Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 > Liver > Flashcards

Liver Flashcards

1
Q

Functions of liver

A 
• metabolism 
• immunity 
• storage 
• detox
• synthesis 
• catabolism
• activation 
• transport
• excretion
Miss CATED
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Liver metabolic processes

A
  • Carbohydrate
  • Lipid
  • Protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Liver Carbohydrate metabolic process

A
  • stores glucose as glycogen
  • glycogenolysis in fasting
  • gluconeogenesis in fasting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Liver lipid metabolic process

A
  • synthesis of cholesterol

* lipoproteins - VLDL, LDL, HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Liver protein metabolic process

A
  • a.a synthesis

* breakdown of a.a to ammonia and then urea for excretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Liver detox ammonia

A
  • harmful ammonia to urea.

* major elimination route of nitrogenous waste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Liver detox drugs

A
  • Phase I reactions - CYP450
  • Phase 2 reactions - conjugation with other compounds to become more hydrophyllic
  • Age, nutrition and genetics influence drug metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Liver Phase 1 detox

A

CYP450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Liver Phase 2 detox

A

conjugation w other compounds to become more hydrophyllic eg gluconosyltransferases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Endocrine activities of liver

A
  • modification of some hormones

* major organ for degradation of hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Modification of some hormones

A
  • vitD3 to 25-OH vit D3
  • Thyroid hormone - convert T4 to more potent T3
  • Insulin-like growth factors produced by hepatocytes modify action of growth hormone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Major organ for degradation of hormones

A
  • insulin and glucagon
  • oestrogens, glucocorticoids, growth hormone, PTH
  • gastrin and other GI hormones (kidney degrades more of these)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Storage in Liver

A
  • fats
  • glycogen
  • trace elements - Cu,Fe
  • vitamins - A,D,K
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Synthesis in Liver

A
  • hormones

* plasma proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hormone synthesis in liver

A
  • insulin-like growth factor

* Thrombopoietin - stimulates platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Plasma protein synthesis in liver

A
  • Coagulation factors
  • transport for cholesterol (lipoproteins)
  • transport for steroid and thyroid hormones
  • Angiotensinogen - salt conservation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Iron transport and metabolism protein synthesis in liver

A

Transferrin, heptaglobin, hemopexin, hepcidin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acute phase protein synthesis in liver

A

Important in inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bile acid synthesis in liver

A
  • 1º - cholic acid and chenodeocycholic acid

* 2º - deoxycholic acid and lithocholic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

1º Bile acid synthesis in the liver

A

Cholic acid and chenodeoxycholic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

2º Bile acid synthesis in liver

A

deoxycholic acid and lithocholic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is bile?

A 
(Aq) alkaline fluid containing: 
•  Bile salts 
•  Cholesterol
•  Lecithin
•  Bilirubin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where bile stored?

A

Stored & concentrated in gall bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Bile secreted by?

A

liver.

• actively diverted to gallbladder between meals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

After meal, bile enters?

A

duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bile salts are?

A

derivatives of cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Bile salts - function?

A

Convert large fat globules into liquid emulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Bile salts once function over

A

Most reabsorbed into blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Micelle structure

A
  • Cholesterol center - all lipid soluble
  • Hydrophobic core
  • Bile salt & lecithin shell -lipid soluble (towards core) & water soluble parts
  • Hydrophilic shell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Bile salt structure

A
  • water soluble part

* lipid-soluble part

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Excretion of cholesterol and bilirubin

A

• through bile secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is secreted through bile?

A
  • cholesterol
  • water
  • electrolytes
  • bile acids
  • phospholipids
  • bilirubin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is bilirubin

A

breakdown product of haem from RBC breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where heme breakdown occurs?

A

• Macrophages of the reticulo-endothelial system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

how bilirubin enter liver ? through which diffusion?

A
  • unconjugated bilirubin transported through blood to liver
  • taken up via facilitated diffusion by liver
  • conjugated with glucuronic acid
36
Q

conjugated bilirubin actively secreted into?

