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Residency Exam > Liver disorders (Background information) (Panopto Video link) > Flashcards

Liver disorders (Background information) (Panopto Video link) Flashcards

1
Q

Describe the presention of drug-induced liver injury

A

Drug-related injury can mimic essentially all patterns of primary liver disease

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2
Q

What are 7 functions of the liver?

A
  1. Activation and deactivation of vitamins
  2. Production of steroid hormones
  3. Protein storage
  4. Metabolism of drugs
  5. Iron storage
  6. Carbohydrate storage
  7. Lipid storage
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3
Q

State the balance of protein, carbohydrate and lipid storage in the liver?

A

The liver can exchange between these substances to correct for deficiencies

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4
Q

What is an example of a carbohydrate stored by the liver?

A

Glucose

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5
Q

What is the functional unit of proteins?

A

Amino acids

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6
Q

In what form is iron stored in the body?

A

As ferritin

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7
Q

How many lobes does the liver consist of?

A

Two

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8
Q

How many lobules are in each lobe of the liver?

A

Each lobe has thousands of lobules

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9
Q

What are the 2 lobes of the liver named?

A

The right lobe and the left lobe

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10
Q

What is the largest organ in the body?

A

The liver

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11
Q

How much does a human liver usually weigh?

A

1 to 1.5 kg

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12
Q

The liver is responsible for what proportion of lean body mass?

A

1.5 to 2.5%

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13
Q

Where is the liver located?

A

In the right upper quadrant of the abdomen under the right rib cage and above the diaphragm

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14
Q

The liver is held in place by what ligament?

A

The coronary ligament

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15
Q

Where is the gall bladder located relative to the liver?

A

Under the right lobe of the liver

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16
Q

What is a unique feature of the liver compared to other organs?

A

It receives a dual blood supply (oxygen rich blood from arterioles but also from the portal vein)

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17
Q

What is the role of the hepatic vein?

A

To take blood from the liver back to the heart

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18
Q

Where is the portal vein located relative to the liver?

A

Below the liver, bringing nutrient-rich blood to the liver from the intestines, stomach and pancreas

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19
Q

What is the role of the hepatic artery?

A

To supply the liver with blood from the aorta

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20
Q

What is the role of the splenic vein?

A

To carry blood from the spleen to the portal vein

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21
Q

What is the role of the splenic artery?

A

To supply blood to the spleen from the aorta

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22
Q

Where is the spleen located in the abdomen?

A

In the right upper quadrant

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23
Q

What is the role of the superior mesenteric artery?

A

To supply blood to the intestine from the aorta

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24
Q

What is the role of the superior mesenteric vein?

A

To supply blood from the intestine towards the liver, joining the splenic vein to form the portal vein

25
Q

What is the role of the superior mesenteric vein?

A

To supply blood from the intestine towards the liver, joining the splenic vein to form the portal vein

26
Q

What is the role of the superior mesenteric vein?

A

To supply blood from the intestine towards the liver, joining the splenic vein to form the portal vein

27
Q

Approximately what proportion of blood supply to the liver occurs via the portal vein?

A

80%

28
Q

Describe the Couinaud system

A

The Couinaud system divides the liver into eight independent functional segments, each with its own own dual vascular inflow, biliary and lymphatic drainage

29
Q

What is the biliary system?

A

A series of channels and ducts which convey bile from the liver to the lumen of the small intestine

30
Q

What are the majority of cells in the liver?

A

Hepatocytes

31
Q

What system are Kupffer cells part of?

A

The reticular endothelial system

32
Q

What is the role of stellate cells?

A

Fat storage

33
Q

Where do hepatic cells secrete bile into?

A

The cannaliculi

34
Q

Describe the pattern of bile flow through the cannaliculi

A

Bile flows parallel but in the opposite direction to blood (which is on the other side of the hepatocytes)

35
Q

What is the portal triad?

A

The grouping of the bile duct, hepatic arteriole and portal vein.VENULES

36
Q

What is the role of the portal vein?

A

It delivers substances from the intestines for processing by the hepatocytes

37
Q

What is the role of the bile duct?

A

It carries bile away from the liver

38
Q

What are the liver sinusoids?

A

Large capillaries between plates of hepatocytes

39
Q

What is the role of liver sinusoids?

A

They contribute to the central vein and ultimately to hepatic veins and IVC

40
Q

What are Kupffer cells?

A

Macrophages of the liver

41
Q

What are Kupffer cells?

A

Macrophages of the liver

42
Q

What is the role of Kupffer cells?

A

Removal of old blood cells and microorganisms

43
Q

What is cirrhosis of the liver?

A

The consequence of chronic liver disease characterised by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules

44
Q

What is cholestasis?

A

A clinical and biochemical syndrome that results when bile flow is impaired

45
Q

How is cirrhosis divided histologically?

A

Into micronodular cirrhosis and macronodular cirrhosis

46
Q

What is jaundice?

A

The discolouration of body tissues caused by abnormally high levels of bilirubin

47
Q

What is the typical level of bilirubin associated with jaundice?

A

> 42/8 to 51.3 umol/L

48
Q

What is steatosis?

A

The process describing abnormal retention of lipids within a cellW

49
Q

What is the cause of steatosis?

A

An impairment of the normal processes of synthesis and elimination of triglycerides

50
Q

What is the result of steatosis?

A

Excess lipid accumulates in vesicles that displace the cytoplasm

51
Q

What are the two categories of steatosis?

A
  1. Microvesicular steatosis
  2. Macrovesicular steatosis
52
Q

What characterises macrovascular steatosis?

A

Vesicles are big enough to distort the nucleus

53
Q

Can steatosis occur as a result of drug-induced liver injury?

A

Yes

54
Q

What is an example of a medication which can cause steatosis of the liver?

A

Methotrexate

55
Q

What is the pathophysiology of ascites?

A

When the body does not produce enough albumin to retain fluid in the vascular space

56
Q

Where does fluid accumulation occur in ascites?

A

In the portal cavity

57
Q

What are the two gold-standard liver tests?

A
  1. Post mortem
  2. Liver biopsy
58
Q

What is the main risk of liver biopsies?

A

Because you are using a large needle into a diseased liver, there is an inherent risk of bleeding

59
Q
A

Residency Exam (22 decks)

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