Hepatobiliary physiology

Question 1

2 main secretory excretory liver functions

Answer 1

1. secretion of bile acid and fluid

2. exretion of metabolic waste and detox

Question 2

where does liver get it’s blood (2)

Answer 2

1. portal vein (80%)

2. hep atic artery (20%)

Question 3

how many lobes of liver and how are they divided

Answer 3

8, based on their blood supply

Question 4

what is fasting and fed state of gall bladder

Answer 4

fed- empty

fasting - full

Question 5

what stims gall bladder to secrete

Answer 5

CCK -

Question 6

what are 2 types of bile acids and how are the converted

Answer 6

primary and secondary - by colonic bacteria

Question 7

what type of molecule are BAs

Answer 7

amphiphillic

Question 8

what are funtions of BA

Answer 8

form fat into micelles for uptake

Question 9

what is path of BA in body

Answer 9

1. synthesized/recycled in liver
2. solubleize fats in the small bowel
3. taken up by distal illeum
4. returned to the liver by the portal veins

Question 10

what is a simple micelle

Answer 10

water soluble cluster of BA

Question 11

what is mixed micelle

Answer 11

cholesterol at center with BA and phospholipids around

Question 12

what is critical miceller conc.

Answer 12

critical amount of BA needed to make a micelle

Question 13

what is a gall stone made of

Answer 13

cholesterol crystals

Question 14

2 things that push normal bile to stones

Answer 14

1. not enough BA

2. too much cholestterol

Question 15

what causes black stones

Answer 15

excess bilirubin in bile - hemolysis or cirrosis

Question 16

what causes brown stones

Answer 16

biliary stasis or infection

Question 17

what is unconjugated vs. conjugated bilirubin

Answer 17

unconjugated - tightly bound to albumin and lipid soluble

conjugated - with glucouronic acid - water soluble

Question 18

what is normal bilirubin and when do we see jaundice

Answer 18

nromal < 22

jaundice > 32

Question 19

3 categories of jaundice and causes

Answer 19

1. pre-hepatic - hemolysis (unconjugated)
2. hepatic - liver disease - most common
3. post-hepatic (obstructive) - blockage of bile ducts (conjugated)

Question 20

what are 2 metabolic functional states

Answer 20

1. absorbitave

2. post-absorbative

Question 21

what is absorbative state of glucose metabolism

Answer 21

gycogenisis from excess glucose

Question 22

what is post-absorbative metabolism of glucose (2)

Answer 22

1. glycogenolysis to make glucose

2. gluconeogenisis from AA, lactate and glycerol

Question 23

what is absorbative state of fat metabolism

Answer 23

TAG are made from glucose for storage in adipose tissue

Question 24

what is post-absorbative metabolism of fat (2)

Answer 24

1. lipolysis

2. ketogenisis - ketone sysnthesied from FAs as an alternative E source

Question 25

what is liver product of AAs (3)

Answer 25

1. emzymes
2. albumin
3. clotting factors, fibrinogen

Question 26

what is byproduct of AA catabolism

Answer 26

ammonia, converted to urea for excretion

Question 27

what is form of most drugs that are detoxed

Answer 27

organic anion

Question 28

what is path of drug removal

Answer 28

1. organic anion > cytochrome p450
2. oxidation > enzyme
3. conjucaiton products > excreted