Basic Hepatic Physiology Flashcards

Question

what constitutes metabolic syndrome

Answer 1

HTN, increased triglycerides, increased BG

Answer 2

obesity DMII metabolic syndrome

Answer 3

steatotosis

Answer 4

what NAFLD progresses to, inflammation. progresses to cirrhosis

Answer 5

``` alpha receptors (vasoconstriction) beta receptors (vasodilation) dopaminergic receptors (vasodilation) cholinergic receptors (vasodilation) ```

Answer 6

``` alpha receptors (vasoconstriction) dopaminergic receptors (vasodilation) ```

Answer 7

.5-1L (commonly occurs in CHF)

Answer 8

blood shifts from hepatic veins and sinusoids into central circulation (as much as 300mL)

Answer 9

1. line hepatic venous sinusoids and cleanse blood as it passes through these sinuses. bacterium that passes into these cells is then digested 2. also phagocytose cellular debris, viruses, proteins, particulate matter 3. release various enzymes, cytokines, other chemical mediators

Answer 10

monocyte macrophage system aka reticuloendothelial system

Answer 11

pores in sinusoids are very permeable and therefore permit passage of the fluid and protein into spaces of disse and that is the creation of lymph fluid

Answer 12

can increase lymph flow to 20x normal, produces "sweating" from the liver surface with large amounts of free fluid entering the abdominal cavity aka ascites

Answer 13

produces high pressure in the GI tract with transudation of fluid through the gut into the abdominal cavity which can also cause ascites

Answer 14

1. carbohydrate metabolism 2. fat metabolism 3. protein metabolism 4. drug metabolism 5. miscellaneous metabolic functions

Answer 15

glucose, fructose, galactose. (glucose is final common pathway for most CHO)

Answer 16

1. conversion of galactose and fructose to glucose 2. storage of large amounts of glycogen (glycogenesis) 3. gluconeogenesis (used from proteins and fats after you've used carbs) 4. formation of many chemical compounds from intermediate products of CHO metabolism

Answer 17

stored as glycogen

Answer 18

storage of glycogen allows liver to remove excess glucose from the blood, store it, and return it to the blood when BG concentration decreases

Answer 19

liver and muscles

Answer 20

epinephrine and glucagon

Answer 21

24 hours. after that, gluconeogenesis uses fat first to compensate.

Answer 22

amino acids glycerol pyruvate lactate

Answer 23

glucocorticoids catecholamines glucagon thyroid hormone

Answer 24

1. oxidation of fatty acids to supply energy for other body functions (beta oxidation) 2. synthesis of large amounts of cholesterol, phospholipids, and lipoproteins 3. synthesis of fat from CHO and proteins

Answer 25

glycerol and 3 fatty acids

Answer 26

to take out of storage and make glucose aka to derive energy from fat (triglycerides)

Answer 27

- they must be split into glycerol and fatty acids - fatty acids are then split by beta oxidation into 2 carbon acetyl radicals that form acetyl coenzyme A - acetyl coA enters the citric acid cycle and is oxidized to liberate tremendous amounts of energy

Answer 28

in all body cells, but occurs especially rapidly in hepatic cells

Answer 29

- converted to acetoacetic acid (combination of 2 acetyl Co-A molecules) - acetoacetic acid is highly soluble and leaves the hepatocytes, enters the blood, and is absorbed by other tissues - the tissues reconvert the acetoacetic acid back into the acetyl Co-A which enters the citric acid cycle and is oxidized to produce energy - in the way liver is responsible for a major part of fat metabolism

Answer 30

cholesterol and phospholipids

Answer 31

1. cell membranes 2. intracellular structures 3. chemical substances important to cell function ex) hormones

Answer 32

1. deamination of proteins (removal of nitrogen) 2. formation of urea for removal of ammonia (NH3) from the body fluids 3. formation of plasma proteins 4. synthesis of amino acids and synthesis of other compounds from amino acids

Answer 33

leucine isoleucine valine

Answer 34

enzymatic process which converts amino acids into their respective keto acids and results in production of ammonia as a byproduct (cleaves off nitrogen and converts back to carbonyl group). liver is principle site

Answer 35

removes ammonia from the body fluids large amounts of ammonia are formed by deamination process. bacteria in the gut with subsequent absorption into the blood

Answer 36

if the liver does not perform deamination or if there is greatly reduced blood flow

Answer 37

shunts portal blood into IVC to bypass liver. increased ammonia and hepatic encephalopathy can develop.

Answer 38

15-50g/day

Answer 39

albumin | a1 antitrypsin

Answer 40

trypsin breaks down proteins. ex)emphysema has lack of antitrypsin so lung tissue is degraded

Answer 41

a keto acid is formed that has the same chemical composition as the AA to be formed except at the keto oxygen. next an amino radical is transferred from an available AA to the veto acid to take the place of the keto oxygen. this process takes many steps.

