Test #3 Flashcards
What is Hepatotoxicity?
Adverse effects in hepatic tissue by chemical, physical, or biological agents
Anatomy of the liver (anterior view, from left to right)
Right lobe, falciform ligament, left lobe
What are Kupffer cells?
Macrophages (phagocytes) in the liver sinusoids that function as immune cells including DESTROYING OLDER RED BLOOD CELLS
What are the three functional units of the liver? (Actually 4)
Hepatic cells, hepatic veins, hepatic arteries, bile ducts
What is another name for a liver cell?
Hepatocyte
What carries chemicals from the GI tract to the liver?
Hepatic Portal Vein
What is responsible for 75% of the blood flow to the liver?
Hepatic Portal Vein
What is responsible for 25% of the blood flow to the liver?
Hepatic artery
What chemical is secreted by the liver to help excrete toxic metabolites?
Bile
Which route is the most important for excreting toxics from the liver?
Fecal route
What are the two routes for excreting toxins from the liver?
Fecal and urinary routes
What direction does bile flow compared to blood flow in the Bile Caniculi and what is this called?
Opposite direction & Counter-current Flow
What is the name of the bile storage organ of the body?
Gall bladder
What is the gall bladder’s main function?
Concentrates and stores bile (does not produce it)
What organ has the highest concentration of xenobitoic-metabolizing enzymes?
Liver
What particular enzyme does the liver have a high concentration of?
Cytochrome P-450
Where do most foreign compounds enter the body?
The GI Tract
What carries nutrients and toxicants from the GI tract to the liver?
Hepatic Portal Vein
The liver has evolved to excrete metabolites by making them what?
Hydrophilic
What class of enzymes are in the liver performing metabolizing reactions?
P-450
When are liver cells most active?
After eating
Which zone of the liver is described as: central, where most chemicals pass through, where peripheral cell death occurs if toxic to vascular system, and contains the most blood?
Zone 1
In what zone of the liver does most of the cell death occur?
Zone 2
Which zone of the liver is a peripheral part of the liver and where most of the metabolizing chemicals (P-450) are located?
Zone 3
What is another name for Steotosis?
Fatty liver
What happens when a hepatotoxin causes abnormal fat handling by the liver and leads to the storage of fat in the liver itself?
Steatosis aka fatty liver
What can Cyclohexane solvent exposure and Tetracycline antibiotic overdose cause?
Steatosis aka fatty liver
What type of lesion is steatosis associated with?
Type 1 lesion
What is cell death in the liver associated with an inflammatory response called?
Cell necrosis
What can acetaminophen (pain medicine), beryllium (toxic metal), chloroform (organic solvent), tannic acid (tanning of pelts by taxidermist), and trichlorethylene (parts cleaner, organic solvent) cause?
Cell necrosis in the liver
Cell necrosis in the liver is associated with which type of lesion?
Type 1
The blocking of bile flow by hepatotoxin, inflammation, and jaundice (yellow colored skin) describe what?
Cholestasis
What can the pharmaceuticals amitriptyline, diazepam, magazine, and sulfanilamide cause in the liver?
Cholestasis
What type of lesion is Cholestasis associated with?
Type 2
In humans, chronic use of ethanol is the single most important cause of what?
Cirrhosis
What is most involved in the first stage of ethanol metabolism?
Alcohol Dehydrogenase (ADH)
What two enzymes (as cofactors) catalyze the conversion of ethanol to acetaldehyde in the liver?
ADH with NAD
What is the most important toxin that causes Cirrhosis?
Carbon Tetrachloride
Carbon Tet is used in what?
Cleaning fluids and fire extinguishers
Which toxin is a hepatotoxin (liver), nephrotoxin (renal/kidney), and probable carcinogen?
Carbon Tet
Which toxic response of the liver causes inflammation and is usually viral in origin?
Hepatitis
What bloodborne pathogens cause hepatitis?
Hepatitis A, B, C, and D viruses
Hepatitis D requires what?
A preexisting chronic hepatitis B infection
Type 2 diabetes is linked with what?
Kidney disease
What are the 4 main kidney functions?
- Excretory - elimination of body waste products
- Regulatory - body homeostasis activities, tries to keep a balance
- Endocrine - production of enzymes in blood
- Blood filter
The production of renin (blood pressure control), prostaglandins (blood calcium level control), and erythropoietin (increase production of RBC’s) are associated with which kidney function?
Endocrine
What % of the total cardiac output do the kidneys receive, exposing them to large amounts of nephrotoxic agents that enter the bloodstream?
25%
How do the veins/arteries of the kidney flow in relation to the nephron?
They flow in opposite directions (counter current)
What are the 2 purposes of the counter current flow in the kidneys?
- To decrease the loss of filtered nutrients and water
2. Concentrate the waste/toxins in the urine for excretion
What % of body weight is extracellular fluid?
20%
What % of body weight is intracellular fluid?
40%
What % of body weight is solid (tissue matter & bone)?
40%
Osmolality: RBC ________ when the osmolality inside the cell is greater than outside the cell
Swells
Osmolality: RBC _______ when the osmolality inside the cell is lower than the osmolality outside the cell
Shrinks
What refers to the body’s electrolyte-water balance?
Osmolality
The rate at which urine is filtered by the glomerulus (how fast) is?
Glomerular Filtration Rate
What test is used to determine the glomerular filtration rate?
Insulin clearance test
What other metabolic product from your body can be measured by a blood and urine sample to find the GFR just like insulin?
Creatinine
What type of determination (test) is a urinalysis?
Chemical
What substances are measured in a urinalysis?
pH, protein, glucose, ketones, urobilogen & bilirubin
What is a urinalysis?
A microscopic examination of centrifuged sediment
What 4 types of sediment can be found in a urinalysis?
- Cells
- Casts
- Crystals
- Bacteria
What 5 types of casts can be found in a urinalysis?
- RBC
- WBC
- Epithelial (dead skin)
- Hyaline (bacteria)
- Waxy & fatty
What are common nephrotoxins (bad for kidney)?
- Mercury
- aspirin
- Anesthetic gas
- Hex chrome
- Uranium
- Cadmium
- Tetracycline (antibiotic)
What does mercury do to the kidney?
Damages proximal tubule of nephron
What does aspirin do to the kidney?
Damages by causing loss of concentration gradient in kidney which results in diluting urine
Anesthetic gas has the same effect as aspirin on the liver true or false?
True
Hex chrome damages what in the kidneys?
Proximal tubule of nephron
Uranium does what to kidney?
Massive necrosis
Cadmium causes what in the kidney?
Proteinuria
What are 4 symptoms of urinary issues?
- Polyuria (excessive urination)
- Glucosuria (sugar in urine)
- Proteinuria (protein byproducts in urine)
- Anuria (lack of urination)