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GI > Physiology of liver, pancreas and gallbladder > Flashcards

Physiology of liver, pancreas and gallbladder Flashcards

1
Q

What is Fe2+ stored in the liver as?

A

ferritin

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2
Q

Iron is transported bound to which protein?

A

transferrin

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3
Q

How much glycogen is stored in the liver?

A

100g

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4
Q

What are the fat soluble vitamins?

A

ADEK

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5
Q

How long can the liver’s glycogen stored last for?

A

12 hours

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6
Q

How long can the liver’s fat stores last for?

A

3 months

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7
Q

What is the aim of liver detoxification?

A

Aims to either make the substance less toxic or increase solubility to allow the substance to be excreted

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8
Q

Describe phase 1 reactions

A

oxidation or hydrolysis reactions

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9
Q

Describe phase 2 reactions

A

Glucoronidation
Conjugation
Excretion

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10
Q

What is glucaronidation?

A

addition of glucaronic acid to a substance

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11
Q

What is conjugation?

A

addition of a chemical group to a substance

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12
Q

What does Gilbert’s syndrome cause?

A

Mild jaundice as a result of inefficiant UDPGT

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13
Q

What can colloid osmotic pressure also be referred to as?

A

oncotic pressure

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14
Q

What is oncotic pressure?

A

form of osmotic pressure induced by proteins in the vessel

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15
Q

What are the main functions of albumin?

A

maintaining oncotic pressure

binding and transporting large/hydrophobic molecules

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16
Q

All but which clotting factors are produced in the liver?

A

All but 4 and 7

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17
Q

What are the vitamin K dependent clotting factors?

A

10, 9, 7, 2

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18
Q

What is produced by the liver that is important for the absorption of vitamin K and other fat soluble vitamins?

A

bile salts

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19
Q

What three types of protein are produced by the liver?

A

Plasma protein e.g albumin
Clotting proteins
Complement proteins (part of immune response)

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20
Q

What is the purpose of the glucose-alanine cycle?

A

to move proteins from the muscle to the liver when glycogen stores are low

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21
Q

What is an important enzyme involved in the glucose-alanine cycle? Its concentration in serum is used to measure liver health.

A

Alanine aminotransferase (ALT)

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22
Q

In the glucose-alanine cycle, what does is glucose converted into in the muscle?

A

pyruvate

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23
Q

In the glucose-alanine cycle, what is pyruvate converted into in the muscle. What enzyme is required for this step?

A

pyruvate is converted into alanine

alanine aminotransferase is required for this step

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24
Q

Apart from pyruvate and alanine aminotransferase, what other substance is required to produce alanine at the muscle?

A

glutamate

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25
Q

What is glutamate converted into at the muscle in the glucose-alanine cycle?

A

alpha-ketoglutarate

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26
Q

What is the next step of the glucose-alanine cycle after alanine has been produced in the muscle?

A

alanine travles in the blood to the liver

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27
Q

What is alanine converted to in the liver?

A

pyruvate

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28
Q

In the glucose-alanine cycle, what is pyruvate converted into at the liver?

A

glucose

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29
Q

Where does glutamate come from initially in the glucose-alanine cycle?

A

muscle proteins

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30
Q

Which cycle is similar in function to the glucose-alanine cycle except more productive?

A

the Cori cycle

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31
Q

Describe what happens to glucose in the muscle in the Cori cycle

A

Glucose is converted to 2 pyruvate

2 pyruvate is converted to 2 lactate

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32
Q

In the Cori cycle, what is used to produce glucose from in the liver

A

2 lactate

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33
Q

In the Cori cycle, what is 2 lactate converted to in the liver?

A

2 lactate is converted to 2 pyruvate

2 pyruvate is converted to glucose

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34
Q

What is NH3?

A

ammonia

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35
Q

What neurotoxic substance does the urea cycle remove?

A

ammonia

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36
Q

In the urea cycle, what is added to ornithine to form citrulline?

A

ammonia and CO2

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37
Q

In the urea cycle, what is added to citrulline to form arginine?

A

ammonia

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38
Q

What does arginine release to regenergate ornithine?

