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Clinical Chemistry 2 > Ch. 25 Liver Function - Part 1 > Flashcards

Ch. 25 Liver Function - Part 1 Flashcards

1
Q

Give the four major functions of the liver

A

Metabolism of carbohydrates, lipids, proteins, and bilirubin
Detoxification of harmful substances
Storage of essential compounds
Excretion/Secretion of substances to prevent harm

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2
Q

If the liver is nonfunctional for any reason, death will occur within approximately 24 hours due to _____

A

Hypoglycemia

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3
Q

Which of the following statements is/are TRUE:
The liver is
A. 1.2 to 1.5 kg in a healthy adult
B. located beneath and attached to the diaphragm
C. Protected by the lower rib cage
D. Held in pace by ligamentous attachments

A

All

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4
Q

Divides the liver into two unequal parts

A

Falciform ligament

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5
Q

The right lobe of the liver is 6x (larger/smaller) than the left lobe

A

Larger

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6
Q

Enumerate the liver’s two sources of blood

A

Hepatic artery

Portal vein

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7
Q

Which among the livers two sources of blood:
Is a branch of the aorta
Supplies oxygen-rich blood
Provides for 25% of the total blood supply to the liver

A

Hepatic artery

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8
Q

Which among the livers two sources of blood:
Supplies nutrient-rich blood from the digestive tract
Provides for 75% of total blood supply

A

Portal vein

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9
Q

Results from the merging of the Hepatic artery and the Portal vein

A

Hepatic sinusoid

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10
Q

The hepatic sinusoid is lined with _____ capable of removing potentially toxic substances from the blood

A

Hepatocytes

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11
Q

It is through this passage that blood leaves the liver

A

Central canal (Central vein)

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12
Q

The collecting system of veins that drain the approximately 1500 mL of blood from the liver empties into what vein

A

Hepatic vein

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13
Q

It is where the excretory system of the liver begins

A

Bile canaliculi

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14
Q

These are small spaces between the hepatocytes that form intrahepatic ducts, where excretory products of the cell can drain

A

Bile canaliculi

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15
Q

Microscopic and functional units of the liver

A

Lobules

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16
Q

They are responsible for all metabolic and excretory functions performed by the liver

A

Lobules

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17
Q

Two major cell types in the liver:

A

Hepatocytes

Kupffer cells

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18
Q

Each six-sided lobule of the liver has portal triads that contains

A

Hepatic artery
Portal vein
Bile duct

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19
Q

These make up 80% of the volume of the liver; large cells that radiate outward from the central vein in plates to the periphery of the lobule

A

Hepatocytes

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20
Q

Responsible for the regenerative properties of the liver.

A

Hepatocytes

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21
Q

These are macrophages that line the sinusoids of the liver. These acts as phagocytes capable of engulfing bacteria, debris, toxins, and other substances flowing through the sinusoids

A

Kupffer cells

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22
Q

The major heme waste product

A

Bilirubin

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23
Q

It is the only organ that has the capacity to rid the body of heme waste products

A

Liver

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24
Q

Principal pigment in bile. Derived from the breakdown of red blood cells

A

Bilirubin

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25
Q

Approximately _____ days after the emergence from the reticuloendothelial tissue, red blood cells are phagocytized and hemoglobin is released.

A

126

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26
Q

What is the composition of bile?

A

Bile acids or salts
Bile pigments
Cholesterol
Other substances extracted from the blood

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27
Q

The body produces approximately __L of bile per day and secretes __L of what is produced

28
Q

Degradation of Hemoglobin produces:

A

Heme
Globin
Iron

29
Q

Among the three components produced from the degradation of hemoglobin, which would be bound by transferrin and returned to the liver or bone marrow for reuse?

30
Q

Among the three components produced from the degradation of hemoglobin, which would be degraded to its constituent amino acids, which are then reused by the body?

31
Q

Among the three components produced from the degradation of hemoglobin, which would be converted to bilirubin in 2 to 3 hours?

32
Q

Before bilirubin is transported to the liver, what amino acid binds to it?

33
Q

Bilirubin bound to albumin is called _____. It is insoluble in water, and cannot be removed from the body until it is has been conjugated by the liver.

A

Unconjugated or Indirect bilirubin (B1)

34
Q

What carrier protein picks up bilirubin once it has been separated from albumin and has flowed through the sinusoidal spaces of the liver

35
Q

It carries the unconjugated bilirubin from the liver to the endoplasmic riticulum

36
Q

Site where the conjugation (esterification) of bilirubin happens

A

Endoplasmic reticulum

37
Q

The enzyme present during esterification; which transfers a glucuronic acid molecule to each of the two propionic acid side chains of bilirubin to form bilirubin diglucuronide

A

Uridyldiphosphate glucuronyl transferases (UDPGT)

38
Q

The form of bilirubin that is water soluble and is able to be secreted from the hepatocyte into the bile canaculi. Once in the hepatic duct, it combines with secretions from the gallbladder through the cystic duct and is expelled through the common bile duct to the intestines.

