Pathophysiology of Liver Disease

Question 1

What vitamins and minerals are stored in the liver?

Answer 1

Vit A, D, B12

Ferritin-bound iron

Question 2

What clotting factors are produced in the liver?

Answer 2

Factor VIII

Von Willebrand’s factor

Question 3

Dual blood supply to the liver

Answer 3

~1.5L/min 80% from portal vein and 20% hepatic artery

50-55% O2 from portal vein and 45-50% from hepatic artery

Question 4

Liver Histology

Answer 4

76% hepatocytes
Non-parenchymal cells include Kupffer cells (30%), sinusoidal endothelial cells (60%) and stellate AKA Ito cells (10%)
Other cell types include fat cells, cholangiocytes and immune cells

Question 5

What are the zones of the liver acinus?

Answer 5

The liver acinus is the smallest physiological unit of the liver and is made of parenchyma.
Zone 1: blood from portal vein and hepatic artery enters acinus
Zone 2: hepatocytes
Zone 3: blood reaches terminal hepatic veins via sinusoids and these join to form the main hepatic vein

All acinus cells are totipotent!

Question 6

Define: acute liver insult

Answer 6

Rapidly resolved on elimination of the injurious agents and the liver restores normal architecture and function completely.

Question 7

Define: chronic liver injury

Answer 7

Continuous acute injury extended over time