Phys 71 Flashcards

Which is a principal function of the liver?

A. Filtration and storage of blood

B. Production of pulmonary surfactant

C. Filtration of cerebrospinal fluid

D. Storage of thyroid hormone

Which liver function involves processing hormones and foreign substances?

A. Bile storage

B. Hormone synthesis

C. Metabolism

D. Erythropoiesis

Which substance is formed by the liver for digestive purposes?

_____

The liver serves as an important storage site for which substances?

A. Vitamins and iron

B. Sodium and chloride

C. Calcium and potassium

D. Glucose and urea

Which hemostatic products are formed by the liver?

A. Platelets

B. Coagulation factors

C. Leukocytes

D. Antibodies

What is the basic functional unit of the liver?

A. Nephron

B. Acinus

C. Liver lobule

D. Alveolus

The classic liver lobule is constructed around what structure?

A. Portal vein

B. Bile duct

C. Hepatic artery

D. Central vein

Bile ducts are located primarily in what structures separating liver lobules?

A. Fibrous septa

B. Central veins

C. Sinusoids

D. Spaces of Disse

Fibrous septa separate what structures in the liver?

A. Hepatic arteries

B. Adjacent liver lobules

C. Central veins

D. Kupffer cells

Which two cell types line hepatic venous sinusoids?

A. Hepatocytes and stellate cells

B. Cholangiocytes and fibroblasts

C. Endothelial cells and Kupffer cells

D. Neutrophils and macrophages

What type of ordinary lining cell is found in hepatic sinusoids?

A. Squamous epithelial cells

B. Cuboidal cells

C. Columnar cells

D. Endothelial cells

Which specialized macrophage is found lining hepatic sinusoids?

A. Kupffer cell

B. Microglial cell

C. Osteoclast

D. Langerhans cell

What space lies between sinusoidal endothelial cells and hepatocytes?

A. Portal space

B. Space of Disse

C. Subarachnoid space

D. Bowman space

The majority of blood entering the liver arrives through which vessel?

A. Hepatic artery

B. Hepatic vein

C. Portal vein

D. Inferior vena cava

Compared with many vascular beds, resistance through normal hepatic sinusoids is what?

_______

What effect does cirrhosis have on hepatic vascular resistance?

A. Increases resistance

B. Decreases resistance

C. Eliminates resistance

D. Has no effect

An increase in hepatic vascular pressure can contribute to what accumulation?

A. Pleural effusion

B. Ascites

C. Pericardial tamponade

D. Pneumothorax

Which growth factor appears important in rapid liver regeneration?

A. EGF

B. TGF-beta

C. Hepatocyte growth factor

D. Insulin-like growth factor

Which factor is described as the main terminator of liver regeneration?

A. HGF

B. EGF

C. TGF-alpha

D. TGF-beta

Liver growth appears to be closely related to what?

A. Body size

B. Heart rate

C. Blood type

D. Lung capacity

Which hepatic cell is primarily responsible for cleansing blood passing through the liver?

A. Hepatocyte

B. Kupffer cell

C. Cholangiocyte

D. Stellate cell

Which carbohydrate is stored by the liver?

______

The liver converts galactose and fructose primarily into what?

______

Which process allows the liver to form glucose from noncarbohydrate precursors?

A. Gluconeogenesis

B. Glycolysis

C. Glycogenolysis

D. Beta-oxidation

Which is a function of the liver in carbohydrate metabolism?

A. Formation of intermediary carbohydrate products

B. Production of bile acids

C. Formation of hemoglobin

D. Production of ADH

What term describes the liver's ability to stabilize blood glucose levels?

A. Glycogen reserve function

B. Glucose buffer function

C. Insulin potentiation

D. Glucose filtration

Which process is an important hepatic function in fat metabolism?

A. Amino acid deamination

B. Urea excretion

C. Fatty acid oxidation

D. Bilirubin conjugation

The liver synthesizes which lipid-related molecules?

A. Cholesterol, phospholipids, and lipoproteins

B. Triglyceride, phospholipids, and lipoproteins

C. Ketones, phospholipids, and lipoproteins

D. Steroid hormones, phospholipids, and lipoproteins

The liver can synthesize fat from what?

A. Only dietary triglycerides

B. Other metabolic sources

C. Only ketone bodies

D. Only bile acids

Which pathway derives energy from fatty acids and occurs rapidly in hepatic cells?

