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Jason's GI Block > Liver/Pancreatic Secretions & Jaundice > Flashcards

Liver/Pancreatic Secretions & Jaundice Flashcards

1
Q

what regulates gall bladder function?

A

CCK

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2
Q

how much bile can human liver make per day?

A

1 L

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3
Q

3 most important human bile acids?

A

cholic acid
deoxycholic acid
chenodeoxycholic acid

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4
Q

how much of bile is recycled? from where?

A

95% from terminal ileum

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5
Q

which cells does bicarb and enzymes come from in the pancreas?

A

bicarb: duct cells
enzymes: acinar cells

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6
Q

what are the inactive form of enzymes?

A

zymogens

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7
Q

What regulates pancreatic secretions? where does it come from?

A

CCK and secretin

from the walls of duodenum

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8
Q

cholesterol is soluble? insoluble?

A

insoluble, will precipitate if not enough bile salts

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9
Q

bile salts from what?

bile pigment from what?

A

salts: cholesterol
pigment: bilirubin

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10
Q

Lecithin is generic name for?

A

phospholipid

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11
Q

unconjugated bile acids are more or less acidic that tauroconjugates?

A

less acidic

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12
Q

what is a detergent?

A

micelles to capture grease

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13
Q

example of a detergent?

A

bile acid

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14
Q

any reserve for bile salts to keep cholesterol in micelles?

A

Nope right at limit, why gall stones are so easily form if over limit

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15
Q

What does lipase need to be activated

A

colipase

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16
Q

what is fatty stool called?

A

steatorrhea

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17
Q

What drug makes steatorrhea?

A

Orlistat

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18
Q

What is the total bile salt pool?

A

3-5g

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19
Q

how does margarine lower cholesterol?

A

plant sterols compete with bile salt absorption receptors

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20
Q

How does cholestryamine affect cholesterol:

A

disrupts negative feedback to make up for excreted cholesterol

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21
Q

3 important intestinal secretions:

A

secretin
Gastrin
Cholescystokinin

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22
Q

What does secretin do?

A

enhances bicarbonate content in pancreatic secretions

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23
Q

where is CCK produced?

A

duodenum

24
Q

CCK does what neurally?

A

give you satiation feeling

25
Q

what does CCK stimulate? 3 things

A

gall bladder contraction
pancreas digestive enzyme
promote insulin release

26
Q

what does Trehalase digest?

A

mushrooms

27
Q

how is Trypsinogen activated?

A

cleaves a sequence to activate once in the intestine by enteropeptidases

28
Q

how to prevent trypsinogen activation in pancreas?

A

trypsin inhibitor in small amount in pancreas

29
Q

Amino peptidase
carboxy peptidase
which side break down protein?

A

Amino: N side
Carboxy: C side

30
Q

two main causes of pancreatitis?

A

alcohol abuse

Gallstones (women older than 50)

31
Q

decreased pain in a chornic alcoholic could mean?

A

advanced pancreas destruction

32
Q

Serum lipase or amylase is more sensitive in dx of pancreatitis?

A

serum lipase

33
Q

what is the most energy expensive thing to digest? carbs? fats or proteins?

A

proteins

34
Q

how many micromolar bilirubin needed for it to show up in eyes

A

35 micromolar

35
Q

jaundice categorized into 4?

A

pre-hepatic
hepatocellular
post-hepatic
neonatal

36
Q

heme oxygenase in macrophages makes what from heme?

A

biliverdin, iron, CO

37
Q

What does biliverdin reductase do?

A

reduces biliverdin to unconjugated bilirubin

38
Q

Sources of heme besides old RBCs? 3 things

A

failed erythropoieses
myoglobin
cytochromes

39
Q

What will patients with jaundice present with re: ALT, AST, GGT, ALP?

A

All raised

40
Q

what does UDP-glucuronyl transferase do?

A

adds glucoronic acid to bilirubin twice to conjugate it and make it soluble

41
Q

when bilirubin-albumin enters hepatocyte, first thing that happens?

A

bilirubin attaches to LIGANDIN

42
Q

Dubin-Johnson syndrome is problem with?

A

cMOAT

43
Q

which big drug interferes with bilirubin reuptake?

A

Rifampicin

44
Q

What heavy metal bad for liver?

A

Copper (wilson’s disease)

45
Q

classic pre-hepatic jaundice is caused by?

A

haemolysis and increase unconjugated plasma bilirubin

46
Q

prevalence of neonatal jaundice?

A

1:3

47
Q

what usually causes neonatal jaundice?

A

immature liver need time to build up LIGANDIN and UDP

change over from foetal to adult haemoglobin Hby to HbB

48
Q

other pathological causes of neonatal jaundice?

A

ABO-RH incompatibility
birth trauma
premature
glucose-6-phosphate dehydrogenase deficiency

49
Q

Gilbert’s Disease?

A

1:20

decreased conjugation of bilirubin with fasting (normal biopsy and lifespan)

50
Q

Why are fava beans bad for someone with glucose-6-phosphate dehydrogenase deficiency?

A

fava beans has divicin and causes oxidative stress and leads to haemolytic anaemia

51
Q

glucose-6-phosphate dehydrogenase deficiency confers resistance to?

A

Malaria

52
Q

what is the most common human enzyme deficiency? 400 million ppl

A

glucose-6-phosphate dehydrogenase deficiency

53
Q

What does glutathione do?

A

antioxidants

54
Q

Who shouldn’t take chloroquine?

A

glucose-6-phosphate dehydrogenase deficiency people

55
Q

what is cholroquine?

A

oldest of antimalarials

56
Q

jaundice in newborn with bilateral cataracts?

A

galactosaemia

Jason's GI Block (32 decks)

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