hepatic

Question 1

what is special about the blood supply to the liver

Answer 1

Dual supply
Portal Circulation
Portal vein
Systemic Circulation
Hepatic Artery

Question 2

what is the functional unit of the liver

Answer 2

hepatocytes

Question 3

functions of the liver

Answer 3

-produces bile acids for excretion of bile (degrades cholestrol to bile acis which mix with bile and drains into gall bladder, emulsifies fats into chyme)
-involved in carbohydrate metabolism (glucogeneosis, glycogenesis, glycogenolysis)
-involved in protein metabolism (plasma protein, albumin and globulins)
-involved in lipid metabolism (FA, triglycerides, cholestrol)
-produces coaggulation factors (may cause patient to bleed out)
-breaks down haemaglobin
-detoxification
-site of ammonium fixation (ammonium-> urea/amino acid)
-storage (glucose, triglycerides, iron)
-immulogical filter

Question 4

what is glycogenesis (genes= to create)

Answer 4

formation of glycogen from glucose

Question 5

what is glycogenolysis

Answer 5

breakdown of glycogen in glucose

Question 6

what is gluconeogenesis (neo= new)

Answer 6

synthesis of glucose from certain amino acids, lactate or glycerol

Question 7

what is icterus

Answer 7

medical time of jaundice
happens when hemaglobin is metabloised into billirubin-> this causes they yellow colour

Question 8

explain bilirubin metabolism

Answer 8

breakdown of rbc: form heam and globin
heam breaks down into iron and biliverdin (green colour)
biliverdin converts into bilirubin (uncojugated)
in the liver, bilirubin in cojugated with albumin (albumin cause it to become conjugated)

Question 9

what is the rls between liver disease and bilirubin

Answer 9

liver disease cause loss of conjugated bilirubin into bloodstream cause jaundice/ icterus appearance

Question 10

steps to diagnosing liver disease

Answer 10

history: anorexia, weight loss, bleeding
physical examination: icterus, orangey faeces
neurological signs ( seizures , blindness, abnormal behaviour)
- diagnostic test: CBC, biochemistry, xray, ultrasound)

Question 11

what is the indication of heaptobillary disease

Answer 11

elevated liver enxymes

Question 12

what are the two different types of liver enzymes

Answer 12

hepatocellular markers: enzymes ALT& AST are released with hepatocyte damage
cholestatic markers: billary enzymes (ALP, GGT)

Question 13

which biochemistry panel do we use

Answer 13

chem 10: ALT, ALP
chem 17: all four

Question 14

what is ALT and what does it mean

Answer 14

alanine amino transferase (ALT)
very specific for liver disease, does not mean that liver disease is permanant, could mean its just damaged and can recover)

Question 15

what us AST and what does it mean

Answer 15

asparate amino transferase (AST)
not as specific bc is present in both liver and muscles (cardiac and skeletal) (damge in muscle can also cause increased levels) damage to either will cause increase

Question 16

what is ALP and what does it mean

Answer 16

Alkaline phosphate (ALP)
present in billary canaliculi cells of liver and in bone
can also increase bc of drugs such as corticosteriod and phenobarbitone
some breed may just have naturally high (Doesnt not mean liver disease)

Question 17

what is ggt and what does it mean

Answer 17

Gamma glutamyl transferase (GGT)
marker of billary stasis (movement)
less specific that ALP

Question 18

what is the most specific test to diagnose liver disease

Answer 18

serum bile acid test

Question 19

what does an increase in serum bile acid mean

Answer 19

there is less blood flow to the liver or loss of functional heapatocyte
(bile acids are excreted in the bile in the duodenum, reabsorbed by the ileum and re- excreted by the liver)

Question 20

how to perform bile acid serum test

Answer 20

• patient has to be fasted for 12hrs
  -at 0hr, pre-prandial blood sample is drawn
• patient is fed a high fat meal in hospital (must finish all the food)
• at 2hr post-prandial blood sample is drawn (food is in small intestine)