A

Conjugated biirubin (B2)

39
Q

Acts upon the conjugated bilirubin in the intestines and produces mesobilirubin

A

Intestinal bacteria

40
Q

Mesobilirubin is reduced to form mesobilirubinogen and then _____ (a colorless product).

A

Urobilinogen

41
Q

Roughly 80% of the formed urobilinogen is oxidized to an orange colored product called _____, which is then extcreted in feces

A

Urobilin/Stercobilin

42
Q

The substance that gives stool its brown color

A

Stercobilin

43
Q

The majority of the remaining 20% of urobilinogen will be absorbed by _____ to be recycled through the liver and re-excreted

A

Extrahepatic circulation

44
Q

What will happen to the lesser fraction of the remaining 20% of urobilinogen in the liver?

A

The lesser fraction of the remaining 20% of urobilinogen will enter systemic circulation and will subsequently be filtered by the kidney and excreted in the urine.

45
Q

Approximately how many mg of bilirubin is produced per day?

A

200 to 300 mg

46
Q

Almost all the bilirubin formed is eliminated in the _____

47
Q

What is the usual level of total bilirubin in the serum of a healthy adult?

A

0.2 - 1.0 mg/dL

48
Q

When carbohydrates are ingested and absorbed, the liver can do three things which are:

A
  1. Use the glucose for its own cellular energy requirements
  2. Circulate the glucose for use at the peripheral tissues
  3. Store glucose as glycogen
49
Q

Principal storage form of glucose

50
Q

It is the major player in maintaining stable glucose concentrations due to its ability to store glucose and degrade glycogen

51
Q

The term used to describe the storing of glucose in the form of glycogen

A

Glycogenesis

52
Q

Degrading glycogen to obtain glucose; could occur at times where there is an increased need for glucose (fasting or stress). Breakdown of glycogen to glucose for use as energy.

A

Glycogenolysis

53
Q

The process wherein the liver creates glucose (Glucose-6-phosphate) from nonsugar carbon substrates like pyruvate, lactate, and amino acid.

A

Gluconeogenesis

54
Q

The liver metabolizes lipids and lipoproteins and gathers free fatty acids from the diet, and those produced by the liver itself. These are then broken down to form _____, which can enter several pathways to form triglycerides, phospholipids, or cholesterol

A

Acetyl-CoA

55
Q

The greatest source of cholesterol in the body comes from _____

A

What is produced by the liver, not from dietary sources.

56
Q

TRUE/FALSE. All proteins are synthesized by the liver. Explain

A

False. Immunoglobulins and adult hemoglobin are not synthesized in the liver

57
Q

It is one of the most important proteins synthesized by the liver

58
Q

This results in the exchange of an amino group on one acid with a ketone group on another acid.

A

Transamination (via Transaminase)

59
Q

After transamination, _____ degrades them to produce ammonium ions that are consumed in the synthesis of urea and urea is excreted by the kidneys

A

Deamination

60
Q

This serves as a gatekeeper between substances absorbed by the gastrointestinal tract and those released into systemic circulation.

61
Q

The process wherein every substance that is absorbed in the gastrointestinal tract must first pass through the liver is referred to as:

A

First pass

62
Q

What are the body’s two mechanisms for detoxification of foreign materials (drugs and poisons) and metabolic products (bilirubin and ammonia)

A
  1. Bind the material reversibly so as to inactivate the compound
  2. Chemically modify the compound so it can be extcreted
63
Q

The most important mechanism in the liver; responsible for the detoxification of many drugs through oxidation, reduction, hydrolysis, hydroxylation, carboxylation, and demethylation.

A

Drug-metabolizing system

64
Q

Many of the drug-metabolizing systems take place in the liver microsome via what isoenzyme?

A

Cytochrome P-450 isoenzymes

65
Q

Metabolism of glucose to lactate or pyruvate for production of energy

A

Glycolysis

66
Q

What are the processes by which the liver detoxifies drugs?

A

oxidation, reduction, hydrolysis, hydroxylation, carboxylation, and demethylation.

67
Q

Many of the detoxification processes of the liver takes place in the _____ via the cytochrome P-450 isoenzyme.

A

Liver microsome

Clinical Chemistry 2 (5 decks)

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