Bile Metabolism/ Liver Flashcards

1
Q

What is the mechanism of bile micelle formation around lipids?

A

Bile salts surround lipids—emulsify(make into little droplets that increase surface area)—Biles salts+ Pancreatic lipase (activated by trypsin) + Co-lipase(binds with hydrophilic heads of bile so pancreatic lipase can get in through to the bile/lipid—hydrolysis for lipase—micelle contained digested lipids—presents to entercoyte where bile exit and diffuses into cell

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2
Q

What is bile and where is it synthesized, secreted, and stored?

A

Bile is an alkaline fluid that aids in fat emulsification and transport.
synthesized: liver that bile canniculi (collects secreted bile)–hepatic duct
Stored: Gall bladder

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3
Q

Whats are side illeal resection?

A
  • more serious
  • loss of bile recycling, -means we are loosing bile in the feces
  • increase in motility through the intestinal tract will cause severe diarrhea

Treatment: Chloestryramine
bind to bile and prevent some of osmotic features
low-fat diet

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4
Q

What is of bilirubin?

A

end product from of heme breakdown

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5
Q

What happens when we take out the gall bladder laproscopically ? cholecystectomy?

A
  • no serious effect
  • surgery usually works well
  • can halt recycling due to increase in liver synthesis of bile secretion causing a back up in liver
  • possible diarhhea
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6
Q

What is the mechanism of bilirubin breakdown?

A

Bilirubin is drawn out with the bile, bacteria will convert bilirubin into urobilinogen—which is then converted then stercobilin (green/brownish color) into feces and recycled back to liver where it is secreted in the urine—(yellow color)

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7
Q

What are the two fates of biliriubin digestion?

A
  1. Final conversion to stercobilin and excretion in brown feces
  2. Recycling of urobilinogen and final excretion in urine yellow
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8
Q

What are the 7 functions of the liver?

A

1.Regulation of Protein, carbohydrate, and lipid metabolism
2.Regulation of cholesterol production and excretion
3.-Oxidation of fatty acids
4Bile acid production
5Degradation of hormones
6.Detoxification and excretion of drugs and toxins
7.Vitamin storage

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9
Q

What percent of cardiac output goes to the liver?

A

~25%

1.5 L/min

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10
Q

What is portal hypertension?

A

increased blood pressure in any vasculature of liver blood supply

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11
Q

What are 2 complications cause pre-hepatic portal hypertension?

A
  1. Portal V thrombosis

2. Congenital atresia

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12
Q

What are 3 complications cause intra-hepatic portal hypertension ?

A
  1. cirrhosisis
  2. fibrosis
  3. wilsons’d
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13
Q

What are 3 complications cause post- hepatic portal hypertension?

A
  1. Any obstruction between the liver and right heart
  2. Thrombosis
  3. CHF
  4. pericarditits
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14
Q

Where is lymph drained from the liver?

A

Space of disse and it then drains into venous blood

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15
Q

What are the 3 most common unusual symptoms of of impaired blood flow to the liver?

A
  1. Ascites
  2. Hepatomealy
  3. Jaundice
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16
Q

What is the process of acites formation?

A

Increased hepatic vein pressure (eg, from increased right vena cava pressure) or increased portal v. pressure (eg, portal v. thrombosis)

Pooling of blood in liver capillaries

Increased HPc

Increased transudation of fluid from plasma and space of Disse into the peritoneal cavity of the abdomen forming ascites (contains both fluid and proteins)

17
Q

What is hepatomegaly?

A

Is an increase in liver size usually due to fluid retention (can also enlarge from excess fat)

What is normal liver blood volume vs a pathological situation?
400ml of blood , pathological situations 1 liter

18
Q

What is jaundice?

A

(seen as yellowing of skin, nail beds, whites of eyes, etc) is caused by increased bilirubin in the blood)

19
Q

What is biliruin?

A

end-product of RBC degradation, and is incorporated into bile, and excreted in feces (metabolite is also excreted by the kidneys).

20
Q

What are the 3 types of jaundice and their mechanism of action?

A
  1. Obstructive jaundice results from obstruction of the bile ducts (cirrhosis, gallstones, biliary atresia, cancer). In each case, the bilirubin that is usually incorporated into bile enters the blood, instead.
  2. Hepatic jaundice can result from acute or chronic hepatitis, drug hepatotoxicity and cirrhosis. This reduces the ability of the cells to metabolize bilirubin.
  3. Hemolytic jaundice results from anything that increases hemolysis of RBCs (eg, malaria, sickle cell anemia, genetic disease (spherocytosis)), and increases bilirubin production faster than bile can excrete it.
21
Q

How does cirrhosis cause blood flow blockage?

A

scarring to the organ cause damage to the tissues and parenchymal cells blocking the free movement of blood through the portal vasculature

22
Q

How does the liver transport glucose into cells?

A

Insulin dependent GLUT-2 for high capacity transport of glucose

23
Q

What are the 5 fates of lipid in the liver?

A
  1. High rate of B-oxidation of a fatty acids
  2. Forms most lipoproteins
  3. Synthesize lots of cholesterol and PLs
  4. Converts unsused lipids to TG’s
  5. Steroid hormone production and transport
24
Q

What is a lipoprotein?

A

any soluble group of protein that combine with lipids and transports, lipids mainly cholesterol through the blood.

25
Q

Why are low density lipoprotein bad?

A

Low density lipoprotein are very sticky and can adhere to walls of vessels causing plaque build up ect, resulting in possible heart disease or cardiac arrest

26
Q

What treatment is given for high cholesterol? And what is the target enzyme?

A

Statins, they targets HMG-CoA reductase. (a rate controlling enzyme in the synthesis in the liver, thereby lowering its levels in the blood.

27
Q

Why do we need terminal illeum

A

recycling of bile to the liver while 10% is excreted in feces?

28
Q

What is the gall bladder for? and how does it exit?

A

bile storage

29
Q

What are the two ways blood enters the liver? Important features of vessels anatomy?

A
  1. Portal vein (1L/min)-deoxygenated blood from the intestinal tract/lower digestive tract
  2. Hepatic artery -(450m/min)
    pressure in well vascularized vessels is kept low to allow free flow out of liver
30
Q

What is found in bile? special features?

A
waste
bilirubin
cholesterol
base
potassium
osmotic, so draws water with it
31
Q

What is the back bone of bile?and main structural components

A

cholesterol back bone

cholic acid with taurinic and glycine

32
Q

What is found in bile? special features?

A
waste
bilirubin
cholesterol
base
potassium
osmotic, so goes water with it
33
Q

What is the back bone of bile? and main structural components?

A

cholesterol back bone

cholic acid with taurinic and glycine making it an amphipathic molecule