Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Emma GI > Liver Physio, Bile Physio, Gallbladder Disease > Flashcards

Liver Physio, Bile Physio, Gallbladder Disease Flashcards

1
Q

liver blood supply

A

portal v. (75%)

hepatic a. (25%)

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

portal v. carries blood from

A

entire capillary system of stomach, spleen, pancreas, intestine

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

primary functions of the liver

A
  • bile production and excretion
  • excretion of bilirubin, CHL, hormones, drugs
  • metabolism of fats, proteins, carbs
  • enzyme activation
  • storage of glycogen, vitamins, minerals
  • synth plasma proteins
  • blood detox
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In the liver, what maintains tissue fluid homeostasis via collecting xs tissue fluid and returning it to venous circulation?

A

lymphatic vascular system

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

plasma components are filtered through liver sinusoidal endothelial cells into the _________, and are regarded as the source of _________.

A

space of Disse

lymphatic fluid

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

ascites fluid

A

lymph, inc when pressure in sinusoids inc much above normal

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

major organic compounds prod by liver, found in bile

A
  • bile acids
  • phospholipids (lecithins)
  • CHL
  • Bile Pigments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T/F

Bilirubin is prod by the liver

A

F

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

things stored in liver

A
  • glucose
  • fat-soluble vitamins (A, D, E, K), folate, B12
  • Fe, Cu
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

liver can synthesis __ of 20 essential aa

A

11

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

liver prod most of circulating plasma proteins EXCEPT

A

Ig, Hb

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

most abundant protein in plasma

A

albumin

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

Fe absorption

A

duodenum

upper jejunum

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

liver stores enough iron to last

A

2-3 years

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

major site of clearance of circulating lipoproteins

A

liver

catabolized in hepatocytes

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

SI production of ammonia

A

aa breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

large bowel production of ammonia

A

bacterial breakdown of aa and urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ammonia effect on CNS

A

serious negative effects that disrupt metabolism and function of protective glial cells (astrocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

liver is the only organ in which complete ______ cycle is found

A

urea

only organ that can NH3 –> non-toxic urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Higher first-pass effect,

A

less active drug getting into systemic circulation after oral admin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

drug metabolism

A

intro hydrophilic functionalities onto drug molecule to make it less lipophilic (promote excretion from body)

22
Q

phase I metabolism of drugs

A

intro functional group (like hyroxyl) –> activates or inactivates –> more hydrophilic/susceptible to excretion

23
Q

phase II metabolism of drugs

A

conjugates glucuronic acid, sulfates, glutathione, aa to the drug

inc molecule weight, inactive/more susceptible to excretion

24
Q

bilirubin

A

prod from degradation of Hb (normal senescence)

25
Q

unconjugated bilirubin is carried through the blood by

A

albumin

26
Q

enzyme responsible for conjugating bilirubin in the liver

A

UDP glucuronosyltransferase

27
Q

primary bile acids

A

cholic and chenodeoxycholic bile acids

synthesized in liver from CHL, modified in gut by bacteria to form secondary bile acids

28
Q

secondary bile acids

A

deoxycholic and lithocholic acid

conjugated w/ glycine or taurine, considered to be func equiv to primary bile acids

29
Q

______ facilitate the digestive action of pancreatic lipase on triglycerides forming fatty acid chains and monoglycerides that can easily diffuse into the enterocyte.

A

Micelles (bile acid + fat droplet)

30
Q

percentage of bile salt pool lost each day to excretion

A

15-30%

31
Q

bulk of fat digestion is where, via which enzyme

A

SI, pancreatic lipase

32
Q

pancreatic lipase

A

SI

hydrolyzes TGs to monoglycerides and free FAs

33
Q

absorption of bile acids from ___ ileum req 2 methods:

A

distal ileum

req

  1. Na dependent symporter
  2. diffusion across cell membranes using hydrophobic surface of bile acid to fuse w/ lipid of cell memb
34
Q

effect of ingestion of food on bile flow

A

eating –> contraction of GB (CCK and neural stim), relax of sphincter of Oddi

35
Q

process of concentrating gb bile

A

as [ions] in interstitial space inc, H2O flows out of bile following ion gradient passively

36
Q

causes of gallstones

A
  1. too much absorption of water from bile
  2. too much absorption of bile acids from bile
  3. too much CHL in bile
  4. inflamm of epithelium
37
Q

~70% gallstones are formed from

A

CHL

38
Q

3 important components of bile

A

CHL
bile salts
phospholipids (90% lecithin)

39
Q

bile acids are secreted into bile after conjugation in liver with

A

taurine

glycine

40
Q

major risk fx for devel of gallstones

A
  • age
  • female sex
  • pregnancy
  • obesity
  • rapid weight loss
  • very low calorie diet
  • surgical therapy of morbid obesity
  • hypertriglyceridemia
  • terminal ileal resection
  • gallbladder stasis
  • DM
  • total parenteral nutrition
  • postvagotomy
  • spinal cord injury
  • reduced physical activity (men)
  • cirrhosis
41
Q

meds that inc risk of gallstone development

A

estrogen, OCP
clofibrate
cefraiaxone
octreotide or somatostatinoma

42
Q

genetic risk fx for gallstone development

A

Native Americans

-Pima Indians, chileans

43
Q

anemias that inc risk of gallstone formation

A
  • sickle-cell

- hereditary spherocytosis

44
Q

composition of gallstones

A

bilirubin pignments
CHL
Ca salts

45
Q

__% of gallstones are heavily calcified

A

15%

most of these are pigment stones

46
Q

brown pigment stones

A

bacteria or parasites

calcium salts of unconjugated bilirubin

asians

47
Q

black pigment stones

A

unconjugated bilirubin + mucin glycoproteins

chronic hemolysis, cirrhosis

48
Q

biliary colic

A

episodic RUQ pain

  • radiates to back or R shoulder
  • jaundice
  • WBC and diff
  • LFTs
  • amylase and lipase
49
Q

choledocholithiasis

A

gallstones obstruct part of bile duct

can lead to cholangitis (EMERGENCY! –>sepsis/shock)

50
Q

gallstone ileus

A

gallbladder forms a fistula w/ digestive tract

pts w/ longstanding gallstone disease

stones pass into bowel and can block gut at level of ligament of treitz or ileocecal valve

tx: surgery

51
Q

gallstone imaging

A

abd US, CT, MRI

HIDA, ERCP, EUS

52
Q

HIDA

A

injects radioactive tracer –> taken up by the liver –> excreted by hepatocytes into the biliary tree –> passes into the gb through the cystic duct.

If cystic duct is obstructed by inflammation or a stone (as in acute cholecystitis), tracer will not enter the gb and the gb will not be visualized.

Emma GI (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions