front 1 liver | back 1 largest solid internal organ; RUQ; 2.5% of body weight and approximately 25% of cardiac output |
front 2 hepatocytes, sinusoidal endothelial cells, Kupffer cells, hepatic stellate cells, cholangiocytes | back 2 major cell types of the liver |
front 3 glucose regulation, protein synthesis, immune surveillance, drug and toxin metabolism, hormone regulation, bile acid synthesis and secretion | back 3 key functions of the liver |
front 4 hepatic artery | back 4 25% oxygen rich |
front 5 portal vein | back 5 75% nutrient rich, oxygen poor |
front 6 portal | back 6 gateway between intestine and systemic blood |
front 7 space of disse | back 7 contains stellate cells and lymph drainage |
front 8 hepatic artery and portal vein -> sinusoids -> central vein -> hepatic veins -> inferior vena cava | back 8 hepatic blood flow pathway |
front 9 basolateral surface | back 9 faces sinusoids/blood |
front 10 apical surface | back 10 faces bile canaliculi |
front 11 tight junctions | back 11 prevents bile leakage |
front 12 smooth ER | back 12 detoxification and metabolism |
front 13 rough ER | back 13 protein synthesis |
front 14 mitochondria | back 14 high ATP demand |
front 15 stored glycogen, iron, B12, and lipids | back 15 additional functions of the liver |
front 16 Kupffer cells | back 16 resident macrophages |
front 17 stellate cells | back 17 quiescent vitamin A storage; activated after injury, deposit collagen, fibrosis/cirrhosis |
front 18 glycogenesis | back 18 stores glucose as glycogen |
front 19 glycogenolysis | back 19 releases glucose during fasting |
front 20 gluconeogenesis | back 20 synthesize glucose from amino acids and other precursors |
front 21 lipids | back 21 convert excess glucose -> triglycerides -> VLDL; produce cholesterol, uptake of LDL, synthesis of HDL |
front 22 cholesterol | back 22 produced for membranes, hormones, vitamins, and bile acids |
front 23 HDL | back 23 synthesized for reverse cholesterol transport |
front 24 amino acids | back 24 metabolized for gluconeogenesis substrate supply; synthesize proteins, breakdown plasma and metabolic proteins |
front 25 plasma proteins (albumin), coagulation factors, complement proteins, carrier proteins, antioxidants and regulatory proteins, thrombopoietin | back 25 major hepatic protein products |
front 26 water, bile salts, phospholipids, bilirubin, excreted toxins | back 26 what makes up bile composition |
front 27 hepatocytes | back 27 location for bile synthesis |
front 28 cystic duct of gallbladder | back 28 storage of bile |
front 29 toxic ammonia -> water soluble urea | back 29 ammonia detoxification process |
front 30 hepatic encephalopathy | back 30 result of hyperammonemia |
front 31 lactulose | back 31 reduces pH and ammonia absorption, increases stool nitrogen excretion |
front 32 reduce neurotoxicity | back 32 goal of managing hyperammonemia |
front 33 heme -> biliverdin -> UBil + albumin -> liver -> conjugated with glucuronide -> excreted in bile | back 33 bilirubin metabolism |
front 34 albumin | back 34 bound to UBili to transport to liver |
front 35 glucuronide | back 35 essential for conjugation and excretion of bili |
front 36 urobilinogen | back 36 gives stool its brown color |
front 37 hemolysis | back 37 increased unconjugated bilirubin cause |
front 38 bile duct obstruction | back 38 increased conjugated bilirubin cause |
front 39 liver failure | back 39 increased conjugated and unconjugated bilirubin cause |
front 40 cytochrome P450 | back 40 phase 1 drug metabolism enzyme |
front 41 phase 1 drug metabolism | back 41 oxidation reduction and hydrolysis; may activate prodrugs or create toxic metabolites |
front 42 phase 2 drug metabolism | back 42 conjugation with glucuronic acid, sulfate, acetyl groups; increases water solubility (renal excretion); detoxification of previous intermediates |
front 43 polymorphisms | back 43 fast vs slow metabolizers |
front 44 enzyme induction vs inhibition | back 44 factors of major drug to drug interactions |
front 45 first pass effect | back 45 oral drug metabolizers before systemic circulation; reduce bioavailability |
front 46 sublingual, IV, and transdermal | back 46 which drugs bypass the liver |