Hepatic Phys And Anesthesia Flashcards

1
Q

What is not a apart of MELD score?

A

Serum albumin

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2
Q

Which is a more objective score Child-Pugh ?

A

Meld because it does not look at things that are subjective such as encephalopathy or as cities

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3
Q

What are the components of the MELD score?

A

Serum creatinine
Bilirubin
INR

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4
Q

What enzyme is messed up in Gilbert syndrome?

A

Bilirubin glucoronyltransferase

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5
Q

What happens in Gilbert with massive blood transfusion

A

Postoperative jaundice due to overwhelming of the enzyme

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6
Q

What does glucagon do to hepatic blood flow?

A

Increases it along with D1 and Beta 2 receptors in the hepatic artery

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7
Q

How much cardiac output does the liver receive.

A

25%

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8
Q

Which vessel to the liver exhibits autoregulation?

A

Hepatic artery

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9
Q

What happens to the hepatic arterial flow when portal vein decreases?

A

It will increase due to accumulation of adenosine which causes vasodilation via the A2 receptors

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10
Q

What agents decrease hepatic blood flow?

A

Beta blockers due to the beta 2 in the hepatic artery

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11
Q

What do alpha receptors do to hepatic blood flow?

A

Decrease it

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12
Q

What does vasopressin do to hepatic blood flow?

A

Decreases it

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13
Q

What do D1 receptors do to hepatic blood flow?

A

Decrease it

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14
Q

What happens to hepatic blood flow in general anesthesia?

A

It decreases due to decreased cardiac output

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15
Q

Where is citrate metabolized?

A

The liver

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16
Q

What is citrate metabolized to?

A

Bicarbonate

17
Q

What does glucagon do to hepatic blood flow?

A

Increases it along with D1 and Beta 2 receptors in the hepatic artery

18
Q

How much cardiac output does the liver receive.

19
Q

Which vessel to the liver exhibits autoregulation?

A

Hepatic artery

20
Q

What happens to the hepatic arterial flow when portal vein decreases?

A

It will increase due to accumulation of adenosine which causes vasodilation via the A2 receptors

21
Q

What agents decrease hepatic blood flow?

A

Beta blockers due to the beta 2 in the hepatic artery

22
Q

What do alpha receptors do to hepatic blood flow?

A

Decrease it

23
Q

What does vasopressin do to hepatic blood flow?

A

Decreases it

24
Q

What do D1 receptors do to hepatic blood flow?

A

Decrease it

25
What happens to hepatic blood flow in general anesthesia?
It decreases due to decreased cardiac output
26
Where is citrate metabolized?
The liver
27
What is citrate metabolized to?
Bicarbonate
28
What does cytochrome P450 do?
Oxidizes organic compounds
29
Where is cytochrome p450?
Endoplasmic reticulum
30
What mineral is associated with cytochrome p450?
Iron
31
What is metabolized by the 2C19 system?
Plavix
32
What is metabolized by 2D6?
Codeine to morphine
33
What is metabolized by 3A4?
Midazolam Lidocaine Oral contraceptives Alfentanil
34
What is metabolized by the 2C19 system?
Plavix
35
What is metabolized by 2D6?
Codeine to morphine
36
What is metabolized by 3A4?
Midazolam Lidocaine Oral contraceptives Alfentanil