Liver Function 2 Flashcards

1
Q

Where does the liver get its blood supply from?

A

The hepatic portal vein and hepatic arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does the hepatic portal vein carry venous blood drained from?

A

Spleen, GI tract and its associated organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of liver cells are parenchymal?

A

Hepatocytes - 80% liver volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What live cells are non parenchymal?

A

Endothelial cells
Kupffer cells
Sinusoidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do bipotential stem cells form?

A

Ovalocytes form hepatocytes and cholangiocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the functions of the liver?

A

Synthesis
Breakdown
Storage
Immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the liver synthesise?

A

Amino acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the liver metabolise?

A

Carbohydrates, proteins and lipids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In the first trimester foetus what is the liver the main site of?

A

Red blood cell production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to bile synthesised by the liver?

A

Some bile drains directly into the duodenum, and some is stored in the gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the role of IGF-1 that is produced by the liver?

A

Important role in childhood growth and continues to have anabolic effects in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The liver is a major site of thrombopoetin production. What is the role of thrombopoietin?

A

Thrombopoietin is a glycoprotein hormone that regulates the production of platelets by the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the liver involved in the breakdown of?

A

Breakdown of insulin and other hormones
Glucoronidates bilirubin, facilitating its excretion into bile
Toxic substances
Drug metabolism - sometimes results in toxication. Toxins are conjugated to avail excretion n bile or urine
Converts ammonia to urea (urea cycle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the liver have immunological effects?

A

The reticuloendothelial system of the liver contains many immunologically active cells, acting as a sieve for antigens carried to it via the portal system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the role of albumin in blood serum?

A

It is the major osmolar component of blood serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What hormone does the liver synthesise that is responsible for raising blood pressure where activated by renin?

A

Angiotensinogen

17
Q

What are the features of bile?

A

Bitter tasting green / yellowish brown
Produced by the liver
Stored ad concentrated in the gallbladder
Discharged to duodenum

18
Q

What is bilirubin?

A

Yellow breakdown product of haem metabolism

Excreted in bile and urine

19
Q

What gives urine colour?

A

Urobilin

20
Q

What gives faeces brown colour?

A

Stercobilin

21
Q

What happens to bilirubin in heme?

A

Form larger ring porphyrins

22
Q

What are bile acids?

A

Steroid acids found in the bile of mammals

Bile acids when conjugated with taurine or glycine in the liver form bile salts

23
Q

Where are primary bile acids synthesised?

A

Liver

24
Q

What are secondary bile acids a result of?

A

Bacterial actions in the colon

25
Q

What account for 80% of organic compounds in bile?

A

Bile acids

Others include phospholipids and cholesterol

26
Q

What are the functions of bile acids?

A

Amphipathic molecules with hydrophobic and hydrophilic regions
Form micelles: aid lipase to digest lipids
Move lipids near brush border - fat absorption
Eliminate cholesterol
Drives bile flow
Emulsify fat soluble vitamins (DEAK) to help absorption
Reduce bacterial floral in small intestine and biliary tract

27
Q

What is the role of micelles?

A

Aid lipases to digest lipids

28
Q

What eliminates cholesterol?

A

Bile salts

29
Q

What emulsifies fat soluble vitamins (DEAK) to help absorption?

A

Bile salts

30
Q

What is a major route of cholesterol metabolism?

A

Synthesis of bile acids

31
Q

What percentage of bile acids are reabsorbed in ileum and recycled for further use? (Enterohepatic circulation)

A

95%

32
Q

What route does bile travel?

A

Produced in the liver
Travel down left or right hepatic duct
Into common hepatic duct
Either flows into gallbladder to be stored via the cystic duct
Or flows down the common pancreatic duct
Flow into duodenum via the sphincter of Oddi

33
Q

What are the intra-hepatic types of biliary disease?

A

PSC
PBC
Secondary biliary cirrhosis

34
Q

What are the extra-hepatic types of liver disease?

A

Within lumen - stones
In wall of the lumen - stricture, cholangiocarcinoma
Extrinsic compression - pancreatic cancer

35
Q

What is jaundice?

A

Hyperbilirubinaema manifest as yellow sclera or skin

Can be painful or painless

36
Q

When does jaundice become apparent?

A

When serum bilirubin >2-3 x ULN

37
Q

What are the causes of post hepatic jaundice?

A

(Conjugated hyperbillirubinaemia)
Blockage of flow of bile through liver to duodenum and / or gallbladder
Within bile lumen; stones, tumour
Within wall of lumen: stricture, PSC
Compression on the lumen; pancreatic cancer, hilar lymphadenopathy

38
Q

What is ERCP?

A

Endoscopic retrograde cholangio-pancreatography
Therapeutic technique
Stone extraction
Stent insertion
Diagnosis
Tissue acquisition - bile brushings - spy glass