Liver

Question 1

How many segments is the liver divided into?

Answer 1

8

Question 2

What classifiation divides the liver?

Answer 2

Couinaud classification

Question 3

What are the liver functions?

Answer 3

• Bile metabolism
• Fat-souble Vitamin storage and/or metabolism
• Protein metabolism
• Carbohydrate metabolism
• Lipid metabolism
• Drug metabolism/detoxification
• Bilirubin metabolism
• Thyroid horomone function

Question 4

What is the bile metabolism in the liver function?

Answer 4

Bile used to excrete material by the kidney
- Bile produced by hepatocyte and travels to duodenum or stored in the gallbladder

Question 5

What is the funtion of vitamins in the liver?

Answer 5

VItamin A, D, E and K absorbed with dietary fats and stored in the liver

Question 6

What is the purpose of Vitamin K?

Answer 6

Synthesis of the prothrombin complex clotting factors

Question 7

How is iron stored in the liver?

Answer 7

Ferritin, haemosiderin and copper

Question 8

How does protein metabolism occur in the liver?

Answer 8

Recieves amino acids from the intestine and muscles and, by controlling the rate of glucongenesis and transmaination regulates plasma levels

Question 9

What is NOT synthesised by protein metabolism?

Answer 9

gamma (y) - globulins (produced in the reticuloendothelial system)

Question 10

What does plasma contain?

Answer 10

Albumin, globulin and fibrinogen

Question 11

What is the main function of Albumin?

Answer 11

Maintain intravscular oncotic (colloid osmotic) pressure

Transport water-insouble substances (E.g bilirubin, hormones, fatty acids and drugs)

Question 12

What coagulation factors are synthesized by the liver?

Answer 12

Fibrinogen, prothmbin, factors V, VII, IX, X, XIII, protein C + S and antithrombin

Question 13

What coagulation factor is NOT synthesized?

Answer 13

One-third of factor VIII

Question 14

What is degradation (ntirogen excretion) in the liver?

Answer 14

Amino acids are degraded via transmaination and oxdiative demination to produce ammonia then coverts to urea and excreted by the kidneys

Question 15

What is the consequence to the failure of liver function?

Answer 15

Severe liver disease

Question 16

What is carbohydrate metabolism?

Answer 16

Glucose homeostasis and maintenance of blood sugar

Question 17

What is formed from excess gluose and stored in the liver or muscles?

Answer 17

Glycogen

Question 18

What is the purpose of HDL (high density lipoproteins)

Answer 18

HDLs are the substrate for lecithin cholesterol acyltransferase which catalyses the conversion of free cholesterol to cholesterol ester

Question 19

How is LDL (low density lipoproteins formed)?

Answer 19

Hepatic lipase removes triglyceride from intermediate density lipoprotein forming LDL

Question 20

How is Bilirubin formed?

Answer 20

Haem groups are broken down via haemolysis in the body (e.g liver, spleen and bone marrow)

Haem→biliverdin→reduced to
unconjugated bilirubin→conjugated bilirubin

Question 21

How is bilirubin removed from the body?

Answer 21

COnjugated bilirubin enters the bile and excreted with bile in faeces

Bilirubin coverts to urobilinogen or uncongugated bilirubin by gut bacteria for reabsorption to undergo enterohepatic circulation

Question 22

What does bile consist of?

Answer 22

Water, electrolytes (e.g sodium/potassium), bile acids, cholesterol, phospholipids and conjugated bilirubin

Question 23

What is the function of bile?

Answer 23

Waste transportation and break down fat during digestion

Question 24

WHat are the two processes in bile secretion?

Answer 24

Bile salt depedent and bile salt independent

Question 25

What is bile salt dependent?

Answer 25

Active transport of bile salt into bile canaliculi drawing water along them

Question 26

What is bile salt independent?

Answer 26

Active transport of other solutes (bicarbonate and glutathione) into the bile canaliculi

Question 27

What are the liver conditions a person may have and their causes?

Answer 27

Alcoholic liver disease (too much alcohol) • Fatty liver disease (too much fat) • Haemochromatosis (too much iron) • Wilson disease (too much cooper) • Viral hepatitis (virus infecting the liver) • Hepatic cancer (too much cell division) • Autoimmune causes (PBC, PSC and AIH)

Question 28

What is albumin?

Answer 28

Protein in the human blood plasma produced by the liver that maintains osmotic pressure and transports molecules like hormones, bilirubin and drugs throughout the body

Question 29

What is Liver cirrhosis?

Answer 29

Scarring of the liver from long term damage preventing its function

Question 30

What is the stages to liver failure?

Answer 30

Hepatitis → fibrosis → cirrhosis→ liver failure

Question 31

What is hepatitis?

Answer 31

Inflammation of the liver caused by viruses and non infectious agents

Question 32

What is fibrous liver?

Answer 32

Scarring that occurs when the liver is damaged by chronic inflammation (E.g hepatitis)

Question 33

What does liver cirrhosis cause?

Answer 33

Dimished ability to produce protein and detoxify substances - causing portal hypertension and hypoalbuminemia Decreased clotting factor synthesis caused by coagulopathy

Question 34

What are the clinical manifestation of chronic liver disease?

Answer 34

- Fatigue - Anorexia - Weight

Question 35

What complications can cause the clinical manifestation of chronic liver disease?

Answer 35

- Portal hyertension - Hepatocellular insufficiency - Hepatocellular carcinoma

Question 36

What is Jaundice?

Answer 36

Yellowish discolouration of the eys, skin and mucous membrane due t overproduction or underclearance of bilirubin - Impaired conjugation of bilirubin deposits in various tissues of the body

Question 37

What is Spotaneous bacterial peritonitis?

Answer 37

Bacteria seep through the gastrointestinal tract and infect the ascitic fluid. Infection spreads to the peritoneal membrance causing inflammation

Question 38

What does spontaenous bacterial peritonitis cause?

Answer 38

- Fever - Abdominal pain - Tenderness - Absent bowel sounds

Question 39

What is Hyperoestrinism?

Answer 39

Catabolism of oestrogen becoming impaired causing excess oestrogen in the body

Question 40

What is Hepatorenal Syndrome?

Answer 40

Functional renal failure as kidneys are normal however gradual loss of renal function - Vasoconstrictors are released in chronic liver disease

Question 41

What are marker of synthetic function?

Answer 41

Albumin and prothombin time

Question 42

What is aminotransferaes (transaminases) role in liver function test?

Answer 42

Contained in hepatocytes and leak into the blood with liver cell damage

Question 43

What enzymes are mesaured?

Answer 43

- Aspartate aminotransferase - Alanine aminotransferase

Question 44

Where can Alkaline phosphatase be found?

Answer 44

Canalicular + sinusoidal membrane, bone, intestine and placenta

Question 45

How many liver nodules are there?

Answer 45

8

Question 46

How does the deoxygenated blood leave?

Answer 46

Via the Inferior vena cava

Question 47

What can be found in liver anatomy?

Answer 47

Portal vein Hepatic artery Bile duct Gall bladder