A

bile and then intestine

37
Q

In intestine, bile?

A
  • glucuronic acid removed by bacteria.

* remaining bilirubin converted to urobilinogen

38
Q

urobilinogen from intestine then?

A
  • reabsorbed from gut into portal blood.
  • some enter enterohepatic urobilinogen cycle
  • remainder transported by blood to kidney.
  • converted to yellow urobilin and excreted, giving urine yellow colour
39
Q

Why urine yellow?

A
  • bilirubin converted to urobilinogen in intestine
  • urobilinogen transported to kidney via blood
  • converted to yellow urobilin and excreted.
40
Q

Urobilinogen to feces, how?

A
  • oxidised by intestinal bacteria to

* brown stercobilin

41
Q

Liver diseases

A
  • gallstones
  • cirrhosis
  • hepatitis
  • drug toxicity
  • alcohol related
  • cancer
  • cholangitis
42
Q

disease where bilirubin cant be metabolised properly

A

Gilberts disease

43
Q

Gilberts disease

A

Inability to metabolise bilirubin properly

44
Q

inherited Cu overload liver disease

A

Wilsons disease

45
Q

Wilsons disease

A

Cu overload, inherited

46
Q

Fe overload, inherited Liver disease

A

Hemochromatosis

47
Q

Hemochromatosis

A

Fe overload, inherited

48
Q

Acute liver disease - classification

A
  • self-limiting
  • leads to hepatocyte inflammation/damage
  • Severe can lead to liver failure
  • usually caused by drugs or viruses
49
Q

Chronic liver disease - classification

A
  • Inflammation >6months
  • leads to permanent damage with structural changes = cirrhosis
  • common cause = alcohol abuse
50
Q

Progression of liver disease

A
  • normal liver
  • chronic injury
  • inflammation/fatty liver
  • early fibrosis 5-50years
  • disrupt liver architecture
  • Cirrhosis, portal HYP
  • hepatocellular carcinoma/liver transplant
51
Q

Fatty liver is ?

A
  • reversible

* large vacuoles of triglyceride fat accumulate in liver cells via steatosis

52
Q

Normal liver cell structure

A
  • hepatocyte
  • hepatic stellate cells
  • sinusoidal endothelial cell
  • kupfer cell
  • sinusoid lumen with normal resistance to blood flow
53
Q

Advanced fibrosis liver structure

A
  • Infiltrating lymphocyte
  • extracellular matrix proteins
  • apoptotic hepatocyte
  • activated kupfter cell
  • sinusoid lumen with increased resistance to blood flow
54
Q

normal vs advanced fibrosis liver - Kupffer cell

A
  • normal =

* advanced fibrosis = activated

55
Q

normal vs advanced fibrosis liver - sinusoid lumen

A
  • normal = normal resistance to blood flow

* advanced = increased resistance

56
Q

Cause - virus & routes

A 
Hepatitis A - fecal-oral route
B - body fluids, mother to baby
C - body fluid
D - body fluids
E - contaminated food & water
G - body fluids
57
Q

Cause - virus & chronic/acute?

A

Hepatitis A - acute, generally resolves suddenly, vaccine
B - acute to chronic, cirrhosis, cancer, vaccine
C - chronic, possibly to cirrhosis, cancer, no vaccine
D - w. B, needs hepB to survive
E - self limited
G - chronic similar to HCV

58
Q

Causes - drugs

A
  • overdose paracetamol
  • statins
  • antibiotics eg amoxicillin, tetracycline
  • methotrexate
  • herbal remedies eg kava kava
  • high dose vitA
  • some wild mushrooms
59
Q

Hepatic encelopathy and ammonia

A
  • normally ammonia from proteins met in liver.
  • detox of ammonia cant happen due to portal hypertension
  • excess ammonia travel to brain.
  • SE: decrease memory, confusion, decreased consciousness
60
Q

Causes - alchol

A
  • most common cause
  • directly toxic to liver cells
  • inflammation, lead to fatty liver, to fibrosis
  • damage occurs >40g/d in men, >20g in women
  • 1 unit = 9g
61
Q

UK alcohol guidelines

A

<14 units per week
• spread over 3 days
• no alcohol in pregnancy

62
Q

Cholestasis is?

