Term
| What is the end product of heme degradation? |
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Definition
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Term
| What does give doo-doo its brown color (& urine its yellow color)? |
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Definition
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Term
| Describe the pathway that hemoglobin takes to become urobilirubin and eventually excreted through your no-no parts. |
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Definition
1) Via the phagocytic reticuloendothelial system, heme is separated from hemoglobin and oxidized into biliverdin
2) Biliverdin is converted to unconjugated bilirubin
3) unconjugated bilirubin enters the bloodstream and binds w/ albumin
4) Albumin transports the unconjugated bilirubin to the liver where it i conjugated, converted to a water-soluble substance, and released in the bile
5) The bile enters the GI tract where bacteria converts the conjugated bilirubin into urobilirubin
6) Urobilirubin is primarily excreted in the stool while some enters the blood and gets filtered in the urine
7) now you know... |
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Term
| What can happen to free hemoglobin if it is not degraded into bilirubin? |
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Definition
| Free hemoglobin can be bound to heptaglobin, a protein that brings it to the liver to be processed and help conserve iron |
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Term
| What is the serum 1/2 life of albumin? |
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Definition
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Term
| Why aren't albumin levels a good indicator of acute liver failure? |
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Definition
| b/c of their prolonged half-life (20 days). Your liver would be toast if you waited for albumin levels to drop. |
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Term
T or F:
Your liver produces most proteins with the exception of immunoglobulins |
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Definition
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Term
| Name 4 metabolic functions of the liver |
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Definition
| Carbohydrate, amino acid, and lipid metabolisms & the synthesis of proteins (albumin). |
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Term
| What are the reticuloendothelial system cells called in your liver? Your skin? |
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Definition
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Term
| What type of reactions happen in Phase I? |
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Definition
| oxidation, reduction, hydrolysis |
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Term
| Where do most Phase I reactions occur? |
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Definition
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Term
| What type of reaction is most common in Phase II? |
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Definition
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Term
T or F:
Phase II reactions decrease the water solubility of drug byproducts |
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Definition
False.
Phase II reactions enhance the water solubility of drug byproducts |
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Term
| At what age do all biotransformation reactions become mature? |
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Definition
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Term
| Why do babies get jaundiced? |
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Definition
Conjugation reactions are not fully functional (except sulfonation). They cannot conjugate (through glucuronidation) bilirubin.
*cytochrome P450 is mature, though |
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Term
| Why should we be cautious giving neonates morphine? |
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Definition
| Both their hepatic conjugation and renal clearance of MSO4 metabolites is reduced = prone to adverse side effects of morphine (resp. depression, apnea) |
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Term
| What test can determine overall hepatic function? |
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Definition
None, fool!
LFTs, ASTs, and ALTs can't assess function but just the presence of liver cell injury or dysfunction |
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Term
| Why is it hard to determine liver function through lab values? |
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Definition
| The liver has a large reserve (~500ml) so there might not be a change in lab values. |
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Term
| _________ and _________ are sensitive indicators of severe hepatic dysfuction (acute & chronic) because of the short half-life of ________ |
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Definition
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Term
| What procedure is used for stone removal, biopsy, baloon dilation, and stent insertion to relieve obstructions? |
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Definition
endoscopic retrograde cholangiopancreatography (ERCP)
- uses endoscopy to visualize ampulla of Vater |
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