Gi Block Two Day 1

Front 1

Contain large lipid droplets and are the major storage site for Vit A; found in space of disse

Back 1

Stellate cells

Front 2

Livers main exocrine function?

Back 2

Secrete bile

Front 3

Portal triad?

Back 3

Hepatic artery, portal vein, bile duct

Front 4

Outline the path of bile in the liver

Back 4

Bile canaliculi (canals of Herin)-->bile ductulestrabecular ducts-->R/L hepatic ducts-->common hepatic duct-->cystic duct or common bile duct-->Gallbladder or duodenum

Front 5

Classic Lobule

Back 5

Single hexagonal block with central vein and portal triads at all 6 corners

Front 6

Liver Acinus

Back 6

2 adjacent classic lobules, w/ the distance b/n central veins (long axis), and the distance b/n portal triads (short axis). This correlates with blood flow, and is broken into 3 zones.

Front 7

What zone is most susceptible to metabolic toxins?

Back 7

Zone 3 b/c it contains P450s

Front 8

What are the surfaces of the hepatocytes?

Back 8

1) Basal: to perisinusoidal space (blood exhchange)
2) Lateral: hepatocyte to hepatocyte
3) Apical: to bile canaliculus"

SIX sides; two of each

Front 9

Oval cells

Back 9

bipotential "stem cells" in biliary epithelium which can form hepatocytes or biliary epithelium during chronic liver damage

Front 10

CCK induce in pancreas?

Back 10

Acinar Cells-->Secrete zymogen granules

Front 11

Secretin induce in pancreas?

Back 11

Centroacinar cells-->secrete alkaline fluid

Front 12

Hepatocytes are rich in ?

Back 12

rER, mitochondria, glycogen granules, and lipid droplets

Front 13

Derivates of monocytes and are involved in the breakdown of senile RBC

Back 13

Kupffer cells

Front 14

Where exchange of substance between blood and hepatocytes

Back 14

Space of Disse

Front 15

If a lobectomy is performed...

Back 15

the remaining lobe will proliferate

Front 16

Bile canaliculi contain?

Back 16

ATPases; suggests that bile secretion is an active process

Front 17

What divides R from L in the liver?

Back 17

Falciform ligament

Front 18

What parts of the liver are donated to an adult

Back 18

Right side (5-8); supplied by right hepatic vein

Left (2,3 not 4) for a peds patient

Front 19

What does the gallbladder directly absorb?

Back 19

H20, Na, Cl, and bicarb

Front 20

Bile acids are reabsorbed where?

Back 20

Mostly in the TI

Front 21

What activates trypsininogen

Back 21

Enterokinase and trypsin; trypsin then activates Chymotrpsin and carboxypeptidase (which make single AA)

Front 22

What type of collagen in reticular fibers of the liver?

Back 22

Type 3

Front 23

What type of epithelium are bile ductules

Back 23

Simple CUBOIDAL

Front 24

What type of epithelium is the gall bladder?

Back 24

Simple COLUMNAR

Front 25

Liver cells plates function?

Back 25

Make bile and drain in the opposite direction

Front 26

Bile salt function?

Back 26

Emulsificationdecreases surface tension and breaks fat globules into smaller size particles; Forms Micelles and helps absorption of fat breakdown products by helping fats remain soluble in an aqueous envirionment (fatty acids, monoglycerides, and cholesterol need to be removed after digestion by micelles)

Front 27

Pancreatic amylase

Back 27

Major amylase that breaks down the starches
Maltose---maltase-->Glucose

Front 28

Lipase

Back 28

Digest Triglycerides

Front 29

bilirubin is kept in solution through interactions with these cytosolic proteins?

Back 29

Ligandins

Front 30

Enzyme that conjugates Bilirubin in the liver?

Back 30

uridine diphosphate glucuronosyltransferase: UGT1A1

Front 31

MOAT (multiorganic anion transporter)

Back 31

In canalicular membranes and is involved in bilirubin excretion

Front 32

The GI tract/BACTERIA converts conjugated bilirubin to

Back 32

Urobilinogen (makes stools brown)

Front 33

What does the kidney convert urobilinogen to?

Back 33

Urobilin;makes urine yellow

Front 34

How are bile acids formed?

Back 34

In liver, cholesterol (7a-hydroxylase)-->bile acids-cholic acid and chenodeoxycholic acid (unique hydroxyl group at position 7) secreted into bile canaliculi, which are specialized channels formed by adjacent hepatocytes

Front 35

Primary bile acids are converted to secondary bile acids by?

Back 35

bacteria in the gut via dehydroxylation rxns (Deoxycholic acid and lithocholic acid)

Front 36

bile acids are reabsorbed in the TI into portal blood and taken up by hepatocytes then?

Back 36

conjugated to glycine or taurine, forming bile salts (lowers the pK and makes them more soluble in the small intestine)

Front 37

Familial Hypercholesterolemia Mutation?

Back 37

Mutation in the gene encoding the LDL receptor
Autosomal dominant with a gene dosage effect

Front 38

Function of the LDL receptor

Back 38

limits LDL production by removing precursor IDL (B-100, apo E-->higher affinity for LDL receptor) from the circulation; LDL receptor enhances LDL degredation by mediating cellular uptake of LDL

Front 39

Treatment for FH

Back 39

Bile acid binding resins (cholestyramine and colestipol): bind bile acids in the lumen preventing reabsorption; therefore more cholesterol is used to make bile acids, the decreased Cholesterol-->increased LDL receptors-->decreased LDL cholesterol (10-20%)
and
HMG--CoA reductase, and diet

Front 40

List the types of unconjugated Hyperbilirubinemia

Back 40

Neonatal Jaundice, Crigler-Najjar types 1 and 2, Gilbert syndrome, Hemolytic, Hepatocellular damage

Front 41

List the types of Conjugated jaundice Hyperbilirubinemia

Back 41

Inability of hepatocytes to secrete conjugated bilirubin into the bile canaliculi
Dubin-Johnson and Rotor Syndrome
Obstruction of the bile ducts

Front 42

List the reasons for Neonatal Jaundice

Back 42

Low activity of UGT1A, Decrease excretory capacity of hepatocytes, Increased bilirubin production 2ndary to accelerated destruction of fetal erythrocytes

Front 43

Treatment for Neonatal Jaundice

Back 43

Phototherapy (430-490 nm); bilirubin can be excreted in bile without conjugation

Front 44

Cirrhosis on histo?

Back 44

Nodules of hepatic parenchyma surrounded by fibrous bands containing lymphocytes and neutrophils

Front 45

What are the fat soluble vitamins?

Back 45

D, E, A, K; bile acids facilitate absorption of these vitamins