Physiology - Liver

Question 1

what hormones are deactivated by the liver?

Answer 1

insulin
glucagon
ADH
steroid hormones

Question 2

what hormones are activated by the liver?

Answer 2

thyroid hormone

vitamin D

Question 3

what effect does the liver have on thyroid hormone?

Answer 3

converts T4 to more active T3

Question 4

what effect does the liver have on vitamin D?

Answer 4

converts it to 25-hydroxy vitamin D aka calcifediol

this is then converted to calcitriol (final active form) in the kidney

Question 5

what things are stored in the liver?

Answer 5

fat soluble vitamins
water soluble vitamin B12
iron 
copper 
glycogen

Question 6

name the four fat soluble vitamins?

Answer 6

A
D
E
K

Question 7

what proteins are synthesised by the liver?

Answer 7

coagulation factors 
albumin
complement proteins 
apolipoproteins
carrier proteins

Question 8

what coagulation factors are synthesised in the liver?

Answer 8

II
VII
IX
X
proteins C+S

Question 9

what are the phagocytes in the liver called?

Answer 9

kupffer cells

Question 10

what is the role of kupffer cells?

Answer 10

destroy particulate matter and old erythrocytes

Question 11

where is bile secreted from?

Answer 11

hepatocytes

cholangiocytes (bile duct cells)

Question 12

what happens to bile in between meals?

Answer 12

stored and concentrated in the gallbladder

Question 13

describe the state of the sphincter of oddi in between meals

Answer 13

closed

to keep bile in the gallbladder

Question 14

what stimulates the gallbladder to contract during a meal?

Answer 14

chyme in the duodenum

via CCK and vagal impulses

Question 15

what happens to bile during a meal?

Answer 15

sphincter of oddi opens and bile moves into the duodenum via cystic and common bile ducts

Question 16

what does the primary juice secreted by hepatocytes into biliary ducts contain?

Answer 16

primary bile acids 
water 
electrolytes 
lipids 
cholesterol 
IgA
bilirubin 
metabolic waste

Question 17

what are the primary bile acids?

Answer 17

cholic acids

chenodeoxycholic acids

Question 18

what is bilirubin?

Answer 18

breakdown product of the porphyrin component of haemoglobin

Question 19

what is the best treatment for symptomatic gallstones?

Answer 19

laparoscopic cholecystectomy

Question 20

what drug can be given for small unproblematic gallstones?

Answer 20

ursodeoxycholic acid

Question 21

what is an adverse effect of ursodeoxycholic acid?

Answer 21

diarrhoea

Question 22

what drugs can be given to relieve biliary spasms?

Answer 22

atropine

GTN

Question 23

what happens to the vast majority of bile salts that enter the duodenum?

Answer 23

reabsorbed in the terminal ileum to undergo enterohepatic recycling

small amount excreted in faeces