Exam 1: Liver

Question 1

what is a lobule

Answer 1

functional unit of the liver

Question 2

what are hepatocytes

Answer 2

liver cells that produce and secrete bile

Question 3

what does bile do

Answer 3

bile stimulates peristalsis and breaks down fats in the intestine

Question 4

what are canaliculus

Answer 4

channels between hepatocytes that drain bile into the common bile duct into the duodenum and gal bladder

Question 5

hepatic artery

Answer 5

carries oxygenated blood into the liver

Question 6

portal vein

Answer 6

carries unoxygenated blood high in nutrients from GI tract into the liver

Question 7

what is the portal vein’s main responsibility

Answer 7

provides energy for the liver

NUTRIENTS TO LIVER

Question 8

where do all visceral veins drain

Answer 8

into the portal vein

Question 9

sinusoids

Answer 9

venous caps of the liver between hepatocytes which carry blood to hepatic vein

Question 10

where are kupffer cells found

Answer 10

line sinusoids

Question 11

what do kupffer cells do

Answer 11

act as macrophages to destroy old WBC’s, RBC’s and bacteria

Question 12

hepatic vein

Answer 12

carries blood from sinusoids to the inferior vena cava

Question 13

what is the metabolism of bilirubin chain

Answer 13

old RBCs break down in blood stream->
heme breakdown produces unconjugated bilirubin in blood->
bilirubin circulates through liver and is conjugated in the hepatocytes->
bilirubin leaves liver in bile via the hepatic duct->
excreted into duodenum->
excreted via feces

Question 14

what does bile contain

Answer 14

h2o, electrolytes, bile acids, cholesterol, bilirubin

Question 15

where does bile drain into

Answer 15

small intestine (duodenum)

Question 16

most acids that are secreted into the duodenum are what

Answer 16

reabsorbed back into the blood

400-800ml is produced a day in an adult

Question 17

bilirubin must be what to exit the blood

Answer 17

Conjugated… water soluble

Question 18

what is jaundice

Answer 18

symptom of liver disease caused by hyperbilirubinemia (excess bilirubin in blood)

Leads to deposition of bile pigment in skin and sclera

Question 19

what are the 3 types of jaundice

Answer 19

1. hemolytic jaundice
2. intrahepatic obstructive jaundice
3. extrahepatic obstructive jaundice

Question 20

hemolytic jaundice

Answer 20

excessive lysis of RBC

liver cannot keep up conjugating which leads to increased unconjugated bilirubin buildup in blood

Question 21

intrahepatic jaundice

Answer 21

(damage to liver)
hepatocellular damage, so liver cannot conjugate or excrete bilirubin

increased unconjugated bilirubin buildup in blood

Question 22

extrahepatic obstructive jaundice

Answer 22

(outside liver)
bile duct obstruction (galstone) so bile cannot get through

leads to increased CONJUGATED bilirubin to accumulate in liver and bloodstream

Question 23

extrahepatic jaundicce can lead to what

Answer 23

intrahepatic obstructive jaundice due to backup

Question 24

hepatitis

Answer 24

inflammation of liver

can lead to degeneration and scarring, necrosis of hepatocytes

Question 25

onset of hep A

Answer 25

acute, sudden

Question 26

onset of hep B

Answer 26

insidious, gradual

Question 27

source of infection for hep a

Answer 27

contaminated food/water | poor sanitation

Question 28

source of infection for hep b

Answer 28

blood- needles, sexual contact

Question 29

mode of transmission hep A

Answer 29

fecal-oral route and blood

Question 30

mode of transmission hep b

Answer 30

body fluids- blood, semen, saliva

Question 31

chronic state hep A

Answer 31

none, self-limiting

Question 32

chronic state hep B

Answer 32

yes- clinical mani for 6+ months

Question 33

diagnosis of hep ABC

Answer 33

HAV antigen and antibodies

Question 34

clinical mani of hep A

Answer 34

``` Fever malaise anorexia nausea jaundice ```

Question 35

clinical mani of hep B

Answer 35

``` anorexia malaise joint aching abdominal pain jaundice may lead to liver failure ```

Question 36

onset of hep C

Answer 36

insidious

Question 37

what are the mani of hep C

Answer 37

fatigue, can progress to permanent liver damage

Question 38

who is at risk for hep C

Answer 38

those with history of snorting/injecting drugs and receiving blood before 1992

Question 39

mode of transmission hep C

Answer 39

blood only

Question 40

biliary atresia definition

Answer 40

CONGENITAL malformation (incorrect development in utero) absence or obstruction of common bile duct (ends in pouch)

Question 41

what is the patho of biliary atresia

Answer 41

atresia leads to plugging, inflammation, fibrosis of bile canaliculi no drainage of bile-> backs up-> damages hepatocytes

Question 42

diagnosis of biliary atresia

Answer 42

increased serum direct bilirubin increased serum liver enzymes

Question 43

clinical mani of biliary atresia

Answer 43

jaundice hepatomegaly acholic (clay colored stools)

Question 44

Cirrhosis of liver

Answer 44

chronic liver disease (failure) marked by degeneration of hepatocytes (inflammation, fibrosis, and scarring)

Question 45

etiology of chrrhosis

Answer 45

1. alcholism : breaks down to acetaldehyde which damages hepatocytes 2. hepatitis

Question 46

decreased amino acids because hepatocytes cant keep up leads to

Answer 46

wasting of body tissues

Question 47

decreased albumin synthesis and decreased levels in the blood stream leads to

Answer 47

edema, ascites (enlarged abdomen), and pleural effusion

Question 48

decreased synthesis of blood clotting compounds (fibrinogen and prothrombin) leads to

Answer 48

``` bleeding: ecchymosis epistaxis blood in urine and stool gums bleeding petachiae ```

Question 49

decreased conversion of glycogen fats and amino acids to glucose leads to

Answer 49

hypoglycemia weightloss fatigue confusion

Question 50

decreased detox of drugs leads to

Answer 50

drowsiness, coma

Question 51

decreased conversion of ammonia to urea leads to

Answer 51

(ammonia cant leave body and screws with brain) | hepatic encephalopathy= personality changes, confusion and coma

Question 52

increased bilirubin leads

Answer 52

jaundice dark red/brown urine acholic stools pruritis

Question 53

portal hyper tension leads to

Answer 53

blood back up: | ascites, splenomegaly, caput medusa, esophageal varicies

Question 54

why does esophageal varicies happen with liver failure

Answer 54

increased pressure builds up in esophageal blood vessels so it ruptures easily, massive hemorrhage and you bleed into airway

Question 55

liver enzymes in chronic liver failure

Answer 55

``` increased: LDH ALT AST ALP these are released from damaged hepatocytes ```

Question 56

what proteins are decreased in liver failure

Answer 56

albumin and pre-albumin

Question 57

which two products build up in blood in liver failure

Answer 57

ammonia and bilirubin