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Gastro (not zara) > Bile > Flashcards

Bile Flashcards

1
Q

How much bile is produced per day?

A

500ml each day

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2
Q

What causes the yellow/green colour of bile?

A

Bilirubin and biliverdin

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3
Q

how much bile do hepatocytes secrete?

A

60% of bile

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4
Q

How much bile are cholangiocytes responsible for secreting?

A

40%

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5
Q

What are the uses of bile?

A
  • Cholesterol homeostasis
  • Absorption of lipids
  • Absorption of vitamins (ADEK)
  • Excretion
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6
Q

What does bile excrete?

A
  • Xenobiotics/drugs
  • Cholesterol metabolites
  • Adrenocortical and other steroid hormones
  • Alkaline phosphatase
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7
Q

How is biliary excretion of bile salts and toxin performed?

A

Trough the use of biliary transporters on the apical and basolateral surfaces of hepatocytes and cholangiocytes

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8
Q

How are hepatocytes involved in bile production?

A

PRIMARY SECRETION
- Secretion of bile salts, lipids and organic ions
- Bile secretions reflect serum concs

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9
Q

How are cholangiocytes involved in bile production?

A
  • Alteration of pH
  • H2O drawn into bile by osmosis via paracellular junctions
  • Luminal glucose and organic acids reabsorbed
  • HCO3- and Cl- actively secreted into bile by CFTR
  • IgA exocytosed
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10
Q

What are the main transporters on the basolateral membrane (IMPORTING)

A
  • Organic anion transporting peptide (OATPs)
  • Na+ taurocholate cotransporting polypeptide (NTCP)
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11
Q

What is the function of OATPs and NTCP?

A

Bile salt uptake

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12
Q

What are the main transporters on the apical surface (exporting)

A
  • Bile Salt Excretory Pump (BSEP)
  • MDR related proteins
  • Products of multidrug resistance genes
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13
Q

What is the BSEP and what is the purpose of it?

A

Active transport of bile acids into the bile

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14
Q

What transporters are MDR related proteins?

A

MRP2 and MRP3

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15
Q

What is the function of MRP2 and MRP3?

A

Transport negatively charged metabolites

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16
Q

What transporters are the products of multi-drug resistance genes?

A

MDR1 and MDR3

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17
Q

What is MDR1 used to transport?

A

excretion of xenobiotics and cytotoxins

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18
Q

What is MDR3 used to transport?

A

Phospatidylcholine

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19
Q

What are bile acids synthesized from?

A

Cholesterol

20
Q

What are the two primary bile acids?

A
  1. Cholic acid
  2. Chenodeoxycholic acid
21
Q

What are the two secondary bile acids?

A
  1. Deoxycholic acid
  2. Lithocolic acid
22
Q

What causes the conversion of primary bile acids into secondary bile acids?

A

Gut bacterial enzymes

23
Q

What are bile acids conjugated with?

A

Glycine and taurine

24
Q

What are the primary functions of bile acids?

A
  • reduce the surface tension of fats
  • emulsify fats prior to their digestion and absorption
25
What is meant by the amphipathic nature of bile salts forming micelles?
2 FACES They have hydrophobic domains on one surface and hydrophilic domains on the other surface
26
Describe the organisation of a micelles?
1x surface hydrophilic domains (hydroxyl & carboxyl) - faces OUT → dissolves in water 2nd surface hydrophobic domains (nucleus & methyl) faces IN → dissolves in fat FFAs & cholesterol INSIDE
27
What happens to the sphincter of oddi between meals?
Sphincter of oddi is closed, and bile is diverted into the gall bladder for storage
28
What happens to the sphincter of Oddi during eating?
The sphincter of Oddi relaxes which allows the secretion of bile into the duodenum
29
What causes the gal bladder to contract?
1. Gastic contents and acidic chyme enter into the duodenum and cause the release of CCK 2. CCK binds to CCKa receptors and causes the gall bladder to contract, and release the stored bile into the intestine
30
What else aside from CCK causes the contraction of the gall bladder?
Ach from the parasympathetic fibres of the vagus nerves
31
What is the purpose of the gall bladder?
To store bile, concentrate it and acidify it
32
What are some of the main components of bile?
Water, bile acids, bilirubin, inorganic salts, cholesterol, fatty acids
33
Where is bilirubin produced from?
- Mostly from Hb breakdown - Breakdown of other haemoproteins - Ineffective bone marrow erythropoeisis
34
How is free bilirubin transported around the body?
Bound to albumin
35
What happens to the bilirubin as it enters the liver?
1) Bilirubin dissociates from albumin 2) Undergoes conjugation with 2 UDP glucoronate molecules to form bilirubin diglucuronide 3) Secreted across conc grad into biliary canaliculi
36
What happens to the bile which enters into the small intestine via the main duodenal papilla?
95% of the bile is reabsorbed from the terminal ileum through Na + / K+ ATPase pumps and Na+ / Bile co-transporters
37
What happens to the 95% of the bile which is reabsorbed?
Taken back to the liver via the portal vein in the entero-hepatic circulation system
38
What happens to the remaining 5% of bile which remains in the small intestine?
converted into secondary bile acids by gut bacteria - Deoxycholic acid absorbed - 99% Lithocolic acid excreted in stool
39
What happens to the bilirubin after it enters into the intestine?
1. Bilirubin -> Urobilinogen -> Stercobilinogen -> Stercobilin
40
What happens to stercobilin?
Secreted out the GI systemas faeces - gives the faeces the distinctive brown colour
41
What percentage of bilirubin is lost in the faeces?
85% is lost in the faeces as stercobilin
42
How does bilirubin enter into the entero-hepatic circulation?
Bilirubin is deconjugated.
43
How does 1% of the bilirubin end up excreted in the kidneys?
Enters into systemic circulation and is excreted.
44
If bile cannot enter gut what happens and why?
**Obstructive Jaundice** - BR cannot be converted into stercobilin and so the faeces becomes very pale - This causes the bile to leave via the kidneys so this causes dark urine
45
What is an ERCP?
Endoscopic retrograde cholangiopancreatography - used to remove distal blockages in biliary system
46
What is a PTC?
Percutaneous transhepatic cholangiography - needle inserted into hepatic bile duct to clear blockage of hepatic ducts

Gastro (not zara) (1 decks)

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