A
  • lack of bile

* due to bile duct & hepatocytes

63
Q

bile duct cholestasis how?

A
  • blocked/obstruction so no outflow
  • gallstones
  • carcinoma
  • cholangitis
64
Q

Acute Liver disease symptoms

A 
GAJAF
•  generalised malaise
•  anorexia
•  Jaundice - later
•  asymptomatic - could be 
•  fever
65
Q

Chronic liver disease symptoms

A 
•  fatigue
•  weight loss
•  nausea/vomiting
•  appetite loss
•  cachexia
•  abdominal swelling
•  right upper ab pain, tenderness
•  jaundice
•  bleeding from gums/nose & easy bruising
could be specific depending on type of disease eg gall stones
66
Q

cachexia

A

wasting of muscle in arms & legs

67
Q

Jaundice - what?

A

• yellowing skin & mucous membrane/sclera

68
Q

Sclera

A

yellowing mucous membrane

69
Q

jaundice - causes

A
  • haemolysis (haemolytic jaundice)
  • heptocellular damage (hepatic jaundice)
  • cholestasis (obstructive jaundice)
70
Q

oesophageal varices is?

A
  • swollen veins is oesophagus
  • portal HYP pushes blood into surrounding blood vessels.
  • thin walled veins in oesophagus close to surface
  • pressure too high = can rupture and bleed
  • uncontrolled bleeding to shock to death
71
Q

ascites

A
  • high pressure inside circulation
  • low pressure inside peritoneal cavity
  • pressure imbalance
72
Q

Ascites - causes

A
  • portal HYP
  • low plasma albumin
  • salt and water retention by kidneys eg secondary hyperaldosteronism
73
Q

hepatic encephalopathy

A
  • buildup of substances/ammonia crosses BBB

* can be associated with cirrhosis, acute liver failure, portal systemic bypass of liver

74
Q

hepatic encephalopathy precipitated by

A
  • dehydrated
  • hypovolaemia
  • GI bleed
  • CNS drugs
  • alcohol
  • increase diet protein
  • constipation
75
Q

hepatic encephalopathy - SE?

A
  • altered mental state,
  • fetor hepaticus
  • asterixis
  • drowsiness
  • confusion
  • coma
  • Wernicke
76
Q

Anaemia in cirrhosis

A
  • iron homeostasis
  • spleen enlarge from portal HYP
  • alochol toxic to bone marrow
  • reduce clotting factor synthesis
77
Q

bleeding and bruising in cirrhosis

A

• reduce clotting factor synthesis

78
Q

Splenomegaly

A

enlarging spleen from portal HYP

79
Q

circulatory changes in liver cirrhosis

A
  • palmar erythema
  • spider naevi
  • finger clubbing
80
Q

skin changes in liver cirrhosis

A

• pruritis

81
Q

Blood tests for liver disease

A
  • LFTs
  • electrolytes
  • FBC
  • viral screens
  • blood clotting
82
Q

Diagnosis of liver disease

A
  • Blood tests
  • medical history
  • imaging
  • liver biopsy
83
Q

imagine of liver disease

A
  • ultrasound
  • CT scan
  • MRI
84
Q

AST

A
  • role in gluconeogenesis - catalyses

* found in hepatocytes, other tissues

85
Q

ALT

A
  • role in gluconeogenesis

* specific to liver

86
Q

ALT & AST levels in liver

A
  • v.high in hepatitis
  • high in cholestatic jaundice/cirrhosis
  • AST:ALT >2 alcohol injury.
  • AST:ALT<1 other liver injuries
87
Q

AST:ALT

A
  • > 2 alcohol

* <1 other liver injuries

Year 3 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions