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liver stuff Flashcards

1
Q

what is liver inflammation most often due to?

A
  • obesity
  • the metabolic syndrome
  • alcohol excess
  • nonalcoholic steatohepatitis
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2
Q

where is the liver situated?

A

-right hypochondrium

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3
Q

how many segments is the liver split into?

A

8

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4
Q

what allows individual segment surgery in the liver?

A

that each segment has its own portal pedicle (branch of hepatic artery, portal vein and bile duct)

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5
Q

what is special about the caudate lobe (lobe 1)?

A
  • physiologically independant part of the liver, receives an independant blood supply from the portal vein and hepatic artery
  • only part of the liver that is directly in contact with the inferior vena cava
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6
Q

where are lymphatics present?

A

-portal tracts

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7
Q

function of liver?

A
  • protein metabolism (ablumin, blood clotting factors)
  • carbohydrate metabolism
  • lipid metabolism
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8
Q

what are hepatocytes?

A

-liver cells

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9
Q

what are the anterosuperior and the posteroinferior surfaces called?

A

anterosuperior- diaohragmatic surface

posteroinferior- visceral surface

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10
Q

what are the 4 main lobes of the liver?

A
  • left
  • right
  • caudate
  • quadrate
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11
Q

how does the liver receive nutrients?

A

-the portal vein delivers nutrient rich, deoxygenated blood from the stomach and intestines (75% of blood)

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12
Q

how does the liver receive oxygenated blood?

A

the left and right hepatic arteries branch off the aorta and supply the liver with oxygenated blood (only supplies 25% of blood)

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13
Q

how does blood leave the liver?

A

through the left, right and middle hepatic veins that join up the inferior vena cava

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14
Q

what are sinusoids?

A

-gaps between the hepatocytes that blood flows through from the hepatic artery + portal vein to the central vein

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15
Q

what makes up the portal triad?

A
  • bile duct
  • hepatic artery
  • portal vein
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16
Q

where are portal triads located?

A

-on the corners of the hexagonal lobules of the liver

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17
Q

what are liver macrophages called?

A

Kupffer cells

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18
Q

where are Kupffer cells found?

A

-sinusoids

19
Q

where is the perisinusoidal space?

A

-between hepatocytes and sinusoids

20
Q

what produces bile?

A

-hepatocytes

21
Q

what is the fibrous protective lining of the liver called?

A

External Glisson’s capsule

22
Q

what are the stages of drug metabolism?

A

Phase 1

  • oxidation
  • reduction
  • hydrolysis

Phase 2
-conjugation

Excretion

  • renal
  • faeces (bile)
  • lungs
  • sweat/tears
  • milk, saliva
23
Q

what is the role of phase 1 in drug metabolism?

A
  • increase drug polarity

- new chemically reactive group permits conjugation

24
Q

what is the role of phase 2 in drug metabolism?

A
  • further increases polarity
  • adds endogenous compound
  • usually results in inactive products
25
Q

what mediates the oxidation of lipid soludble drugs?

A

CYP450

26
Q

what are the ‘True LFTs’?

A
  • albumin
  • bilirubin
  • prothrombin time

The chemical markers that measure the livers ability to synthesise proteins

27
Q

what does increased ALT indicate?

A

hepatucellular injury

28
Q

what does increased AST indicate?

A

may be elevated in:

  • liver injury
  • MI
  • pancreatits
  • haemolytic anaemia
  • renal or MSK disease
29
Q

where is AST found?

A
  • heart
  • liver
  • skeletal muscle
  • kidneys
  • brain
  • RBC
30
Q

what does increased ALP suggest?

A

cholestasis

31
Q

what does increased GGT indicate?

A
  • biliary obstruction
  • liver and pancreas disease
  • CV disease
  • alcohol
32
Q

what LFT changes are seen in hepatocellular injury?

A

increase ALT

increast AST

33
Q

what LFT changes are seen in cholestasis?

A

increase ALP

increase GGT

34
Q

what does AST< ALT indicate

A

-chronic liver disease

35
Q

what does AST>ALT suggest?

A
  • cirrhosis

- acute alcoholic hepatitis

36
Q

what is diagnosis if transferases (AST or ALT) very high? (>1000)

A

-alomst certanly hepatitis

37
Q

what does a AST:ALT ratio of >2 suggest?

A

alcohol

38
Q

what will never occur to AST in chronic liver disease?

A

> 1000

39
Q

when may albumin fall?

A
  • cirrhosis
  • nephrotic syndrome
  • inflammation in acute phase temporarily decreases albumin
40
Q

what can increase prothrombin time indicate?

A

-liver disease causing reduced production of clotting factors

41
Q

what are the types of jaundice?

A
  • pre hepatic
  • hepatocellular
  • post hepatic (obstructive)
42
Q

what does AST increased 20x suggest?

A

acute cause

43
Q

what does AST increased 5-10x suggest?

A

chronic cause

GI (34 decks)

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