synthesis 14/12 very bad deck Flashcards
Which plasma proteins are synthesised by the liver?
most of them, except for immunoglobulins
e.g.
albumin, CRP
Properties of albumin?
negatively charged
66 kDalton
10-15g produced by the liver per day
What are the functions of albumin?
plasma oncotic pressure
but also carrier protein for hormones, vitamins, electrolytes(Ca2+, Mg2+…), drugs
What is hypoalbuminaemia?
What are the causes?
What are the consequences?
low albumin in the blood
inflammation, liver disease, renal disease, burns/trauma, sepsis, malnutrition
oedema, effusions, carrier protein - may need to adjust for this in tests
How is the clotting cascade related to the liver?
Majority of the components are made in the liver
How is Vitamin K important in the clotting cascade?
Required in synthesis of some products of cascade, so
Why is bleeding associaated with liver disease?
reduced synthesis of clotting factors
- reduced synthesis of inhibitors
- production of abnormal/dysfunctional proteins
- enhanced fibrolytic activity
- reduced hepatic clearance of clotting factors
- disseminated intravascular coagulation
… lead to the development of varices that then bleed
What is ammonia a product of?
catabolism - proteins to ammonia and a-keto acids
WHat is the glucose alanine cycle?
muscle respiring anaerobically and producing ammonia, converted to alanine that travels in the blood to the liver
Liver converts it to pyruvate to be used in muscles
Overall loss of energy but muscle ains
learn urea cycle :)
What does the urea cycle do?
Produces urea from ammonia
What does high ammonia lead to?
neurotoxicity, cerebral oedema, ultimately brainstem death
What is the only hormone that signals being fed? (only anabolic hormone)
Insulin
Treatment of too much urea?
avoidance of catabolism - give glucose polymers when unwell
Give dextrose for induction of anabolism - if blood sugar remaining high, don’t forget insulin
Low dietary protein
Haemofiltration
More extremes…
