Physio Exam 3 Lec 6

Front 1

Bile primary functions

Back 1

Promotion of the digestion and absorption of dietary lipid and cholesterol.

Elimination of waste products

Front 2

Compounds are processed by hepatocytes in 4 steps:

Back 2

1)uptake across the sinusoidal basolateral membrane
2)Intracelllular transport
3)chemical modification
4)export across the canalicular (apical) membrane

Front 3

what are the only compounds capable of reaching the space of disse?

Back 3

nutrients

Front 4

Bile composition

Back 4

Secretory constituents
excretory constituents
obligatory constituents
housekeeper constituents

Front 5

Secretory constituents

Back 5

Bile
Glutathione (antioxidant)

Front 6

Excretory constituents

Back 6

Cholesterol
Bilirubin
Iron, Copper
Lipophilic drugs

Front 7

Obligatory constituents

Back 7

Organic acids
Electrolytes.
These two maintain bile functionality

Front 8

Housekeeper constituents

Back 8

Phospholipids
Mucus
H
HCO3
Immunoglobins

Front 9

Which solutes are actively secreted in bile

Back 9

Bile acids
Phosphotidylcholine
conjugated bilirubin
Xenobiotics

Front 10

Which solutes are passively permeated (paracellularly) in bile

Back 10

Water
Glucose
Calcium
Glutathione
AA
Urea

Front 11

Rate limiting enzyme of bile synthesis is

Back 11

7a-hydroxylase (CYP7A1)

Front 12

Bile is conjugated to

Back 12

taurine or glycine, otherwise bile would precipitate

Front 13

Bile acids are secreted by

Back 13

hepatocytes into bile

Front 14

Bile is reabsorbed from

Back 14

intestine to return back to the liver

Front 15

bile is essential for

Back 15

dietary fat and cholesterol absorption

Front 16

Non-conjugated bile acids precipitate in

Back 16

high acidity (high pKa)

Front 17

Conjugated bile acids' solubility increases in

Back 17

acidic environment (low pKa)

Front 18

Primary bile acids are formed in

Back 18

the liver; cholic acid and chenodeoxycholic acid

Front 19

Secondary bile acids formed in

Back 19

the intestine by the enteric bacteria (microflora)

Front 20

In general, liver makes bile___ and intestine makes it

Back 20

more soluble
less soluble

Front 21

when is bile better to absorb fat?

Back 21

when it's more hydrophobic

Front 22

Highly hydrophobic acids have been implicated in the promotion of

Back 22

colon cancer

Front 23

increase in the hydrophobicity of bile acids in the intestinal lumen is associated with

Back 23

an increase in cholesterol absorption

Front 24

why is bile a good detergent?

Back 24

all the hydroxyl groups clustered in one place, thats why they're good detergents

Front 25

Bile acids function in whole organism

Back 25

1- Elimination of cholesterol

Front 26

function of bile in hepatocytes

Back 26

1) Induction of bile flow and biliary lipid secretion
2) regulation of gene expression

Front 27

Function of bile in biliary tract

Back 27

1-Solubilization of cholesterol
2-stimulation of HCO3 secretion

Front 28

Function of bile in small intestine

Back 28

1-Solubilization of dietary lipids and fat
soluble vitamins
2- Stimulation of secretion antimicrobial factors

Front 29

Function of bile in large intestine

Back 29

1- Modulation of electrolyte absorption
and secretion
2- Stimulation of propulsive motility

Front 30

Bile gut coming back from gut gets back through

Back 30

NTCP (Na+ dependent taurocholic cotransport polypeptide), conjugated or nonconjugated

Front 31

Some nonconjugated biles can be protonated and diffuse across

Back 31

the membrane passively

Front 32

OATP (Organic Anion Transporting Polypeptide) mediates

Back 32

transport of biles into hepatocytes, but NTCP is the main transport

Front 33

BSEP (Bile Salt export pump) job is to

Back 33

take bile to canaliculi and it uses ATP

Front 34

Some Bile acids are sulfated and later

Back 34

secreted into canaliculi by MRP2

Front 35

If absorption of Bile by intestine is inhibited then

Back 35

cholesterol can be stimulated to be degraded even more. Hypercholesteremia can be treated by inhibiting the reabsorption of bile in the gut

