Liver CPC Flashcards
What is the normal organisation of the liver?
Arranged in trabeculae with sinusoids between them
What does the portal triad consist of?
Artery
Vein
Bile duct
In which direction does blood flow in the liver?
From the portal triad through the sinusoid into the central vein
What is the name of the space between the hepatocytes and the endothelium/
Space of Disse
What happens in the Space of Disse?
Blood comes into contact with liver enzymes
Explain the zones of the liver.
The area between the portal tract and the central vein is divided into 3 zones.
Zone 1 = closest to portal tract, highest oxygenation concentration
Zone 2 = in the middle
Zone 3 = most susceptible to hypoxia, most metabolically active cells
What is the Van den Bergh reaction?
Used to measure fractionated bilirubin
Is paediatric jaundice usually conjugated or unconjugated?
Unconjugated
Because the liver is immature and cannot conjugate enough
What does phototherapy do to treat jaundice?
Convert bilirubin into lumirubin and photobilirubin
They do not need to be conjugated to be excreted
What is the genetic inheritance of Gilbert’s syndrome?
Autosomal recessive
What drug can be used to lower bilirubin levels in Gilbert’s syndrome?
Phenobarbital
What enzyme is affected in Gilbert’s syndrome?
UDP glucuronyl transferase
What type of bilirubin is always present in the urine of normal people?
Urobilinogen
Tells you the enterohepatic circulation is intact
What does negative urinary urobilinogen suggest?
Biliary obstruction
What is the best representative marker of liver cell function?
Prothrombin time
Normal = 12-14 seconds