A. Glycolysis

B. Gluconeogenesis

C. Beta-oxidation

D. Glycogenesis

Because the liver cannot use all of the acetyl-CoA it produces, some is converted into what?

A. Pyruvate

B. Lactate

C. Cholesterol

D. Acetoacetic acid

Most cholesterol produced by the liver is converted into what?

A. Bile salts

B. Glucose

C. Amino acids

D. Urea

Which is an important hepatic function in protein metabolism?

A. Fatty acid synthesis

B. Deamination of amino acids

C. Glucose filtration

D. Bile storage

The liver converts nitrogen from amino acid metabolism into what product?

A. Bilirubin

B. Creatinine

C. Urea

D. Glucose

Which circulating molecules are synthesized by the liver during protein metabolism?

A. Thyroid hormones

B. Red blood cells

C. Immunoglobulins

D. Plasma proteins

Which amino acid-related process is performed by the liver?

A. Interconversion of amino acids

B. Production of all essential amino acids

C. Storage of all amino acids indefinitely

D. Excretion of amino acids into bile

The liver can use amino acids to synthesize what?

A. Other compounds

B. Only glucose

C. Only ketones

D. Only bilirubin

Depletion of plasma proteins causes what response in the liver according to these notes?

A. Atrophy

B. Hypertrophy

C. Fibrosis immediately

D. Necrosis

Which vitamin is stored in the greatest quantity in the liver?

A. Vitamin C

B. Vitamin D

C. Vitamin A

D. Vitamin K

In what form is iron stored in the liver?

A. Hemosiderin

B. Transferrin

C. Hemoglobin

D. Ferritin

One major route for excreting calcium from the body involves secretion by the liver into what?

A. Bile

B. Urine

C. Sweat

D. Saliva

When hemoglobin is split, it forms which two components?

A. Iron and bilirubin

B. Heme and globin

C. Heme and albumin

D. Globin and ferritin

Which portion of hemoglobin ultimately contributes to bilirubin formation?

A. Globin amino acids

B. Plasma proteins

C. Pyrrole nuclei from heme

D. Ferritin stores

How many pyrrole nuclei are present in the heme structure that gives rise to bilirubin?

A. One

B. Two

C. Three

D. Four

What is the first substance formed in the bilirubin pathway?

A. Biliverdin

B. Conjugated bilirubin

C. Urobilinogen

D. Stercobilin

Biliverdin is rapidly converted into what?

A. Conjugated bilirubin

B. Unconjugated bilirubin

C. Urobilin

D. Heme

What chemical process converts biliverdin into unconjugated bilirubin?

A. Oxidation

B. Conjugation

C. Reduction

D. Hydrolysis

Which sequence correctly describes early bilirubin formation?

A. Bilirubin → biliverdin → heme

B. Globin → biliverdin → bilirubin

C. Heme → conjugated bilirubin → biliverdin

D. Heme-derived pyrroles → biliverdin → unconjugated bilirubin

A patient with cirrhosis develops increased resistance to blood flow through what structures?

A. Hepatic sinusoids

B. Bile canaliculi

C. Spaces of Disse

D. Gallbladder ducts

Increased sinusoidal resistance in cirrhosis can ultimately contribute to what physical finding?

A. Pulmonary edema

B. Ascites

C. Pneumothorax

D. Hemarthrosis

Which combination consists entirely of hepatic carbohydrate functions?

A. Glycogen storage, gluconeogenesis, fructose-to-glucose conversion

B. Beta-oxidation, ketogenesis, bile formation

C. Urea formation, deamination, plasma protein synthesis

D. Ferritin storage, bile salt synthesis, coagulation factor formation

Which combination consists entirely of hepatic fat-metabolism functions?

A. Gluconeogenesis, glycogen storage, urea synthesis

B. Fatty acid oxidation, cholesterol synthesis, lipoprotein synthesis

C. Deamination, plasma protein synthesis, bilirubin formation

D. Iron storage, bile production, glucose buffering

Which combination consists entirely of hepatic protein-metabolism functions?

A. Beta-oxidation, ketogenesis, lipoprotein synthesis

B. Glycogen storage, gluconeogenesis, glucose buffering

C. Deamination, urea formation, plasma protein formation

D. Bile formation, ferritin storage, calcium excretion

Unconjugated bilirubin binds to which plasma protein for transport?

A. Transferrin

B. Albumin

C. Fibrinogen

D. Globulin

Why does unconjugated bilirubin bind albumin in plasma?

