Liver, biliary tree and pancrease

Question 1

portal blood flow features

Answer 1

• low hydrostatic pressure
• little resistance to flow
• maximal contact in sinusoids

Question 2

functions of the liver

Answer 2

• energy metabolism and substrate conversion
• synthesis and secretion of proteins
• solubilizing, transportaiton and storage
• protection and clearance

Question 3

molecules metabolized by liver

Answer 3

carbohydrates
proteins
lipids
drugs

Question 4

reactions that protein is metabolized by

Answer 4

oxidative deamination

transamination

Question 5

dysfunction of protein metabolism disease

Answer 5

hepatic encephalopathy

Question 6

dysfunction of lipid metabolism disease

Answer 6

steatosis

hyperlipidemia

Question 7

phase I metabolism reactions

Answer 7

oxidation
hydroxylation
reduction

Question 8

phase II metabolism reactions

Answer 8

glucuronide
sulfate
glycine
glutathione

Question 9

proteins synthesized by liver

Answer 9

serum albumin

clotting factors

Question 10

serum albumin role

Answer 10

• plasma oncotic pressure

- binding protein

Question 11

protection and clearance functions of liver

Answer 11

• phagocytic and endocytic functions (Kupffer cells)
• ammonia metabolism
• hepatocyte synthesis of glutathione

Question 12

causes of acute hepatitis

Answer 12

• viral hepatitis
• drugs
• poisons
• toxins
• autoimmune

Question 13

hep A genome

Answer 13

RNA

Question 14

hep B genome

Answer 14

DNA

Question 15

hep A acute or chronic

Answer 15

acute only

Question 16

hep B acute or chronic

Answer 16

acute and can progress to chronic

Question 17

hep A results from

Answer 17

direct killing of hepatocytes

Question 18

hep B results from

Answer 18

attack of host immune system after recognition of viral antigen

Question 19

hep C genome

Answer 19

RNA

Question 20

hep C acute or chronic

Answer 20

mostly chronic

Question 21

most common cause of cirrhosis

Answer 21

hep C

Question 22

how is alcohol toxic to liver

Answer 22

increases fluidity of biologic membranes, disrupting cellular functions

Question 23

Wilson’s disease

Answer 23

• copper deposits in eye

- sign of chronic metabolic hepatitis

Question 24

mechanisms of liver injury

Answer 24

inflammation
fibrosis
cirrhosis (extensive fibrosis)

Question 25

manifestations of liver dysfunction

Answer 25

- portal hypertension | - clinical presentation (ascites, hypoalbuminemia)

Question 26

2 outcomes of portal hypertension

Answer 26

- portal-to-systemic shunting | - disorder of renal Na and H20 homeostasis

Question 27

results of portal-to-systemic shunting

Answer 27

- increased intrahepatic venous pressure - increased sinusoid pressure - decreased hepatic filtration - blood bypasses liver

Question 28

results of renal Na and H20 homeostasis disorder

Answer 28

- altered intravascular pressure | - increased NO levels

Question 29

main clinical manifestations of cirrhosis

Answer 29

ascites hypoalbuminemia peripheral edema jaundice

Question 30

ascites

Answer 30

inappropriate excessive renal retention of Na and thus peritoneal fluid in abdomen

Question 31

treatment for ascites

Answer 31

diuretics Na restriction paracentesis

Question 32

organs involved in biliary tree

Answer 32

liver gallbladder pancreas duodenum

Question 33

sequence of biliary tree functions

Answer 33

- absorb Na and water - liver concentrate bile - gallbladder stores bile - bile released - bile acid delivered to duodenum for digestion

Question 34

symptoms of gallbladder disease

Answer 34

- episodic RUQ pain | - n/v

Question 35

symptoms of bile duct obstruction

Answer 35

- jaundice - pruritus - dark urine - acholic stools (pale poop)

Question 36

two functions of pancreas

Answer 36

- produce digestive fluid/juices to neutralize acidic chyme | - produce hormones

Question 37

diseases of pancreas

Answer 37

- diabetes - pancreatic cancer - acute pancreatitis - chronic pancreatitis

Question 38

acute pancreatitis features

Answer 38

- short inflammation | - immune response to tissue necrosis caused by digestive enzymes released from damaged exocrine cells

Question 39

causes of acute pancreatitis

Answer 39

gallstones overeating high alcohol consumption tissue injury

Question 40

chronic pancreatitis features

Answer 40

- lasts longer than 3 weeks | - due to irregular fibrosis that replaces endocrine and exocrine cells

Question 41

causes of chronic pancreatitis

Answer 41

- mostly high alcohol consumption | - acute pancreatitis

Question 42

symptoms of chronic pancreatitis

Answer 42

insufficient endocrine and exocrine release