Liver 1

Question 1

Major Functions of the Liver

Answer 1

1. Metabolism + Storage of:
   - Fat, Carbs, Protein, Vitamins, and Minerals
2. Blood Volume reservoir
   - Distends/compresses to alter circulating blood volume
3. Blood Filter:
   - Helps purify blood by removing bilirubin
4. Blood clotting Factors:
   - Including prothrombin + fibrinogen
5. Drug Metabolism + Detoxification

Question 2

Functional Unit of the Liver

Answer 2

Lobes (made up of hepatocytes)

Question 3

The portal Circulatory system

Answer 3

brings blood to the liver from the stomach, intestines, spleen, and pancreas

The absorbed products of digestion come directly to the liver, and are sent to the lobules

FIRST PASS METABOLISM

Question 4

Liver function Test Results

Answer 4

Liver Enzymes (UP)
ALT
AST
Alk Phos

Bilirubin (UP)
0.1-1.2

Serum Ammonia (UP)

Serum Protein (Down)

Serum Albumin (Down)

Prothrombin time (UP)
-takes longer to clot

Question 5

At what bilirubin level is jaundice noticeable at

Answer 5

-Noticeable + problematic when > 2-2.5 mg/dl

Question 6

Hemolytic Jaundice

Answer 6

increased breakdown of RBC’s (many causes)

Question 7

Hepatocellular Jaundice

Answer 7

Liver unable to take up bilirubin from blood or unable to conjugate it

(liver isn’t working)

Question 8

Obstructive Jaundice

Answer 8

decreased or obstructed flow of bile

Not a liver problem, probably gallstones

Question 9

2 types of Bilirubin

Answer 9

Direct: Conjugated (30%)

Indirect: Unconjugated (70%)

Question 10

Indirect bilirubin

Answer 10

(unconjugated): bilirubin overproduction OR impaired liver functioning (70%)

Question 11

Direct Bilirubin

Answer 11

(conjugated) : liver working, but can’t get the bilirubin out
- Bile duct obstruction, gall stones

Question 12

Jaundice manifestations

Answer 12

Urine: darker

Liver Enzymes: elevated

Stools: normal or clay colored

Pruitis: bilirubin buildup

Question 13

Most common types of hepatitis

Answer 13

Hepatitis B + C are most common

Question 14

This type of HEP is very dangerous for pregnancy

Answer 14

HEP E

Question 15

Other viruses that can cause Hepatitis

Answer 15

(Epstein-Barr, cytomegalovirus)

Question 16

Steps of viral hepatitis

Answer 16

1. Viral Infection
2. Immune response: Inflammatory mediators (around liver)
3. Lysis of infected cells
4. Edema and swelling of tissue
5. Tissue hypoxia
6. Hepatocyte Death!

Question 17

Similar between all types of hepatitis

Answer 17

Many cases of ALL types of hepatitis are asymptomatic

-can range from none, mild, to liver failure

Question 18

Elevated Liver enzymes are not NECESSARILY a sign of

Answer 18

Cellular damage

Question 19

3 stages of Viral Hepatitis

Answer 19

1. prodromal
2. icteric
3. Recovery

Question 20

1. Prodromal

Answer 20

2 weeks after exposure

Fatigue, anorexia, malaise, N/V, hyperalgesia, cough, low-grade fever

HIGHLY transmissible

Question 21

2. Icteric

Answer 21

Begins with jaundice

(active phase)

Jaundice, dark urine, clay-colored stools

Liver enlarged and may be painful to palpation

Fatigue, abdominal pain persists or increases in severity

Some stay in this phase (chronic hepatitis)

Question 22

3. Recovery

Answer 22

Resolution of jaundice

6-8 weeks after exposure, symptoms diminish

Liver remains enlarged/tender

Question 23

Complications of viral HEP

Answer 23

• Chronic Hepatitis
• Liver cirrhosis
• Liver cancer
• Fulminant viral hepatitis (acute liver failure)

Question 24

Most patients with acute viral hepatitis recover completely with no complications T/F

Answer 24

True

Question 25

Mortality rate of viral hepatitis

Answer 25

Overall mortality rate is <1%

-Higher mortality in elderly and comorbidities