Answer 42

modify substances through CYP450 through oxidation or reduction

Answer 43

90% of all reactions primarily via CYP450 enzymes and secondarily by mixed function oxidases often generates reactive oxygen species because carboxyl, epoxy, and hydroxyl groups are introduced into the parent compound

Answer 44

mainly catalyzed by CYP450 enzymes

Answer 45

ethanol barbiturates ketamine benzos

Answer 46

ranitidine amiodarone ciprofloxacin

Answer 47

``` lidocaine morphine verapamil labetalol propanolol ```

Answer 48

acetaminophen- glutathione is a free radical scavenger isoniazid: metabolite that causes cells to activate their programmed cell death halothane: hepatitis

Answer 49

``` (efficiently extracted because fairly lipid soluble at baseline) lidocaine meperidine morphine nortrriptyline pentazocine propoxyphene propanolol labetalol verapamil ```

Answer 50

``` acetaminophen clindamycin diazepam digoxin phenytoin theophylline warfarin ```

Answer 51

may or may not follow a phase 1 reaction, involves conjugation of a substance with a water soluble metabolite

Answer 52

taking something small and adding something large and charged to make it water soluble so it can be excreted in the urine or bile glucoronide is most common, then sulfate taurine and glycine can also be utilized by the body

Answer 53

A, B12, D, E, K

Answer 54

protein produced by hepatic cells, excreted in large amounts to bind to excess iron in body fluids. apoferritin+iron=ferritin which is then stored in hepatocytes until the iron is needed elsewhere in the body

Answer 55

binds to iron and carries it in the blood for transport so iron does not travel in its free radical form and oxidize everything

Answer 56

2 (prothrombin), 7, 9, 10

Answer 57

coagulopathy due to impaired formation of factors 2, 7, 9, 10

Answer 58

factor 8 and vWF

Answer 59

``` thyroid hormone insulin steroid hormones including cortisol, aldosterone, estrogen glucagon ADH ```

Answer 60

bile salts cholesterol phospholipids conjugated bilirubin

Answer 61

the left and right hepatic ducts

Answer 62

cystic duct and hepatic duct

Answer 63

sphincter of oddi

Answer 64

hormone released from intestinal mucosa in response to fat and protein that causes contraction of the gallbladder, relaxation of the sphincter of odd, and ejection of bile into the small intestine. also called the "cystic system"

Answer 65

major end product of hgb degradation. provides valuable tool for diagnosing blood diseases and various types of liver disease

Answer 66

1. HGB is split into globin and heme 2. heme ring is opened and Fe is released and is transported in blood by transferrin 3. 4 pyrrole rings of the porphyrin structure are converted to biliverdin 4. biliverdin is rapidly converted to free bilirubin and is released from the macrophages 5. free bilirubin immediately combines with plasma albumin

Answer 67

increase in partial pressure O2

Answer 68

free bilirubin or bilirubin bound to plasma protein. absorbed by hepatocytes, released from albumin, and then conjugated.

Answer 69

bilirubin conjugated with either glucoronide (80%) or sulfate (20%) then excreted from hepatocytes by an active transport process into bile canaliculi and then into the intestines

Answer 70

in the intestine, about 1/2 of conjugated bilirubin is then converted by bacteria to urobilinogen which is reabsorbed back into the blood. some of it is excreted into urine, majority is excreted back into intestines and eliminated by feces

Answer 71

excess unconjugated OR conjugated bilirubin in the ECF

Answer 72

hemolytic | obstructive

Answer 73

increased destruction/hemolyzation of RBC's. - increased production of bilirubin by macrophages - increased unconjugated (free/indirect) bilirubin in blood. hepatocytes cannot process or conjugate all of this bilirubin - so while this results in a primarily increased unconjugated bilirubin, you will aolso see a secondary increased in conjugated bilirubin as well - rate of urobilinogen in intestine and urinary excretion increases but - excretory function of liver is not impaired

Answer 74

obstruction of bile ducts or damage to hepatocytes (hepatitis) preventing usual amounts of bilirubin from being excreted into GI tract. - unconjugated bilirubin enters hepatocytes and is conjugated the usual way. however, now cannot pass from liver into intestine - conjugated bilirubin enters blood probably either by rupture of cannaliculi or direct emptying of bile into lymph system - therefore, will see most bilirubin in conjugated form

Answer 75

gallstones, malignancies

Answer 76

no conjugated bilirubin can reach the intestines to be converted to urobilinogen and therefore no urobilinogen is reabsorbed into the blood and excreted by kidneys. the urobilinogen test is COMPLETELY negative

Basic Hepatic Physiology Flashcards

(108 cards)