Liver/Pancreatic Secretions & Jaundice Flashcards
what regulates gall bladder function?
CCK
how much bile can human liver make per day?
1 L
3 most important human bile acids?
cholic acid
deoxycholic acid
chenodeoxycholic acid
how much of bile is recycled? from where?
95% from terminal ileum
which cells does bicarb and enzymes come from in the pancreas?
bicarb: duct cells
enzymes: acinar cells
what are the inactive form of enzymes?
zymogens
What regulates pancreatic secretions? where does it come from?
CCK and secretin
from the walls of duodenum
cholesterol is soluble? insoluble?
insoluble, will precipitate if not enough bile salts
bile salts from what?
bile pigment from what?
salts: cholesterol
pigment: bilirubin
Lecithin is generic name for?
phospholipid
unconjugated bile acids are more or less acidic that tauroconjugates?
less acidic
what is a detergent?
micelles to capture grease
example of a detergent?
bile acid
any reserve for bile salts to keep cholesterol in micelles?
Nope right at limit, why gall stones are so easily form if over limit
What does lipase need to be activated
colipase
what is fatty stool called?
steatorrhea
What drug makes steatorrhea?
Orlistat
What is the total bile salt pool?
3-5g
how does margarine lower cholesterol?
plant sterols compete with bile salt absorption receptors
How does cholestryamine affect cholesterol:
disrupts negative feedback to make up for excreted cholesterol
3 important intestinal secretions:
secretin
Gastrin
Cholescystokinin
What does secretin do?
enhances bicarbonate content in pancreatic secretions
where is CCK produced?
duodenum
CCK does what neurally?
give you satiation feeling
what does CCK stimulate? 3 things
gall bladder contraction
pancreas digestive enzyme
promote insulin release
what does Trehalase digest?
mushrooms
how is Trypsinogen activated?
cleaves a sequence to activate once in the intestine by enteropeptidases
how to prevent trypsinogen activation in pancreas?
trypsin inhibitor in small amount in pancreas
Amino peptidase
carboxy peptidase
which side break down protein?
Amino: N side
Carboxy: C side
two main causes of pancreatitis?
alcohol abuse
Gallstones (women older than 50)
decreased pain in a chornic alcoholic could mean?
advanced pancreas destruction
Serum lipase or amylase is more sensitive in dx of pancreatitis?
serum lipase
what is the most energy expensive thing to digest? carbs? fats or proteins?
proteins
how many micromolar bilirubin needed for it to show up in eyes
35 micromolar
jaundice categorized into 4?
pre-hepatic
hepatocellular
post-hepatic
neonatal
heme oxygenase in macrophages makes what from heme?
biliverdin, iron, CO
What does biliverdin reductase do?
reduces biliverdin to unconjugated bilirubin
Sources of heme besides old RBCs? 3 things
failed erythropoieses
myoglobin
cytochromes
What will patients with jaundice present with re: ALT, AST, GGT, ALP?
All raised
what does UDP-glucuronyl transferase do?
adds glucoronic acid to bilirubin twice to conjugate it and make it soluble
when bilirubin-albumin enters hepatocyte, first thing that happens?
bilirubin attaches to LIGANDIN
Dubin-Johnson syndrome is problem with?
cMOAT
which big drug interferes with bilirubin reuptake?
Rifampicin
What heavy metal bad for liver?
Copper (wilson’s disease)
classic pre-hepatic jaundice is caused by?
haemolysis and increase unconjugated plasma bilirubin
prevalence of neonatal jaundice?
1:3
what usually causes neonatal jaundice?
immature liver need time to build up LIGANDIN and UDP
change over from foetal to adult haemoglobin Hby to HbB
other pathological causes of neonatal jaundice?
ABO-RH incompatibility
birth trauma
premature
glucose-6-phosphate dehydrogenase deficiency
Gilbert’s Disease?
1:20
decreased conjugation of bilirubin with fasting (normal biopsy and lifespan)
Why are fava beans bad for someone with glucose-6-phosphate dehydrogenase deficiency?
fava beans has divicin and causes oxidative stress and leads to haemolytic anaemia
glucose-6-phosphate dehydrogenase deficiency confers resistance to?
Malaria
what is the most common human enzyme deficiency? 400 million ppl
glucose-6-phosphate dehydrogenase deficiency
What does glutathione do?
antioxidants
Who shouldn’t take chloroquine?
glucose-6-phosphate dehydrogenase deficiency people
what is cholroquine?
oldest of antimalarials
jaundice in newborn with bilateral cataracts?
galactosaemia
