vessels to drain into what major vessel?

Answer 10

hepatic vein –> IVC

Question 11

reticular fibers of the liver are composed of what type of fibrillar collagen?

Answer 11

3

Question 12

type of epithelium lining gallbladder lumen

Answer 12

simple columnar

Question 13

principal product of pancreatic acinar cells

Answer 13

digestive enzymes

Question 14

intercalated ducts of the pancreas contribute what to the exocrine secretion of the pancreas?

Answer 14

bicarbonate and water

Question 15

ddx: cholestatic/obstructive diseases

Answer 15

stones, PBC, PSC, medications

Question 16

ddx: ALT > 500

Answer 16

autoimmune hepatitis, hepatitis A&B

Question 17

alcoholic liver disease rarely has transaminases greater than what?

Answer 17

300

Question 18

ddx: intrahepatic cholestasis

Answer 18

alcoholic liver disease, PBC, viral hepatitis

Question 19

ALT > AST

Answer 19

viral hepatitis

Question 20

AST > ALT

Answer 20

alcoholic hepatitis

Question 21

most common causes of acute and fulminant liver failure

Answer 21

medications (acetaminophen) and viral hepatitis

Question 22

alcohol should not be taken with what narcotic?

Answer 22

acetaminophen (CYP2E1)

Question 23

3 effects of increased acetaldehyde

Answer 23

1. activates stellate cells to form collagen
2. shears microfilaments of hepatocyte –> ballooning
3. Kupffer cells produce TNFalpha