PHYS 2 Hepatobilliary function Flashcards
Liver physiology and role in GI function
why location is important?
main functions?
(4)
cirrhosis
what is it?
most common cause?
this leads to accumulation of?
which leads to?
cirrhosis can cause?
develops when? most often occurs where?
changes to venous circulation associated with portal hypertension
(2)
Liver dysfunction can lead to?
how?
some effects?
bile produced and secreted where?
bile composition? mainly?
bile function?
(2)
location of synthesis of primary bile acids?
secondary?
bile salt conjugation location?
most common bile acid?
what forms micelles?
bile secretion results from actions of biliary sytem organs
what are these organs?
mechanism of bile secretion and absorption of bile salts.
starting with release of bile salts
what are positive regulators and what do they work on?
steps 1-5
bile salts secreted where?
canalicular bile secreted by ductule cells in response to?
bile salts recirculated to liver via what circulation not the portal vein different name
synthesis happens why?
uptake of bile salts across basolateral membrane of hepatocytes mediated by what? (2)
transporters at the hepatocyte and enterocyte
where is bile reabsorbed? what type of transport at each?
most important part?
how much excreted in feces?
relationship between rates of bile acid synthesis and secretion?
why?
whats inhibited?
interruption of enterohepatic circulation?
example?
ileal resection
bile secretion via two mechanisms
almost all bile formation is driven by?
a small portion stimulated by?
secretion of bile acids accompanied by?
canalicular bile is primarily an ( )
Secretin stimulates what? this results in an increase of what? decrease in?
bile flow between digestion?
on eating?
bilirubin production and excretion
start with?
to bilirubin?
bloodstream?
liver? jaundice why?
bile?
reabsorbed?
excreted?
urobilinogen in pee
jaundice
sign of what?
signs/symptoms?
what allows quantitation of jaundice?
this is expressed in what three ways?
unconjugated vis conjugated?
5 known hereditary defects in bilirubin metabolism
other problem that can happen? in conjugated jaundice
hemolytic anemia
due to?
will lead to?
this causes?
physiological neonatal jaundice
what type of bilirubin?
when?
2 main causes?
signs?
Gilbert syndrome
what type of bilirubin?
mild/severe?
episodes happen when?
mutation in?
enzyme? activity level?
what else may be impaired?
signs symptoms of 30%
other disease that has to do with mutation in gene that code for UDP Glucuronyltransferase?
type of bilirubin?
two types?
which is more severe?
Crigler-Najjar syndrome type 1
starts when?
how much function of enzyme?
high levels can cause what? this is called?
what helps treat?
neurologic dysfunction due to bilirubin is called?
permanent or reversible?
develops when?
major clinical features include?
damages what
neurons
astrocytes
microglia
oligodendrocytes
Crigler-Najjar syndrome type 2
starts when?
function of enzyme?
develop kernicterus?
survive until?
treatments for Crigler-Najjar syndrome
3
then one each for type 1 and 2
increased conjugated bilirubin without elevation of liver enzymes?
defect in ability to? mutation in?
jaundice mild or severe? made worse by?
what else is different with liver?
buildup of both unconjugated and conjugated bilirubin in blood?
majority is?
gene mutations in?
liver color?
bilirubin metabolism disorders
problem from blood into the liver?
problem with UGT1A1?
problem with MRP2?
Primary treatment in neonates with unconjugated hyperbilirubinemia?
newborn with serum biliribun > ?
works how?
gallstones
occur when?
causes?
look of pigment vs cholesterol
different spots gallstones can get stuck?
and size
liver function tests
why is this name off?
include what tests?
reference ranges?
Biochemical tests
liver enzymes commonly measured?
pattern may suggest underlying cause?
hepatocyte injury?
bile duct injury?
function tests
abnormal what might be seen as imparied hepatic synthetic function?
(3)
Bilirubin: in part measures liver’s ability to?
function tests
albumin: what will reduce level of albumin?
one thing that does this?
Hypoalbuminemia can be seen when?
PT: degree of hepatic?
increases as what?
what correlates with severity of hepatic dysfunction?
liver modifies drugs or toxic substances through the what?
Liver enzymes can modify what?
PHase 1?
PHase II?
first pass metabolism