A

Urea

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39
Q

In the urea cycle, the release of urea from arginine forms what substance?

A

ornithine

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40
Q

what does LDL stand for?

A

low density lipoproteins

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41
Q

what does HDL stand for?

A

high density lipoproteins

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42
Q

What does VLDL stand for?

A

very low density lipoproteins

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43
Q

What type of lipoprotein is used to transport lipids from the liver to adipose tissue?

A

VLDL

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44
Q

What cell is the main store of lipids?

A

adipocytes

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45
Q

When VLDLs reach adipocytes, how does the fat enter the adipocyte?

A

VLDLs release their triglycerides

triglycerides diffuse into adipocytes

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46
Q

Emulsification of fatty acids by bile forms what ?

A

micelles

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47
Q

Where in the GI tract does lipid digestion primarily occur?

A

the small intestine (but some occurs in the mouth and stomach)

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48
Q

Lipase converts triglycerides into?

A

monoglyercide +2 fatty acids

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49
Q

Describe the solubility of pancreatic lipase?

A

water soluble

50
Q

Why can pancreatic lipase only act on the surface of fat droplets?

A

It is water soluble

51
Q

Which enzyme holds lipase to the surface of the lipid droplet?

A

colipase

52
Q

How do the fatty acids + monoglycerides get into the epithelial cells?

A

via diffusion

53
Q

Where in the intestinal epithelial cells are monoglycerides and fatty acids resynthesised into triglycerides?

A

smooth endoplasmic reticulum

54
Q

What are triglycerides packaged into after their resynthesis in the intestinal epithelial cells?

A

chylomicrons

55
Q

What type of vessel do chylomicrons pass into from the intestinal epithelial cells?

A

lacteals

56
Q

Where are LDLs formed and what is their function?

A

formed in plasma

deliver cholesterol to cells

57
Q

Where are high density lipoproteins formed and what do they do?

A

formed in the liver

remove excess cholesterol from blood and tissues via excretion in bile

58
Q

Where are VLDLs formed and what do they do?

A

formed in liver (hepatocytes)

deliver triglycerides from liver to adipocytes

59
Q

Which type of lipoprotein delivers cholesterol to cells?

A

low density lipoproteins

60
Q

Which type of lipoprotein removes excess cholesterol from the blood and tissues via excretion in bile?

A

High density lipoproteins

61
Q

What essentially is fatty acid beta oxidation?

A

breaking down lipids to release energy

Each cycle shortens the fatty acid chains by 2 carbons until the fatty acid is only 2 carbons long

62
Q

Where does fatty acid beta oxidation occur?

A

the mitochondria of hepatocytes

63
Q

What type of cell continuously secretes bile?

A

hepatocytes

64
Q

What components are in bile?

A 
bile salts 
lecithin (a phospholipid)
HCO3- 
Cholesterol
Bile pigments e.g bilirubin
65
Q

What is lecithin?

A

a phospholipid

66
Q

Bile is released from the gallbaldder in response to which hormone?

A

CCK

67
Q

Which type of bilirubin is toxic and lipid soluble?

A

unconjugated bilirubin

68
Q

Which type of bilirubin is water soluble?

A

conjugated bilirubin

69
Q

Which cells phagocytose red blood cells? what is hemoglobin broken down into?

A

macrophages

hemoglobin is broken down into heme and globin

70
Q

What happens to the globin from the breakdown of hemoglobin?

A

globin is hydrolysed to from amino acids and these are used to make new proteins

71
Q

Which enzyme breaks down heme into biliverdin and Fe2+?

A

heme oxygenase

72
Q

What are the products of the breakdown of heme by heme oxygenase?

A

biliverdin and Fe2+

73
Q

Biliverdin results from the breakdown of what substance?

A

heme

74
Q

What colour is biliverdin?

A

green

75
Q

What is biliverdin converted into by the enzyme biliverdin reductase?

A

unconjugated bilirubin

76
Q

Which enzyme converts biliverdin into unconjugated bilirubin?

A

biliverdin reductase

77
Q

What colour is unconjugated bilirubin?

