Liver Function

Question 1

Functions of the liver
metabolism of…
d
s
c

Answer 1

Metb of carbs, lipids, proteins,bilirubin
Detox
storage of compounds
Cleaving waste

Question 2

Describe the livers resilience

Answer 2

can regenerate w short term damage
limited

Question 3

gross anatomy
weight
beneath…
protected by/held by

extremely?

Answer 3

1.2-1.5kg
beneath and attached to diapragm
protected by ribs/held by ligaments

extremely vascular

Question 4

Gross anatomy of lobes
connected by?
right lobe size?
Blood supply
h
p

Answer 4

two lobes connected by falcif ligament
right lobe 6x larger than left

hepatic artery - 25%
Portal vein - 75%

Question 5

Microanatomy
divided into…
responsible for?
how many sides?
what at corners?

Answer 5

divided into lobules
resposible for excetion/met functions
6 sided with central vein
portal triads at corners

Question 6

major cell types in liver

Answer 6

hepatocytes
kupper cells (macrophages speciifc to liver)

Question 7

T/F liver has bad regeneration in transplants

Answer 7

false its good

Question 8

Bichemical functions of liver

Answer 8

excretion/secretion
storage
metabolism
detox

Question 9

What happens if the liver stops working

Answer 9

death in 24hr due to hypoglycemia

Question 10

Excretion/secretion definition

Answer 10

processing/excretion of endogenous/exog materials in bile or urine
ex bilirubin

Question 11

The liver is the only organ that can get rid of?

Answer 11

heme waste products

Question 12

Describe Bile
made of ….b/p/c
body produces?
excretes?
what is principle pigment?

Answer 12

made of bile acid salts pigments and cholesterols
body produced 3L/day
excretes 1L/day
bilirubin is the principle pigment

Question 13

Unconjugated bilirubin

Answer 13

indirect, bound by ALB and transported to liver,
INSOLUBLE in h20 cannot be removed from the body

Question 13

Conjugated bilirubin
also called bilirubin dig…
solubility
secreted from? into?

Answer 13

bilirubin diglucoulronide
h20 SOLUBLE can be secreted from hepatocyte into bile canalculi

Question 14

urobilinogen

Answer 14

colorless product of bilirubin formed by action of bacteria
excreted in feces, circulation or urine

Question 15

Metabolism in liver
carbs
ways of processing
g
c
s

Answer 15

carbs - one of the most important

3 ways of processing
glucose for energy
circulation glucose for use by periph tissues
storage of glucose as glycogen

Question 16

T/F the liver has Major importance in maintaining glucose levels

Answer 16

t

Question 17

glycogenesis

Answer 17

glucose stored as glycogen

Question 18

Glycogenolysis

Answer 18

breakdown glycogen

Question 19

gluconeogensis

Answer 19

creation of glucose from non sugar /carb substance

Question 20

Lipids
metabolized where?
l/lp
forms?
how much daily prod of lipids from liver

Answer 20

metab in liver under normal circumstances
lipids and lipoproteins
forms ACETLY-COA from free fatty acids
70% daily prod of lipids from liver

Question 21

What does ACETYL-COA do
forms

Answer 21

forms triglycerides, phosph, cholesterols

Question 22

Proteins
almost all synth in…..
essential role in development of….
one of most important
trans/deanim of…

Answer 22

almost all synth in liver except Igs and Hgb
essential role in develope of Hgb in infants
ALB one of most important
trans/deanimation of AA

Question 23

First pass

Answer 23

every substance absorbed into gi must pass through the liver before reaching the rest of the body

Question 24

Mech for detoxing drugs
f
m

Answer 24

foregin materials (drugs/posions) and metabolic functions (bilirubin/ammonia)

Question 25

Jaundice
discoloration
retention of
noticable at what amount
icterus
classified based on?

Answer 25

yellow discoloration
retention of bilirubin
noticable jaundice 3-5mg
Icterus - discolor of plasma/serum
CLASSIFED BASED ON SITE

Question 26

Prehepatic jaundice
increased…
acute/chronic
what rarely exceeds 5mg
also called?

