fiziologie hepatica

Question 1

functia excretorie

Answer 1

captare,conjugare si excreie bilirubina
celule Kupfer - identificare compusi non-self
eliminare amoniac,metaboliti ,med,xenobiotici

Question 2

functia de depozit

Answer 2

vit A,D,K,B12, fier sub forma de feritina

Question 3

metabolismul bilirubinei

Answer 3

hemul e degradat de sist reticuloendotelial
fierul e reutilizat
globina catabolizata in aa
bilirubina neconjugata se formeaza din porfirina(hem) si e transp de albumina in ficat
se combina cu acid glucuronic si devine conjugata/solubila in apa

Question 4

metabolismul bilirubinei

Answer 4

hemul e degradat de sist reticuloendotelial
fierul e reutilizat
globina catabolizata in aa
bilirubina neconjugata se formeaza din porfirina(hem) si e transp de albumina in ficat
se combina cu acid glucuronic si devine conjugata/solubila in apa

Question 5

circulatia enteohepatica a bilirubinei

Answer 5

la nivelul ileonului teminal, bilirubina conj se transf in forma neconj in prezenta beta-glucuronidazei
prin metabolizare => UROBILINOGEN

Question 6

urobilina

Answer 6

produs final al oxidarii urobilinogenului

Question 7

urobilinogen

Answer 7

excretat in urina
transf in stercobilinogen
reabsorbit

Question 8

bilirubina serica

Answer 8

reflecta cap ficatului de a capta,procesa si secreta bilirubina
valori bili indirecta -0,3-1,2 mg/dl
directa < 0,4
total - 0,3-1,2 mg/dl

Question 9

urobilinogen in urina/fecale

Answer 9

max 4mg/24 h
stercobilinogen - 40-280 mg/24 h

Question 10

nu apare in fecale

Answer 10

bilirubina

Question 11

bilirubina conj se gaseste in fecale in

Answer 11

colestaza
icter obstructiv

Question 12

raport TGP/TGO

Answer 12

normal = 1,15
hepatita virala >1(TGP crescut)
hepatita cronica - aprox 1
IMA <1
cancer ,ciroza etanolica <1

Question 12

raport TGP/TGO

Answer 12

normal = 1,15
hepatita virala >1(TGP crescut)
hepatita cronica - aprox 1
IMA <1
cancer ,ciroza etanolica <1

Question 13

ALP

Answer 13

fosfataza alcalina
valori normal - 3–39 UI/L
crescuta fiziologic la copil si gravide
ALP in hepatocite se dat sintezei crescute ,stim de obstructia cailor biliare

Question 14

valori ALP

Answer 14

normale in icter hemolitic
crescute in hepatite si icter posthepatic
mult crescute in incter obstructiv

Question 15

metabolism glucidic in ficat

Answer 15

galactoza = monozaharid metabolizat aproape exclusiv hepatic
face diferenta intre icter obstructiv(galactozemie normala ) si nonobstructiv()>4,5g

Question 16

Metabolism lipidic

Answer 16

Colesterol toal = 150-250 mg/dl
60-70%esterificat
in bolile de parenchim hepatic = scade CT, scade frsctia esterificata

Question 17

metabolism proteic

Answer 17

determinare NH3
valori normale - 40micrograme/100ml
patologic - >200 micrograme100ml

Question 18

sinteza proteinelor plasmatice

Answer 18

testare relevanta in bolile cronice
proteine totael - 80-110 mgdl
albumina - 40-50 mgdl
globuline - 25-35 mg/dl

Question 19

albumina

Answer 19

aintetizata exclusiv in ficat
scadere albumine =>ASCITA
rol in mentinerea presiunii coloidosmotice si rol de transportor

Question 20

factorii coagularii

Answer 20

proteine sintetizate hepatic asociate cu metaboliti ai vit K

Question 21

timp de PT

Answer 21

timp necesar PT sa formeze cheagul dupa adaugarea Ca