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Pharmacology > Hepatic System > Flashcards

Hepatic System Flashcards

1
Q

What is the hepatic system?

A

Liver + gall bladder

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2
Q

What is the structure of the liver?

A 
Highly vascularised 
4 lobes = 2 major + 2 minor
Well defined thin capsule of connective tissue
Rich in nerve endings 
Covered by single layer of mesothelium
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3
Q

What are the 2 major lobes?

A

Left & right

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4
Q

What are 2 minor lobes?

A

Caudate & quadrate

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5
Q

What is the function of gall bladder?

A

Bile storage + secretion

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6
Q

Where is gall bladder?

A

Under right lobe of liver

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7
Q

What is the liver lobule?

A

Functional unit of the liver

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8
Q

What is liver lobule structure?

A

Specialised epithelial cells + hepatocytes

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9
Q

What is the liver lobule composed of?

A

Central terminal hepatic venule
Interconnecting places of hepatocytes
Peripherally arranged portal triad

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10
Q

What are the hepatocyte zones in liver lobule?

A

Centrilobular, periportal + mid zone

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11
Q

What are the 2 vessels the liver receives blood form?

A

Hepatic portal vein

Hepatic artery

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12
Q

What does the portal vein do?

A

Conducts blood to liver + NOT directly to heart
Nutrient rich blood from digestive tract + spleen
Filters toxins from digestive tract

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13
Q

What percentage of blood does portal vein supply to the liver?

A

75%

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14
Q

What does the hepatic artery do?

A

Oxygenated blood supply from aorta

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15
Q

What percentage of blood does hepatic artery supply to the liver?

A

25%

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16
Q

Does the liver lobule have capillaries?

A

NO

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17
Q

What does the portal vein + hepatic artery discharge into?

A

Liver sinusoids

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18
Q

What are the liver sinusoids lined with and why?

A

Phagocytes (Kupffer cells)

= destroy bacteria

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19
Q

Where are pericytes found in sinusoids?

A

Disse (perisinusoidal space)

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20
Q

What is stored in sinusoids?

A

Retinoid

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21
Q

What does damage of sinusoids lead to?

A

Transdifferentiation into proliferative fibrogenic myofibroblasts + liver fibrosis

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22
Q

What does bile canaliculi coalesce into?

A

Bile ductiles, running alongside portal veins

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23
Q

Does blood + bile flow in opposite directions?

A

YES

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24
Q

What are functions of the liver?

A 
Detoxification + metabolism 
Decomposition of erythrocytes + excretion of bilirubin 
Cholesterol synthesis + lipogenesis 
Carbohydrate metabolism 
Protein synthesis 
Hormone production
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25
Q

What does the liver store?

A

Glycogen
Vitamin A, D, E, K + B12
Fe
Cu

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26
Q

What is glycogenesis?

A

Synthesis of glycogen from excess glucose-6-phosphate

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27
Q

What happens in glycogenesis?

A 
Glucose converted to G6P using 1x ATP
G6P converted to G1P
Activated by UTP=UTP-glucose
UTP-glucose attaches to end of glucose chain
UDP released
(converted to UTP using ATP)
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28
Q

What happens in glycogenolysis?

A

Glucose phosphorylated when cleaved from glycogen to form G1P
G1P —-> G6P, which enters glycolysis
Phosphorylated glucose can’t enter cells
G6P hydrolysed to glucose

29
Q

What is glycogenolysis activated by?

A

Glucagon in liver

30
Q

What is glycogenolysis inhibited by?

31
Q

What is gluconeogenesis?

A

Glucose from non-carbohydrates

32
Q

What molecules are considered glucogenic?

A

Any that can be converted to pyruvate

eg. lactate, alanine, glycerol

33
Q

What is is the process of gluconeogenesis?

A

Reversible reactions of glycolysis

34
Q

What 3 reactions are not reversible?

A

Hexokinase
Phosphofructokinase
Pyruvate kinase

35
Q

What pathway is gluconeogenesis?

A

Red enzyme gluconeogenic pathway

36
Q

What do red enzymes do?