Answer 26

increased bilirubin to liver
acute/chronic hem anemia
bilirubin rare exceeds 5mg
also called
UNCONJUGATED HYPERBILIRUIB (bound to alb)

Question 27

Post hepatic jaundice
what kind of disease?
physical obstruction =
what form is bilirubin in? not?
stool?

Answer 27

biliary obstructive disease
physical obstruction: gallstones/tumors
bilirubin is CONJUGATED but not excreted
stool - grey colored

Question 28

Hepatic jaundice
primary….
disorders of …

Answer 28

primary liver problems
disorders of bilirubin metabolism, transport defects, hepatocell injury

Question 29

Gilberts syndrome
auto recessive
consequences
intermediate….uh
underlying…due to

Answer 29

auto recessive disorder
no clinical conseqeunces
intermediate unconjugated hyperbiliruin underlying liver disease due to defective conjug system

Question 30

Crigler-Najjar syndrome
chronic non…..
type 1: abs
type 2: severe
rare?

Answer 30

chronic non-hem unconjugated hyperbilirubin

Type 1: absence of enzyme conjug
2: severve deficiny of enzyme for conjugation

rare but can result in death

Question 31

Dubin-Johnson sydrome
c/h
rare?
o
ability to remove?
granules?
life?

Answer 31

conjugated hyperbili
rare auto recessive
obstructive in nature
ability to remove conjug bilirubin affected
dark stained granules
normal life

Question 32

delta bilirubin

Answer 32

conjugated bilirubin bound to ALB

Question 33

Rotor syndrome
auto?
rare?
what is less effectivly taken up…
normal?

Answer 33

auto recessive
rare bengn
bilirubin less effetive taken up by liver and removed
norm ALP/GGT from biliary obstruction

Question 34

Physiologic jaundice
neonatal
common
deficient in
last function to be activated in…

Answer 34

neonatal hyperbilirubin
common w/in first week of life
def in UDPGT enzyme required for bili conjugation
last liver fucntions to be activated in prenatal life

Question 35

Kernicterus
uncong……
therapy?
danger level

Answer 35

unconjugated bilirubin buildup in neonatal brain
light therapy, IVIG danger level >20mg

Question 36

Cirrhosis
what replaces norm
blocks?
signs?
prognosis
most common cause?
other causes?

Answer 36

scar tissue replaces normal
blocks blood flow
signs rare in early stages
poor prognosis
ALCOHOLISM
(HBV/HCV/HDV)

Question 37

Tumors
p/m
benign: ha/ha
malignant: h…%…pb

Answer 37

primary or metastatic (colon/lung/breast)

Benign: hepato adenoma/hemaangiomas

Malign: HCC 90% primary bile duct carcinoma

Question 38

Reyes syndrome
disorders caused by
age?
cause?
ACUTE?
3x….
drug

Answer 38

group of disorders caused by infection/metb. toxin/drug induced disease
children exclusively
unknown cause VIRAL INFECTION
ACUTE = non inflam encephalatis

3x ammonia/AST/ALT

ASPIRIN

Question 39

Drug/alc related disorders
1/3 acute liver failure caused by
prim target

most common immune…

Answer 39

drug induced liver disease 1/3 of acute liver failure
liver primary target for adverse drug rxn

MOST COMMON IMMUNE- DAMAGE TO HEPATOCYTE

Question 40

Ethanol
most important…
ac
what % goes to liver

stgs

Answer 40

most important drug related to toxicity
alcoholic cirrhosis
90% of alc absorbed goes to liver

3 stgs:
alc fatty liver
alc hepatitis
alc cirrhosis

Question 41

Fatty liver disease
changes?
slight elevation in?
nodes?
ages?

Answer 41

few changes in liver function
slight elev in AST/ALT/GTT
fatty node
middle aged/obesity
reduce factors

Question 42

Alc hepatitis
symptoms
mod elev in
total bili
dec
inc

Answer 42

fever acitis, muscle loss
moderate AST/ALT/GTT
total bilirubin >5mg
dec alb
increase PT/creatinine

Question 43

Alc cirrhosis
symptoms
survival
what % abst from drinking recover
common in?
increased
biop
dec

Answer 43

gi bleed/acites
5 yr survival
60% abst from drinking
common in males
inc AST/ALP
liver biopsy
dec ALB

Question 44

T/F acetomenophin/tranquilizers affect the liver

Answer 44

true