Liver, pancreatic secretions and jaundice Flashcards
What is the name of food when it exits the stomach?
Chyme
At what level must blood bilirubin by at for jaundice to occur?
35 micromolar - 3x the normal amount
What does colipase do?
Activates lipase
Prevents bile acids inhibiting the lipase
What population gets pancreatitis the most?
Females >50
Why do a high proportion of babies get jaundice?
Is there is a lot of haemolysis during the switch from foetal to adult Hb and the liver it’s yet developed enough to deal with the extra load.
What happens when fatty acids enter to intestinal mucosa?
Reform triglycerides
Which pancreatic cells release bicarbonate?
Duct cells
What drug can be used to decrease fat absorption?
Orlistat
What are bile salts made from?
Cholesterol
What does CCK do to the gallbladder?
Stimulates contraction
Which pancreatic cells release enzymes?
Acinar
What serum markers are indicative of pancreatitis?
Lipase (most characteristic)
Amylase
Is Gilbert’s syndrome severe? What goes wrong?
No, usually subclinical
Decreased conjugation of bilirubin
What are zymogens?
Inactivated precursor forms of enzymes
What happens to faeces after a fatty meal?
It’s darker due to more bile
What is a hepatic cause of jaundice?
Intrahepatic obstruction - cirrhosis
What activates colipase?
Trypsin
How much bile can the liver produce per day?
Up to 1L
What is the function of the taurine and glycine groups on bile salts?
Increase solubility
What is cyst a general term for?
A Bladder-like structure
What structure does bile acids form in digested lipids?
Micelles
What happens in Dubin-Johnson syndrome? Is it severe?
Impaired secretion of conjugated bilirubin
Mild symptoms
What does secretin enhance the secretion of?
Bicarbonate in the acinar cells of pancreas
What happens when you have a deficiency in glucose-6-phosphate dehydrogenase?
You can’t produce as much glutathione (glutathione protects against ROSs) > More ROS > RBCs damaged
What percentage of bilirubin comes from the breakdown of old RBCs?
80%
What endocrine hormones do islets of Langerhan make?
Insulin
Glucagon
How does increasing the fat cotent of faeces affect its appearance?
Paler, whiter
Greasy
Foul smelling
What is enterohepatic circulation?
Where bile salts are absorbed in the terminal ileum for recycling
What happens when you go on chloroquine when you have a deficiency in G6PD?
ROS from chloroquine aren’t removed by glutathione > membrane destruction and globin precipitation > haemolytic jaundice, Heinz bodies
What type of agents are bile salts?
Detergents
What are two other names for bile?
Gall
Chole
What percentage of bile salts are recycled?
95%
What happens in Crigler-Najjar syndrome? Is it severe?
UDP glucuronyl transferase deficiency
Yes, transplant required
Describe the structure of bile salts
Steroid structure with a carboxylic acid group that is commonly amide linked to taurine or glycine
In what form are lipids that lipases breakdown?
Triglycerides
What does a deficiency in galatose–6-phosphate uridylyl transferase result in?
Hypergalatosaemia > jaundice, cataracts
Why to premature babies get jaundice more?
Ligandin and UDP glucuronyl transferase takes longer to reach normal levels
What are the most important bile salts?
Cholic acid
Deoxycholic acid
Chenodeoxycholic acid
What gives gallstones their colour?
Bilirubin derivatives
What are gallstones predominantly made of?
Cholesterol
What is the function of the trypsin inhibitor?
Binds in the active zone of trypsin so that it isn’t inappropriately activated in the pancreas
Which cells make insulin?
Beta cells
What does a loss of K cause?
Feeling of weariness
What is a pre-hepatic cause of jaundice?
Haemolysis
Where is cholecystokinin produced?
Walls of the duodenum
What does carboxypeptidase do?
Cleaves the C-terminus of proteins
What is occuring in pancreatitis?
Pancreatic enzymes are self digesting
What is good about having a glucose-6-phosphate dehydrogenase deficiency?
Confer resistence to malaria
Is bilirubin in haemolytic jaundice conjugated or unconjugated?
It’s not that white and black - there is a mix
What is post hepatic cause of jaundice?
Gallstone
What are the effects of CCK?
Gallbladder contraction
Digestive enzyme secretion from pancreas
Insulin secretion
Satiation in CNS
What are some causes of greater or prolonged hyperbilirubinaemia in babies?
Haemolytic disorder
Glucose-6-phosphate dehydrogenase deficiency
Birth trauma
How do natural plant steroids reduce cholesterol?
Block bile salt receptors > new cholesterol must be used to make bile
