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603 Physiology > Hepatic 2 > Flashcards

Hepatic 2 Flashcards

1
Q

Basolateral aspect of hepatocytes

A

faces Space of Disse

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2
Q

Apical aspect of hepatocytes

A

faces canniculi lumen

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3
Q

What molecules can be reabsorbed from the bile with Na+ transport?

A

adenosine and AAs

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4
Q

Are transporters in the apical membrae unidirectional?

A

yes (mostly)

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5
Q

icterus

A

jaundice

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6
Q

hyperbilirubinemia

A

excess bilirubin in blood serum

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7
Q

Jaundice

A

yellowing of the skin and/or whites of the eyes, d/t excess bilirubin

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8
Q

3 Possible Causes of Jaundice

A
  1. Obstruction of the Bile Duct
  2. Liver Disease
  3. Excessive breakdown of RBCs
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9
Q

How can the liver get rid of RBCs?

A

Kupffer cells will phagocytose the dying RBCs and breakdown into hemoglobin, then into heme and globin

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10
Q

3 Major Organs that can breakdown RBCs

A
  1. Liver
  2. Spleen
  3. Bone Marrow
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11
Q

What is globin broken down into?

A

amino acids

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12
Q

What happens to the heme of old RBCs?

A

the iron component of heme can be used by the bone marrow; can also be broken down to bile and go to the gallbladder

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13
Q

How does heme become bile?

A

Heme goes through a redox rxn to become bilirubiin, which is then secreted to the blood where it binds to albumin, then hepatocytes pick up the complex, albumin removed, conjugated by UGT, and goes to gallbladder as bile

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14
Q

What makes shells and bird poop green?

A

biliverdin

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15
Q

urobilinogen

A

when bacteria metabolize bilirubin in the intestine

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16
Q

3 Pathways of Urobilinogen

A
  1. 20% reabsorbed by intestine and into the portal vein
  2. 20% excreted via the kidneys
  3. 60% metabolized into stercobilin
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17
Q

What gives urine its yellow color?

A

urobilin, the oxidized form of urobilinogen when exposed to air

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18
Q

What component makes feces brown?

A

stercobilin

19
Q

3 Types of Hyperbilirubinemia

A
  1. Pre-hepatic
  2. Hepatic
  3. Post-hepatic
20
Q

Pre-Hepatic Hyperbilirubinemia

A

increased RBC destruction –> lots of heme –> lots of circulating bilirubin

21
Q

Which types of hyperbilirubinemia would have high unconjugated bilirubin levels in the blood?

A

pre-hepatic and hepatic

22
Q

Which types of hyperbilirubinemia would have high levels of conjugate bilirubin in the blood?

A

post-hepatic

23
Q

Hepatic Hyperbilirubinemia

A

hepatic dysfunction/damage affects liver’s ability to transform the bilirubin so it will “back up” in the blood serum

24
Q

Post-Hepatic Hyperbilirubinemia

A

blockage of biliary outflow; conjugated bilirubin goes back into systemic ciculation

25
Q

Cholestasis

A

blockage of biliary outflow

26
Q

Cholelilthiasis

A

gallstones

27
Q

Which type of hyperbilirubinemia results in dark-colored urine?

A

post-hepatic (conjugated is more polar so can go through the kidney)

28
Q

Diagnostics to differentiate between pre-hepatic and hepatic?

A

Pre-hepatic will have dec. RBCs
Hepatic will have inc. AST, inc. ALT, and dec. albumin

29
Q

2 Major Functions of Bile

A
  1. Bile is the excretory route for solutes that can’t be excreted by the kidney
  2. Needed to form micelles for lipid digestion and absorption
30
Q

Constituents of Bile

A

bile acids/salts, phospholipids, cholesterol, IgA,bile pigments, water, inorganic salts, mucus

31
Q

Which constitueents of bile are amphipathic?

A

bile acids, bile salts, and phopholipids

32
Q

IgA in bile

A

inhibits bacterial growth within the bile

33
Q

Bile Acids vs. Bile Salts

A

Bile Acids are protonated, neutral, not [very] water soluble
Bile Salts are deproteonated, negatively charged, more water soluble

34
Q

Which is more water soluble - bile acid or salt?

A

bile salts

35
Q

Why are bile salts negatively charged?

A

d/t conjugation with sulfate or glucuronate (or glycine or taurine)

36
Q

Only cell type that can synthesize bile acids?

A

hepatocytes

37
Q

Primary Bile Acids

A

synthesized in hepatocytes

38
Q

Secondary Bile Acids

A

synthesized in intestine by bacteria that dehydroxylates the primaries

39
Q

Do hepatocyte secretions have more bile salts or bile acids?

A

bile salts

40
Q

How are secondary bile acids reabsorbed in the gut?

A

enterohepatic recirculation

41
Q

Enterohepatic circulation

A

95% of bile acids and salts are absorbed in ileum and colon (some throughout entire GI but these are main locations) and enter portal venous system

42
Q

Cholangiocytes

A

name of biliary epithelial cells

43
Q

3 Ways Bile Secretion is Controlled

A
  1. Positive feedback - increase secretion of bile salts
  2. Negative feedback - decrease synthesis of bile salts
  3. CCK - secreted by intestine after a meal and inc. release of bile acid from gallbladder

603 Physiology (22 decks)

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