cgeorge's version from 2016-02-22 19:31


Question Answer
AST/ALT areTransferase enzymes in hepatocytes. Involved in metabolism
Albumin is made by theLiver
High ALP will indicateBlocked biliary ducts or cancer that has spread to bones
Ascites is whenFluid builds up between the 2 layers of the peritoneum
Varices areDilated blood vessels in the oesophagus and stomach caused by portal hypertension
Both alkaline phosphatase and gamma glutamyl transferase are elevated in bile duct and liver diseases
Bilirubin has to be in excess of ... to cause jaundice2mg/ml
Heme in RBC is broken down intoIron and unconjugated bilirubin (lipid soluble)
What percentage of bile is reabsorbed back into the blood and where?95% and reabsorbed in to the blood within the ileum
Explain reabsorption of bileVenous blood from the ileum goes straight into the portal vein and through the liver sinusoids. Hepatocytes extract bile acids from the sinusoidal blood. Bile salts then transported across the hepatocytes to be resecreted into canaliculi
Which hormone stimulates contraction of the gall bladder?CCK
Which hormone stimulates biliary duct cells and what is the response?Secretin, and it stimulates the biliary duct cells to secrete bicarbs and water which expands the volume of the bile, increasing its flow out of the intestine
Daily production of Bilirubin is 250-300mg/day
How many times are bile salts recyled per day?6-8 times
Role of bile (to do with lipids)Bile is a lipid carrier and can solublize lipids by forming micelles
Explain bilirubin metabolismKupferr cells break down RBC into heme, heme broken down into iron and unconjugated bilirubin (lipid soluble.) Unconj bilirubin carried to liver via albumin to be conjugated. Conjugated with addition of glucuronic acid by UDP glucoronyltransferase. Conjugated bilirubin is water soluble. Its then excreted by the liver in bile into the SI. Its then metabolised by b-glucaranidase to form urobilinogens (lipid solbule). 15% of urobilongens are reabsorbed into blood within the ileum and sent back to the liver
Prehepatic jaundice is caused byHaemolysis (lots of RBC break down)
Gilberts syndrome can cause ... via...Pre hepatic jaundice by mutation in the UDP enzyme, meaning it cant conjugate bilirubin as efficiently meaning theres loads of unconjugated bilirubin
Hepatic jaundice could be caused byLiver disease caused by viral hepatitis or toxic causes e.g. Alcohol
Hep A is transmitted by Fecal oral transmission
Hep B is transmitted bySex
Hep C is transmitted by Blood
Only Hepatitis virus with no vaccine is Hep C
Cholestasis is a Blockage of bile flow as a result of liver damage
Posthepatic jaundice is caused by Obstructed bile flow e.g. gallstones or pancreatic cancer
2 types of gallstones;small ones from pigments like heme, or big fat ones made of fat
Pale faeces and dark wee is a symptom of Gallstones