Liver

Question 1

Functions of the liver

Answer 1

• metabolism and/or storage of fat, CHO, pro, vit and min
• holds blood volume and distends/compresses based on volume
• filters blood by removing bilirubin
• make blood clotting factors
• drug metabolism and detoxification

Question 2

bilirubin

Answer 2

product of Heme b/d (mostly hgb)

Question 3

Clotting factors made by the liver

Answer 3

Prothrombin and fibrinogen

Question 4

Biggest organ

Answer 4

Liver - 3 lb, 3-5% CO

Question 5

Structure of liver

Answer 5

Lobules of hepatocytes around a central vein

Question 6

Special characteristic of lobules

Answer 6

one of few cells that can regenerate (if other parts of the liver is healthy)

Question 7

Functional unit of the liver

Answer 7

lobules

Question 8

Kupffer cells and function

Answer 8

Line inner capillaries/sinusoids of the liver; remove bac and toxins from blood

Question 9

Portal vein

Answer 9

Carries deoxygenated blood from the abdominal organs (stomach, intestines, spleen, pancreas) and lower extremities to the liver

Question 10

Blood through the hepatic vein is…

Answer 10

rich in nutrients from the intestinal tract

Question 11

First pass effect

Answer 11

Liver absorbs products of digestion

Question 12

Liver function test (LFTs)

Answer 12

Measure AST, ALT, alk phos

Question 13

When do we worry about LFTs

Answer 13

if liver levels are above 150 or sometimes not even then; not a great indicator of severity–high alk phos does not mean failure necessarily

Question 14

Serum ammonia levels with liver failure

Answer 14

increased

Question 15

Total serum albumin levels with liver failure

Answer 15

decreased

Question 16

Serum protein levels with liver failure

Answer 16

decreased (since the liver makes protein)

Question 17

prothrombin time with liver failure

Answer 17

increased (since the liver makes clotting factors)–more likely to bleed

Question 18

Jaundice (icterus)

Answer 18

inc bili in blood (conjugated or unconjugated)

Question 19

Bili level indicative of jaundice

Answer 19

2-2.5

Question 20

Hemolytic jaundice

Answer 20

b/d excess RBCs from pathological causes, bleeding, or excess production of RBCs

Question 21

Hepatocellular jaundice

Answer 21

liver not working, can’t take up/conjugate it

Question 22

Obstructive jaundice

Answer 22

dec or obstructive flow of bile - often gallstones

Question 23

Increased conjugated/direct bilirubin

Answer 23

• 30%
• liver works but can’t get bili out - gallstone, bile duct obstruction

Question 24

Unconjugated/indirect bilirubin

Answer 24

• 70%
• bilirubin overproduction (from hemolysis or impaired erythropoiesis) OR impaired liver fxn

Question 25

It is possible for direct and indirect bili to be elevated?

Answer 25

Yes but it is rare

Question 26

CM of jaundice

Answer 26

darker urine, inc liver enzymes, normal or clay stool, pruritis