Exam 2- GI Alterations (Hepatitis/Liver)

Question 1

Functions of the Liver

Answer 1

• Metabolic functions (detoxification, carb/fat/protein/steroid metabolism)
• Bile Synthesis
• Storage
• Filtration (phagocytes, Kupffer cells)

Question 2

Liver Functions - Storage

Answer 2

• Blood storage in case of hypovolemia
• Vitamin and mineral storage (magnesium, Vits A, B, D, E, K), 30% of bodys iron supply
• Glucose as Glycogen
• Fatty acids (minerals) & amino acids (albumin)

Question 3

Liver Functions - Bile Synthesis

Answer 3

• Produces formation of bile, bile salts, bilirubin, et cholesterol
• Bile production: 500-1000mL/day
• Binds bilirubin to albumin, excess results in jaundice
• Excrete 1L/day

Question 4

Carbohydrate Metabolism - Metabolic Liver Functions

Answer 4

Gluconeogensis- amino & fatty acids to glucose
Glycogenesis- Glucose to glycogen
Glycogenolysis - Glycogen to glucose

Question 5

Protein Metabolism - Metabolic Liver Functions

Answer 5

• Synthesis of Amino acids, plasma proteins (albumin globulins and fibrinogen), clotting factors
• Formation of urea from ammonia
• Albumin maintains blood oncotic pressure and prevents plasma loss from the capillaries
• Globulins are essential for cellular enzymatic reactions
• Fibrinogen helps to form blood clots
• Production and removal of blood clotting factors: liver synthesizes prothrombin (factor I), fibrinogen (factor II), and factors VIII, IX, & X

Question 6

Fat Metabolism - Metabolic Liver Functions

Answer 6

• Synthesis of lipoproteins, fatty acids
• Breakdown of triglycerides
• Synthesis & breakdown of cholesterol
• Formation of Ketones

Question 7

Detoxification - Metabolic Liver Functions

Answer 7

Inactivation/metabolization/excretion of drugs, hormones, and other toxic substances

Question 8

Steroid Metabolism - Metabolic Liver Functions

Answer 8

Conjugation and excretion of endogenous steroids

Question 9

Liver Functions - Filtration

Answer 9

• Filtration: Kufpffer cells are absorbed thru the GI tract, and prevent bacteria from reaching the circulation
• WBC, RBC Hgb to bilirubin

Question 10

Hepatitis

Answer 10

Liver inflammation

Question 11

Types of Hepatitis

Answer 11

Viral (A-G)
Bacterial
Non-infectious (drugs/chemical exposure)

Question 12

Most common Hepatitis

Answer 12

Viral Hep B

Question 13

Hepatitis A

Answer 13

• RNA Virus, 35% of the population
• Fecal/oral transmission
• Self-limiting (1-4 weeks)
• Risks: Crowded conditions, restaurant/daycare worker, poor sanitation, contaminated food/water
• Prevention = Hand washing
• TX = Family members get HAV to prevent infections

Question 14

Hepatitis B

Answer 14

• DNA Virus, 50% of population, Most Common

- Transmission: Percutaneous (IV, needle, mucosal exposure to blood/body fluids; perinatal