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liver phys 557
| Question | Answer |
|---|---|
| How much does the liver weigh? | 3lb |
| What is the functional unit of the liver? | the liver lobule |
| How much of the CO does the liver represent? | 27% |
| The liver is a _____ flow, _____ pressure system. | high , low |
| What disease process causes an increase in pressure to fibrotic deposition around blood vessels and in the spaces of Disse? | cirrhosis |
| What is non-steatohepatitis associated with? | Type II DM and obesity |
| What is caused by transudation of fluid from the liver into the abdominal cavity? | ascites |
| What are high portal pressures caused by? | fibrotic deposition |
| Under normal conditions, how much blood is stored in the liver? | 450ml |
| With an increase in what, the liver is capable of sequestering 500-1000ml beyond normal limits? | right atrial pressure |
| In the absence of infection, fibrosis, or inflammation, what is possible? | regeneration |
| Liver cells do not over-proliferate. T/F | T |
| What plays a role in the division and growth of cells? | Hepatocyte growth factor |
| What is HGF produced by? | mesenchymal cells of the liver and some other tissues |
| HGF is not produced by the __________, but the hepatocytes demonstrate a mitogenic response after HGF stimulation. | hepatocytes |
| Following complete liver regeneration, what is released by hepatic cells? | cytokine |
| What is a potent inhibitor of liver growth? | transforming growth factor |
| In healthy states, a liver to body weight ratio is maintained. T/F | T |
| What cells are responsible for clearing intestinal bacteria from the portal vein? | kupffer |
| Less than __% of the enteric microbes pass the Kupffer cell entry system. | 1 |
| The liver metabolizes what? | Carbs |
| The liver stores what? | glycogen |
| The liver converts galactose and fructose to what? | glucose |
| This is the process of glucose formation from non-carbohydrate sources such as lactate. | Gluconeogenesis |
| How is excess glucose stored in the liver? | as glycogen |
| Glycogen is liberated when what falls? | blood glucose levels |
| Patients with liver disease experience large fluctuations in blood glucose levels. T/F | T |
| What two things are liberated from triglycerides and converted to glucose? | Amino acids and glycerol |
| The liver ________ fatty acids to meet energy requirements. | oxidizes |
| The liver _________ cholesterol, phospholipids, and lipoproteins. | synthesizes |
| What splits lipids into glycerol and fatty acids to form acetyl CoA? | beta oxidation |
| Acetyl CoA is converted to ________-_______ acid, which is a highly soluble acid used in the liver as energy. | aceto-acetic acid |
| Aceto acetic acid is again converted in other bodily tissues to _________ ___ for energy. | Acetyl CoA |
| 80% of the cholesterol synthesized in the liver is converted to what? | bile salts |
| The remaining 20% of cholesterol is transported in __________ and utilized to form membranes, cellular structures, and a multitude of physiologic active substrates. | lipoproteins |
| Deamination of ________ ________ occurs in the liver so they can be used as an energy source for converting fats or carbs. | amino acids |
| The liver forms urea and removes what? | ammonia |
| The liver can form up to ____ grams of protein per day. | 50 |
| To a small extent, the _____ also participate in the deamination of amino acids. | kidneys |
| What vitamins are stored in large amount in the liver? | A,D, and B12 |
| Iron stored as _____ in combination with _______ binds and stores excess iron until needed. | ferritin and apoferritin |
| What coag factors are manufactured by the liver? | fibrinogen, Prothrombin (FII), accelerator globulin, Factor VII, Vit K |
| What are the vit K dependent factors? | 2, 9, 10, 12 |
| What drugs are excreted by the liver? | PCN, Amp, and sulfonamides |
| What hormones are associated with the liver? | thyroxine, estrogens, cortisol, and aldosterone |
| Excess of this electrolyte is excreted in the bile for elimination via feces? | calcium |
| What is the end product of hemoglobin degradation? | bilirubin |
| What is the lifespan of the red blood cell? | 120 days |
| Lysis via the reticuloendothelial system of the _____ liberates homoglobin. | spleen |
| Once unconjugated albumin bound bilirubin enters the liver cells is released from the plasma albumin and is conjugated with glucuronic acid, what is it now called? | conjugated hemoglobin or direct hemoglobin |
| Conjugated bilirubin is excreted from _________ by active transport into the bile canaliculi for excretion into the _____________. | hepatocytes, intestine |
| Conjugated bilirubin is converted by bacteria in the gut to highly soluble ______________. | urobilinogen |
| What is a normal bilirubin level? | 0.5mg/dl |
| What occurs when levels exceed three times normal or 1.5 mg/dl? | jaundice |
| What overwhelms the capacity of the liver, is a marked increase in free or unconjugated bilirubin in the blood, and a marked increase in urobilinogen in the gut which is excreted in the urine? | hemolytic jaundice |
| What is caused by gallstones, cancerous tumor, hepatitis, destruction of bile ducts, bilirubin cannot pass from the blood to the intestine, and conjugation continues to occur? | obstructive jaundice |
| With obstructive jaundice, conjugated bilirubin leaves the liver via what system? | lymph |
| Usually conjugated bilirubin leaves the liver via the _________ and sphincter of Odi. | gallbladder |
| In hemolytic jaundice, what is elevated? | unconjugated bilirubin |
| In obstructive jaundice, what is elevated? | conjugated bilirubin |
| What reaction is utilized to differentiate between conjugated and unconjugated bilirubin? | van den bergh |
| With this type of jaundice there is no urobilinogen that is reabsorbed in the blood that can be excreted into the kidneys. | total obstructive jaundice |
| Total obstructive jaundice also results in a lack of what? | stercobilin |
| In ___________ obstruction jaundice, conjugated bilirubin does appear in the urine. | partial |
| In its original form, __________ is fat soluble, not water soluble. | bilirubin |
| What modifies bilirubin as it arrives at the liver, and converts it to a water soluble compound? | glucuronyl transferase |
| The process of converting bilirubin to a water soluble form is called _______ ____________ because one of the steps involved is the attachment of bilirubin to another molecule. | bilirubin conjugation |
| This is not a disease, but a sign of a disease. | Jaundice |
| Unconjugated bilirubin, accumulates in fatty tissues, most notably the _______, where we would notice yellow pigment. | skin |
| Most bilirubin is produced by RBC breakdown in the __________. | spleen |
| Conjugated bilirubin does not readily cross the _____. | BBB |
| ________________ bilirubin does cross the BBB. | unconjugated |
| What 4 possible problems could cause jaundice? | 1. increased RBC breakdown 2. Failure of hepatocyte conjugation 3. failure of hepatocyte excretion of conjugated bilirubin into the bile canaliculi 4. extra hepatic obstruction (gallstones) |
| What happens to cause an increase in unconjugated hyperbilirubinemia? | 1. increase in bilirubin production, 2. decreased hepatic uptake of bili by hepatocytes 3. decreased conjugation of the bili |
Created by:
Jmw015
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