Liver 1 -anat, function, tests

Question 1

2 liver cell types and what they do

Answer 1

1. kupfer cells - immune
2. hepatocytes
   - metaboism/detox
   - synthesis
   - elimination in bile
   - deliver to heart

Question 2

4 liver molecules/functions that are produced

Answer 2

1. bile to duod for fats
2. carbs to glycogen for storage
   3 . lipid
3. proteins - albukin, clotting factors

Question 3

normal liver anatomy

Answer 3

2 lobes, 8 segments with own bloos supply

Question 4

2 blood supplies to liver

Answer 4

1. hepatic A - O2 rich

2 portal vein - nutrient rich

Question 5

classic microscopic anatomy

Answer 5

central vein in middle with 6 triads around (HA, portal vein, bile duct)

Question 6

3 zones fo liver

Answer 6

1 closest to the triad

Question 7

blood flow in the liverq

Answer 7

from portal vein toward central vein

Question 8

bile flow in liver

Answer 8

formed in hepatocytes and into cannaliculi

- flow towards the portal triad

Question 9

2 enzymes with hepatoctye injury

Answer 9

1. AST > 40 - also in skeletal muscle

2. ALT > 40 - also in cardiac and skel muscle

Question 10

2 enzymeswith cholestasis

Answer 10

1. ALP > 105 -

2. GGT > 40 - destruction of portal tracts, alc

Question 11

What is issue with ALP and age

Answer 11

levels are quite high in teens

Question 12

3 types of liver functions and 2 tests

Answer 12

1. impaired delivery to liver
   - low platelets
   - portal hypertension
2. impaired synthesis
   - high INR]
   - low albumin
3. impaired elim
   - high conj. bili

Question 13

what can be seen on morpholgy

Answer 13

not seen till bad- cirrosis

Question 14

2 imaging tech for biliary tree

Answer 14

• ERCP

- MRI

Question 15

when does failure start to happen

Answer 15

fairly late

Question 16

4 differebnt patterns can look for

Answer 16

1. activity - mild or severe elevations
2. severity - evidence of advanced disease - function and hypertension
3. hepatocellular - AST?ALT
4. cholestatis - ALP/GGT

Question 17

5 patterns of liver injury

Answer 17

1. cell degen or accumulation of material within cells
2. necrosis/apop
3. inflammation
4. regeneration
5. fibrosis

Question 18

what is diffue nodular formations with fibrosis

Answer 18

cirrosis

Question 19

what level of enzymes is concern

Answer 19

15X is urgent