Lecture 9

Question 1

Where is billiuben derived from?

Answer 1

Heme in hemoglobin

Question 2

What are the two types of billiruben?

Answer 2

Conjugated and unconjugated! unconjugated is not water soluble and is indirect approach!

-Conjugated billiruben is water soluble and made directlyusing UDP glucuronyl transferase!

Question 3

What is the function of bile?

Answer 3

Aids in lipid digestion,

-Emulsifies lipids because of its amphiphilic nature and can allow lipase to break down large fat molecules

Question 4

What are the causes of jaundice?

Answer 4

• Obstruction of billary tree
• Temporary or permenant abnormal hepatocyte function
• Make too much billiruben (Due to hemolysis)
• Born with bad billiruben genes

Question 5

What are the things LFTs measure?

Answer 5

Liver function test hepatocyte activity and billiary obstruction

• Alt (cytoplasm -hepatitis) and Ast (Mitochondira-alcohol) these test hepatocyte function
• GGT and Alkaline phosphotase is billary obsruction

Question 6

When is the conjucgated billiruben increase and when is unconjugated increase?

Answer 6

• Conjugated increase when there is an obstiruction of billary tree
• UCB happens when there s too much hemolysis
• Ammonia is hugh in serum crrrohsis aka liver damage

Question 7

How does the liver look like in billary cirrhosis?

Answer 7

-Its nodular, pigmented and firm

Question 8

What is primary billary cirrhosis?

Answer 8

Chronic progressive Autoimmune,

• More likely in women
• fatigue, jaundice and xanthoma (Yellow patches on skin due to collection of fats in macrophages
• The autoimmunity is due to high mitochondiral antibodies

-LEADS TO BILE DUCT DESTRCTION

Question 9

What is cholestasis?

Answer 9

• A disease that shows bile pigments in hepatocytes, Bile plugs in canaliculi
• Bile duct proliferation

-REDUCTION OR SLOWING DOWN OF bile flow

Question 10

What can caused by cholestasis?

Answer 10

Bile stones! primarly will show bile duct poliferation

• secondary inflammation -PMNs
• Distended ductes and calaiculi
• bile lakes in parecnhyma
• -periportal cirrhosis! aka fibrosis

Question 11

Sclerosing cholangitis (Inflammation of bile ducts)

Answer 11

possibly autoimmune,
more common in makes
-increase in serum alkaline phosphatase because that measures obstruction of billary tree
-Involves small and large extrahepatic bile ducts
-constriction of bile ducts
– You will see onion skin like fibrosis and you do trichromatic stain for portal fibrosis to see the collagen

Question 12

What is acute cholecystitis

Answer 12

gall bladder inflammation

-can be due to obstruction and ischemia or due to spesis shock and trauma

Question 13

What are the different types of gall stones?

Answer 13

• Yellow is cholestrol and its the most common
• Billiruben is going to be black stones
• Calcium carbonate stones are white and opaq

Question 14

Hepatocellualr carcinoma vs cholangiolar carcinoma?

Answer 14

one is cancer of livercells and cholangiolar carcinoma is damage to bile ducts

Question 15

What are the different types of possible liver cancers?

Answer 15

• Bengin hemaangioma and hepatic adenoma
• Malignant: Hepatocellular carcinoma and choligiocarcinoma

Most of the cancers are due to secondary metabolim to the liver.

Question 16

Whats a hepatocelluar carcinoma shape vs choligiocarcinoma?

Answer 16

Its usually a large tumor in te liver! due to lier cells not ducts.
=This one youll see more little tumors thorigh out

Question 17

liver metastisis is usually what type?

Answer 17

CANON ball metastisis