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Pathophys, GI LIver Cancer > Liver > Flashcards

Liver Flashcards

1
Q

Liver septae

A

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

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2
Q

Function of liver septae?

A

Supportive structure for vessels,

Divides liver parenchyma into functional lobules

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3
Q

Flow of blood within liver

A

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

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4
Q

Flow of bile in liver

A

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

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5
Q

Cool thing about bile flow vs blood flow

A

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

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6
Q

Capillaries of the liver

A

Sinusoids - FENESTRATED CAPILLARIES

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7
Q

Sinuoids receive blood from

A

TWO SOURCES

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

where hepatic and portal blood mix!

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8
Q

Function of the liver’s fenestrated capillaries (Sinusoids)

A

Allows for flow of larger molecules across surface

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9
Q

Where to hepatic and portal blood mix?

A

SINUOIDS - THE (fenestrated) CAPILLARIES OF THE LIVER

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10
Q

What lies just below the sinusoidal endothelium?

A

Hepatocytes

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11
Q

Macrophage of the liver known as

A

Kuppfer Cells

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12
Q

Zone I hepatocytes are found

A

Closest to the hepatic vascular dyad - artery/portal vein

RECEIVES OXYGEN / NUTRIENTS FIRST

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13
Q

Jobs of Zone I hepatocytes

A

Gluconeogenesis
Glycogen creation

Protein breakdown / urea + nitrogen formation

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14
Q

Zone III hepatocytes are found

A

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

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15
Q

Zone III hepatocytes specialize in

A

Glycolysis

Lipogenesis

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16
Q

Where does protein breakdown into urea / nitrogen occur?

A

In Zone I hepatocytes - closest to hepatic vascular dyad

17
Q

Where does glycolysis in liver occur?

A

In Zone III hepatocytes - closest to central vein

18
Q

Where does Glycogen creation occur?

A

In Zone I hepatocytes - closest to hepatic vascular dyad

19
Q

Where does gluconeogenesis occur?

A

In Zone I hepatocytes, closest to hepatic vascular dyad

20
Q

Where does lipogenesis occur?

A

In Zone III hepatocytes - closest to central vein

21
Q

Dilated intracellular space between adjacent hepatocytes

A

Bile Duct

22
Q

Recycling of bile

A

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

23
Q

Blood drainage from liver

A

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

24
Q

80% of ACUTE liver disease caused by

A

Drugs (Paracetamol, Halothane, ecstasy etc0

25
Q

5% of ACUTE liver disease caused by

A

VIRAL (A, B C, D)

26
Q

80% of CHRONIC hepatitis caused by

A

Infectious
Alcohol
(or combo)

27
Q

2 most common causes of chronic hepatitis

A
  1. Hep C (26%)

2. Alcohol (24%)

28
Q

HAV is what kind of virus?

A

Picornavirus

29
Q

HAV cycle

A

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

30
Q

Diagnostic evidence of active HAV infection

A

Anti- HAV IgM

31
Q

HAV incubation period

A

2-6 weeks

32
Q

Hep B DECOY particles

A

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

33
Q

Hep B Carrier State - integration

A

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

34
Q

Bodily fluids w highest concentration of HBV

A

Blood
Serum
Wound exudates

35
Q

Bodily fluids w lowest concentration of HBV

A 
Urine
Breast milk
Sweat
Tears
Feces
36
Q

asymptomatic but +HbcAg and/or HbeAg

A

Chronic Persistant Hepatitis

37
Q

symptomatic exacerbations of chronic hepatitis

A

Chronic Active Hepatitis

38
Q

Sequence of HBV serum markers in HBV infection

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

Pathophys, GI LIver Cancer (4 decks)

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