buzzwords - GI Flashcards
red flags
dysphagia, GI blood loss, persistent vomiting, unexplained weight loss, upper abdominal mass
what things should you ask about diarrhoea
frequency, nocturnal diarrhoea, colour and consistency, blood
herbal and ‘food supplements’, possible toxins, alcohol
liver
what should be suspected in known liver, pancreas, small bowel disease
malabsorption
gynaecomastia ->
hyperoestrogenism (cirrhosis)
easy brusing is due to
vit c deficiency (scurvy)
major functions of liver
detoxification and degradation, excretion of cholesterol and bilirubin, production of hepatic bile
where does blood go to liver
from hepatic portal vein (75%), hep artery (25%)
where does venous and arterial blood mix in liver
sinusoids
what is the direction of blood in liver
flows inwards towards the central vein through the sinusoids
what is contained in the sinusoidal space
endothelial cells to form fenestrated structure
kuppfer cells - macrophages resident to sinuoidal vascular space (remove particulate matter eg bacteria and senescent RBCs)
stellate (ito) cells in space of disse - storage of vitA
what is phase 1 of drug oxidation
oxidation/reduction/hydrolysis
makes drug more polar, adds a chemically reactive group (a handle) permitting conjugation (functionalisation)
what is phase 2 of drug oxidation
conjugation
adds endogenous compunds increasing polarity eg glucuronyl, sulphate, methyl, acetyl, glycyl, glutathione groups
what are the 3 plasma proteins
albumin
alpha-globulins
beta-globulins
what does albumin do
transports fatty acids, bilirubin, thyroid, aspirin