A. To undergo oxidation

B. To be transported

C. To form stercobilin

D. To enter urine

Unconjugated bilirubin is conjugated primarily with what substance?

A. Sulfuric acid

B. Acetic acid

C. Glucuronic acid

D. Lactic acid

Approximately what percentage of unconjugated bilirubin is conjugated with glucuronic acid according to these notes?

A. 20%

B. 40%

C. 60%

D. 80%

Which enzyme converts heme to biliverdin?

A. Heme oxygenase

B. Biliverdin reductase

C. Glucuronyl transferase

D. Urobilin oxidase

Heme oxygenase catalyzes conversion of heme into what?

A. Bilirubin

B. Biliverdin

C. Urobilin

D. Stercobilin

In the intestine, bilirubin is converted into what?

A. Biliverdin

B. Stercobilin

C. Urobilinogen

D. Urobilin

What mediates conversion of bilirubin to urobilinogen in the intestine?

A. Hepatocytes

B. Pancreatic enzymes

C. Bile salts

D. Intestinal bacteria

In the feces, urobilinogen is converted into what pigment?

A. Stercobilin

B. Bilirubin

C. Urobilin

D. Biliverdin

What process converts fecal urobilinogen into stercobilin?

A. Reduction

B. Oxidation

C. Conjugation

D. Hydrolysis

Stercobilin is formed primarily in what location?

A. Urine

B. Plasma

C. Feces

D. Liver

Which pigment is formed from urinary urobilinogen after exposure to air?

A. Urobilin

B. Stercobilin

C. Biliverdin

D. Heme

Jaundice is caused by excess accumulation of what substance?

A. Cholesterol

B. Bilirubin

C. Albumin

D. Ferritin

Excess bilirubin causing jaundice accumulates primarily in what compartment?

A. Intracellular fluid

B. Plasma only

C. Extracellular fluid

D. Cerebrospinal fluid

Which process can cause jaundice by increasing bilirubin production?

A. Decreased bile formation

B. Reduced cholesterol synthesis

C. Increased albumin production

D. Destruction of red blood cells

Which mechanical problem can cause jaundice?

A. Obstruction of bile ducts

B. Ureteral obstruction

C. Intestinal obstruction

D. Bronchial obstruction

Which hepatic problem can cause jaundice?

A. Increased glycogen storage

B. Damage to liver cells

C. Increased albumin synthesis

D. Increased bile flow

Bile duct obstruction most strongly increases which bilirubin fraction?

A. Conjugated bilirubin

B. Unconjugated bilirubin

C. Biliverdin

D. Urobilin

In hemolytic jaundice, which form of bilirubin predominates?

A. Conjugated bilirubin

B. Unconjugated bilirubin

C. Urobilin

D. Stercobilin

Which test can help distinguish obstructive from hemolytic jaundice?

A. Coombs test

B. Schilling test

C. Benedict test

D. Van den Bergh reaction

The van den Bergh reaction is used to differentiate which conditions?

A. Obstructive and hemolytic jaundice

B. Diabetes mellitus and diabetes insipidus

C. Hepatitis and pancreatitis

D. Nephrotic and nephritic syndromes

In complete obstructive jaundice, urinary urobilinogen is expected to be what?

A. Strongly positive

B. Negative

C. Mildly elevated

D. Unchanged

Why is urinary urobilinogen absent in total obstructive jaundice according to these notes?

A. RBC destruction stops

B. Bilirubin cannot reach the intestine

C. Albumin production increases

D. Biliverdin cannot form

Which sequence correctly describes bilirubin metabolism in the intestine?

A. Bilirubin → stercobilin → urobilinogen

B. Biliverdin → urobilin → bilirubin

C. Bilirubin → urobilinogen → stercobilin

D. Urobilin → bilirubin → biliverdin

Which sequence correctly describes urinary pigment formation?

A. Bilirubin → stercobilin

B. Biliverdin → albumin

C. Heme → urobilin

D. Urobilinogen → urobilin

Which sequence correctly describes the early heme degradation pathway?

A. Heme → biliverdin → bilirubin

B. Heme → urobilin → bilirubin

C. Bilirubin → heme → biliverdin

D. Heme → stercobilin → bilirubin

A patient with bile duct obstruction would most likely have an increase in which bilirubin type?

A. Unconjugated

B. Conjugated

C. Biliverdin

D. Urobilin

A patient with extensive hemolysis would most likely have an increase in which bilirubin type?

A. Conjugated

B. Stercobilin

C. Unconjugated

D. Urobilin