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Hugh's MD1 Abdominal > Liver, pancreatic secretions and jaundice > Flashcards

Liver, pancreatic secretions and jaundice Flashcards

1
Q

What is the name of food when it exits the stomach?

A

Chyme

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1
Q

At what level must blood bilirubin by at for jaundice to occur?

A

35 micromolar - 3x the normal amount

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2
Q

What does colipase do?

A

Activates lipase

Prevents bile acids inhibiting the lipase

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2
Q

What population gets pancreatitis the most?

A

Females >50

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2
Q

Why do a high proportion of babies get jaundice?

A

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.

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3
Q

What happens when fatty acids enter to intestinal mucosa?

A

Reform triglycerides

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4
Q

Which pancreatic cells release bicarbonate?

A

Duct cells

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4
Q

What drug can be used to decrease fat absorption?

A

Orlistat

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5
Q

What are bile salts made from?

A

Cholesterol

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6
Q

What does CCK do to the gallbladder?

A

Stimulates contraction

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6
Q

Which pancreatic cells release enzymes?

A

Acinar

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6
Q

What serum markers are indicative of pancreatitis?

A

Lipase (most characteristic)

Amylase

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6
Q

Is Gilbert’s syndrome severe? What goes wrong?

A

No, usually subclinical

Decreased conjugation of bilirubin

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8
Q

What are zymogens?

A

Inactivated precursor forms of enzymes

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9
Q

What happens to faeces after a fatty meal?

A

It’s darker due to more bile

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10
Q

What is a hepatic cause of jaundice?

A

Intrahepatic obstruction - cirrhosis

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11
Q

What activates colipase?

A

Trypsin

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12
Q

How much bile can the liver produce per day?

A

Up to 1L

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13
Q

What is the function of the taurine and glycine groups on bile salts?

A

Increase solubility

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14
Q

What is cyst a general term for?

A

A Bladder-like structure

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15
Q

What structure does bile acids form in digested lipids?

A

Micelles

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15
Q

What happens in Dubin-Johnson syndrome? Is it severe?

A

Impaired secretion of conjugated bilirubin

Mild symptoms

16
Q

What does secretin enhance the secretion of?

A

Bicarbonate in the acinar cells of pancreas

17
Q

What happens when you have a deficiency in glucose-6-phosphate dehydrogenase?

A

You can’t produce as much glutathione (glutathione protects against ROSs) > More ROS > RBCs damaged

18
Q

What percentage of bilirubin comes from the breakdown of old RBCs?

A

80%

19
Q

What endocrine hormones do islets of Langerhan make?

A

Insulin

Glucagon

20
Q

How does increasing the fat cotent of faeces affect its appearance?

A

Paler, whiter

Greasy

Foul smelling

22
Q

What is enterohepatic circulation?

A

Where bile salts are absorbed in the terminal ileum for recycling

23
Q

What happens when you go on chloroquine when you have a deficiency in G6PD?

A

ROS from chloroquine aren’t removed by glutathione > membrane destruction and globin precipitation > haemolytic jaundice, Heinz bodies

25
Q

What type of agents are bile salts?

A

Detergents

26
Q

What are two other names for bile?

A

Gall

Chole

28
Q

What percentage of bile salts are recycled?

A

95%

28
Q

What happens in Crigler-Najjar syndrome? Is it severe?

A

UDP glucuronyl transferase deficiency

Yes, transplant required

29
Q

Describe the structure of bile salts

A

Steroid structure with a carboxylic acid group that is commonly amide linked to taurine or glycine

31
Q

In what form are lipids that lipases breakdown?

A

Triglycerides

32
Q

What does a deficiency in galatose–6-phosphate uridylyl transferase result in?

A

Hypergalatosaemia > jaundice, cataracts

33
Q

Why to premature babies get jaundice more?

A

Ligandin and UDP glucuronyl transferase takes longer to reach normal levels

34
Q

What are the most important bile salts?

A

Cholic acid

Deoxycholic acid

Chenodeoxycholic acid

35
Q

What gives gallstones their colour?

A

Bilirubin derivatives

36
Q

What are gallstones predominantly made of?

A

Cholesterol

37
Q

What is the function of the trypsin inhibitor?

A

Binds in the active zone of trypsin so that it isn’t inappropriately activated in the pancreas

39
Q

Which cells make insulin?

A

Beta cells

41
Q

What does a loss of K cause?

A

Feeling of weariness

42
Q

What is a pre-hepatic cause of jaundice?

A

Haemolysis

43
Q

Where is cholecystokinin produced?

A

Walls of the duodenum

44
Q

What does carboxypeptidase do?

A

Cleaves the C-terminus of proteins

46
Q

What is occuring in pancreatitis?

A

Pancreatic enzymes are self digesting

47
Q

What is good about having a glucose-6-phosphate dehydrogenase deficiency?

A

Confer resistence to malaria

49
Q

Is bilirubin in haemolytic jaundice conjugated or unconjugated?

A

It’s not that white and black - there is a mix

50
Q

What is post hepatic cause of jaundice?

A

Gallstone

51
Q

What are the effects of CCK?

A

Gallbladder contraction

Digestive enzyme secretion from pancreas

Insulin secretion

Satiation in CNS

52
Q

What are some causes of greater or prolonged hyperbilirubinaemia in babies?

A

Haemolytic disorder

Glucose-6-phosphate dehydrogenase deficiency

Birth trauma

53
Q

How do natural plant steroids reduce cholesterol?

A

Block bile salt receptors > new cholesterol must be used to make bile

Hugh's MD1 Abdominal (21 decks)

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