A

Overcome high negative free energy of irreversible reactions of glycolysis

37
Q

What is the Cori cycle?

A

Flow of lactate + glucose between muscles + liver

38
Q

What happens in Cori cycle?

A

Lactate oxidised back t pyruvate in liver
Gluconeogenesis converts pyruvate to glucose
Transferred to muscles

39
Q

What happens in liver metabolism?

A

Liver converts glucose via acetyl-CoA into fatty acids
Retrieves FAs from lipids supplied with chylomicrons from intestine
Converted into neutral fats + phospholipids
VLDL formed

40
Q

What is cholesterol used for?

A

Synthesis of bile acids, cell membranes + hormones

41
Q

What happens to excess cholesterol?

A

Converted into bile acids or excreted with the bile

42
Q

What are bile acids?

A

Steroids synthesised in liver from cholesterol

43
Q

What is bile produced by?

A

Hepatocytes and passes into bile canaliculi

44
Q

Where does bile canaliculi carry bile back to?

A

Portal triad

45
Q

What is lipid digestion?

A

Bile facilitate solubilisation of dietary lipids during digestion by micelle formation

46
Q

How is bilirubin formed?

A

Phagocytised + haemoglobin released

47
Q

Describe process of bilirubin formation

A

Globin metabolised + amino acid recycled
Fe bound to transferrin + returned to liver & BM
Haem converted to bilirubin, bound to albumin

48
Q

How is bilirubin metabolised in the liver?

A

Uptake of bilirubin by hepatocytes
Bilirubin conjugated with 2 glucuronic acids by UDP -glucuronyl transferase
Conjugate bilirubin transported into bile canaliculi + bile
Intestinal bacteria degrade bilirubin + urobilinogen

49
Q

What happens to bilirubin after it has been degraded?

A

80% oxidised to stercobilin + excreted in faeces

20% enters extrahepatic circulation + excreted in urine

50
Q

What is the first pass effect?

A

Substance absorbed from GI tract passes through liver

51
Q

What are phase I reactions?

A

Metabolism

52
Q

Describe what happens in phase I reactions

A

Convert parent compound into more polar molecule
By adding or unmasking functional group
Often metabolites inactive

53
Q

Describe what happens in phase II reactions

A

Conjugation with endogenous substrate to increase aq solubility
Conjugation with glucoronide, sulfate, acetate + amino acid

54
Q

When do transaminases enzymes increase?

A

When liver is inflamed + damaged

55
Q

When do cholestatic enzymes increase?

A

When biliary tract damaged + inflamed

56
Q

Describe liver at foetal + newborn

A

1st trimester, liver main site of RBC production

By 32 weeks BM takes over

57
Q

Describe liver at childhood

A

Liver produces insulin-like growth factor

Hormones plays role in childhood growth

58
Q

Describe geriatric liver

A

Oxidative capacity of liver decreases with age

Reduced metabolism = longer drug exposure + reduced toxin clearance

59
Q

What is hepatitis?

A

Inflammation of liver

60
Q

What is cirrhosis?

A

Formation of fibrous tissue in liver replacing dead cells

61
Q

What is haemochromatosis?

A

Excessive iron accumulation + liver damage

62
Q

What is hepatic system cancer?

A

Hepatocellular carcinoma, cholangiocarcinoma

63
Q

What is Wilson’s disease?

A

Hereditary disease causing copper retention

64
Q

What is biliary syndrome?

A

Genetic disorder of bilirubin metabolism

65
Q

What is jaundice?

A

Yellow coloured skin, nail beds & sclera caused by deposition of bilirubin due to hyperbilirubinemia

66
Q

What are the three types of jaundice?

A

Haemolytic
Obstructive
Hepatocellular

67
Q

What is haemolytic jaundice?

A

Excessive RBC lysis

68
Q

What is obstructive jaundice?

A

Conjugated bilirubin prevented from entering intestine

69
Q

What is hepatocellular jaundice?

A

Liver damage causes low conjugation efficiency

Pharmacology (40 decks)

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