A

yellow

78
Q

Where is unconjugated bilirubin converted into conjugated bilirubin + glucaronic acid ?

A

the liver

79
Q

What does the liver convert unconjugated bilirubin into?

A

conjugated bilirubin and glucaronic acid

80
Q

How is conjugated bilirubin excreted from the liver?

A

In bile

81
Q

What is conjugated bilirubin converted into in the ileum and the beginning of the large intestine?

A

urobilinogen

82
Q

What converts conjugated bilirubin into urobilinogen?

A

bacteria

83
Q

How do bacteria convert unconjugated bilirubin into urobilinogen ?

A

remove glucaronic acid

84
Q

Describe the solubility of urobilinogen?

A

lipid soluble

85
Q

What is the majority of urobilinogen oxidised to form?

A

stercobilin

86
Q

What colour is stercobilin?

A

brown

87
Q

What chemical is responsible for the brown colour of feces?

A

stercobilin

88
Q

What percentage of urobilinogen is reabsorbed and bound to albumin in the blood?

A

10-15%

89
Q

What is urobilinogen converted into at the kidneys?

A

urobilin

90
Q

Which chemical is primarily responsible for the yellow colour of urine?

A

urobilin

91
Q

What happens to the reabsorbed urobilinogen that does not go to the kidneys ?

A

enters the enterohepatic urobilinogen cycle and is resecreted into the bile

92
Q

What is the cause of jaundice?

A

increased bilirubin in the blood

93
Q

What are the different types of jaundice?

A

pre hepatic
hepatic
post hepatic

94
Q

Describe post hepatic jaundice

A

impaired excretion due to mechanical obstruction to bile flow
elevated conjugated bilirubin in serum

95
Q

Describe pre hepatic jaundice

A

excessive hemolysis

elevated unconjugated bilirubin in serum

96
Q

How is unconjugated bilirubin transported to the liver?

A

via albumin

97
Q

What enzyme is involved in the conversion of unconjugated bilirubin into conjugated bilirubin?

A

UDPGT

98
Q

What colour is bilirubin in bile?

A

yellow/green

99
Q

What are the exocrine secretions of the pancreas?

A

HCO3-
Zymogens
Digestive enzymes

100
Q

What does the pancreas secrete that neutralises chyme in the duodenum?

A

HCO3-

101
Q

Where are the zymogens secreted by the pancreas activated?

A

the duodenum

102
Q

What part of small intestine releases secretin?

A

the duodenum

103
Q

What hormone stimulates HCO3- secretion from the pancreas?

A

secretin

104
Q

How is HCO3- secreted by pancreatic duct cells?

A

a Cl-/HCO3- exchanger

105
Q

What is HCO3- exchanged for when it is secreted by the duct cells of the pancreas?

A

Cl-

106
Q

Cl- brought into pancreatic duct cells are recycled back into the lumen by what channel?

A

CFTR channels

107
Q

What is the function of CFTR channels?

A

movement of Cl- from inside the pancreatic duct cell into the lumen

108
Q

Which channel is non-functional in cystic fibrosis?

A

CFTR

109
Q

Give two examples of zymogens

A

trypsinogen

chymotrypsinogen

110
Q

Which enzyme is key for activating zymogens?

A

enterokinase

trypsin also plays an important role in the activation of zymogens

111
Q

What is the function of trypsin?

A

digests proteins

activates zymogens

112
Q

What is the function of alpha-amylase?

A

digests starch into maltose

113
Q

What hormone inhibits the release of digestive enzymes?

A

somatostatin

114
Q

What cell type produces pancreatic lipase, trypsin and alpha-amylase?

A

pancreatic acinar cells

115
Q

What hormone stimulates the release of pancreatic digestive enzymes?

A

CCK

116
Q

What do alpha cells in the pancreas secrete?

A

glucagon

117
Q

What do beta cells in the pancreas secrete?

A

insulin

118
Q

What do delta cells in the pancreas secrete?

A

somatostatin

119
Q

What hormone inhibits pancreatic exocrine secretion as well as glucagon and insulin secretion ?

A

somatostain

120
Q

What is CCK released by?

A

the duodenum

GI (11 decks)

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