Front 36

Bile Ileal Absorption is via

Back 36

Apical Sodium Depedent Bile Acid Transporter (ASBT). Once inside cell bile is bound to Ileal Bile Acid Binding Protein (IBABP). Bile is transported to circulation via Organic Solute Transporter (Ost-a/b)

Front 37

Biliary tract functions

Back 37

Transfers bile to the intestinal lumen
Provides osmotic equilibration for bile
Secretes bicarbonate
Secretes IgA
Secretion of mucus

Front 38

BBiliary tract provides osmotic equilibration by

Back 38

Free permeability to H2O
Limited permeability to ions

Front 39

Canaliculus function

Back 39

Bile formation (Hepatocyte)

Front 40

Sphincter of Oddi function

Back 40

Regulated delivery of bile to duodenum. Prevention of reflux

Front 41

Main process in gallbladder is

Back 41

Isotonic absorption of NaCl. So it concetrates bile by actively removing NaCl and hence water

Front 42

Cholangiocytes main job

Back 42

Bicarbonate secretion--similar to ductule cells

Front 43

Bile acid secretion increases mainly by

Back 43

Canalicular bile secretion and not ductular secretion

Front 44

Secretin increases bile flow at the ductules due to

Back 44

bicarbonate

Front 45

what dissolves cholesterol to be added into the bile

Back 45

Bile acids and phospholipids

Front 46

Cholesterol is taken back to the liver by

Back 46

LDL

Front 47

Cholesterol brough via LDL is pumped into canaliculi through

Back 47

BSEP

Front 48

Cholesterol brought via HDL is pumped into canaliculi through

Back 48

abc 5/8

Front 49

Bilirubin is synthesized from

Back 49

the metabolism of hemoglobin

Front 50

Bilirubin enters hepatocytes and gets conjugated and gets added into bile

Back 50

by MRP2

Front 51

In the intestine, bacteria will unconjugate bilirubin and it will convert it into

Back 51

urobilinogen

Front 52

what happens to urobilinogen?

Back 52

Some of this will reach kidney and get excreted, and some will be taken by the liver and conjugated again. Some bilirubin gets excreted in the feces, gives feces its color.

Front 53

If more cholesterol than bile can solubilize, than the solution will be

Back 53

precipitated into a crystal like structure=cholesterol gallstone

Front 54

Retention of Bile acids leads to

Back 54

Hepatocyte injury

Front 55

Retention of bilirubin leads to

Back 55

Jaundice

Front 56

retention of cholesterol leads to

Back 56

Xanthomata

Front 57

Defective micellar solubilization of lipid leads to

Back 57

Malabsorption of cholesterol especifically.TGA and fat soluble vits

Front 58

Hepatocanilicular cholestasis

Back 58

vIRA-Alcoholic liver, estrogens/anabolic stool. congenital

Front 59

Interlobular bile ducts cholestasis

Back 59

Drugs, primary biliary cirrhosis, hepatic rejection

Front 60

Extrahepatic bile ducts

Back 60

Cancer, Stones, sclerosing cholangititis

Front 61

Obstruction of bile flow leasa ro less bile acids in the intestinal lumen and

Back 61

Impairment of fat absorption and bacterial overgrowth

Front 62

Bile acid malabsorption in diseased ileum (surgical resection, chrons, radiation ileitis)

Back 62

Reduces intestinal absorption
Increases colonic [bile acid] leading to diarrhea

Front 63

Decreased micellar leads to

Back 63

fat soluble vits deficiency

Front 64

Decreased fat uptake leads to

Back 64

cALORIE Deficiency

Front 65

Diarrhea results from

Back 65

Decreased micellar->decreased fat uptake->increased passage of fat into colon (bacterial lipases)->increased [fatt acid]->increased water secretion

Front 66

Steatorrhea results from

Back 66

Decreased micellar->decreased fat uptake->increased passage of fat into colon (bacterial lipases)