Liver

Question 1

Liver septae

Answer 1

Liver’s connective tissue capsule branches and extends throughout the liver substance as septae

Question 2

Function of liver septae?

Answer 2

Supportive structure for vessels,

Divides liver parenchyma into functional lobules

Question 3

Flow of blood within liver

Answer 3

Hepatic and Portal Veins > Sinusoids > Central Veins > Vena Cava

Question 4

Flow of bile in liver

Answer 4

Liver cells > bile canaliculi > bile ducts > hepatic ducts > cystic ducts > common bile duct > duodenum

Question 5

Cool thing about bile flow vs blood flow

Answer 5

Lined up parallel to each other BUT flow in OPPOSITE directions!

Question 6

Capillaries of the liver

Answer 6

Sinusoids - FENESTRATED CAPILLARIES

Question 7

Sinuoids receive blood from

Answer 7

TWO SOURCES

1. Arteriole from hepatic artery
2. Venule from portal vein

where hepatic and portal blood mix!

Question 8

Function of the liver’s fenestrated capillaries (Sinusoids)

Answer 8

Allows for flow of larger molecules across surface

Question 9

Where to hepatic and portal blood mix?

Answer 9

SINUOIDS - THE (fenestrated) CAPILLARIES OF THE LIVER

Question 10

What lies just below the sinusoidal endothelium?

Answer 10

Hepatocytes

Question 11

Macrophage of the liver known as

Answer 11

Kuppfer Cells

Question 12

Zone I hepatocytes are found

Answer 12

Closest to the hepatic vascular dyad - artery/portal vein

RECEIVES OXYGEN / NUTRIENTS FIRST

Question 13

Jobs of Zone I hepatocytes

Answer 13

Gluconeogenesis
Glycogen creation

Protein breakdown / urea + nitrogen formation

Question 14

Zone III hepatocytes are found

Answer 14

Closest to the Central Vein - which drains blood from liver to IVC

Question 15

Zone III hepatocytes specialize in

Answer 15

Glycolysis

Lipogenesis

Question 16

Where does protein breakdown into urea / nitrogen occur?

Answer 16

In Zone I hepatocytes - closest to hepatic vascular dyad

Question 17

Where does glycolysis in liver occur?

Answer 17

In Zone III hepatocytes - closest to central vein

Question 18

Where does Glycogen creation occur?

Answer 18

In Zone I hepatocytes - closest to hepatic vascular dyad

Question 19

Where does gluconeogenesis occur?

Answer 19

In Zone I hepatocytes, closest to hepatic vascular dyad

Question 20

Where does lipogenesis occur?

Answer 20

In Zone III hepatocytes - closest to central vein

Question 21

Dilated intracellular space between adjacent hepatocytes

Answer 21

Bile Duct

Question 22

Recycling of bile

Answer 22

95% of bile recycled, often 2-3 times per MEAL

Question 23

Blood drainage from liver

Answer 23

Each lobule’s CENTRAL VEIN > to HEPATIC VEIN > to INFERIOR VENA CAVA

Question 24

80% of ACUTE liver disease caused by

Answer 24

Drugs (Paracetamol, Halothane, ecstasy etc0

Question 25

5% of ACUTE liver disease caused by

Answer 25

VIRAL (A, B C, D)

Question 26

80% of CHRONIC hepatitis caused by

Answer 26

Infectious Alcohol (or combo)

Question 27

2 most common causes of chronic hepatitis

Answer 27

1. Hep C (26%) | 2. Alcohol (24%)

Question 28

HAV is what kind of virus?

Answer 28

Picornavirus

Question 29

HAV cycle

Answer 29

Replicates in hepatocyte cytoplasm in a LYTIC CYCLE HAV invades into human body by fecal-oral route, multiplies in the intestinal epithelium & reaches the liver by hematogenous spread. SPREAD VIA BILIARY CHANNELS After one week, the HAV reach liver cells where they replicate. They then enter intestine with bile and appear in feces. After HAV replicating and discharging, liver cell damage begins

Question 30

Diagnostic evidence of active HAV infection

Answer 30

Anti- HAV IgM

Question 31

HAV incubation period

Answer 31

2-6 weeks

Question 32

Hep B DECOY particles

Answer 32

basically the HBsAG, released into bloodstream upon infection, distracts host immune system

Question 33

Hep B Carrier State - integration

Answer 33

Some viral DNA integrates into host genome - leads to carrier state (10%)

Question 34

Bodily fluids w highest concentration of HBV

Answer 34

Blood Serum Wound exudates

Question 35

Bodily fluids w lowest concentration of HBV

Answer 35

``` Urine Breast milk Sweat Tears Feces ```

Question 36

asymptomatic but +HbcAg and/or HbeAg

Answer 36

Chronic Persistant Hepatitis

Question 37

symptomatic exacerbations of chronic hepatitis

Answer 37

Chronic Active Hepatitis

Question 38

Sequence of HBV serum markers in HBV infection

Answer 38

1. HBsAG (3-4 weeks post exposure) 2. IgM anti-HBc (6 weeks) 3. anti-HBs (32 weeks)