Term
| What detoxifies xenobiotics in the liver? |
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Definition
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Term
| The liver plays a role in the metabolism of what dietary substances? |
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Definition
| Carbohydrates, lipids, proteins |
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Term
| Increased bilirubin in plasma implies what impaired liver function? |
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Definition
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Term
Decreased glucose in plasma implies what impaired liver function?
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Definition
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Term
Decreased albumin and increased prothrombin time in plasma implies what impaired liver function?
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Definition
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Term
Increased ammonia and decreased urea in plasma implies what impaired liver function?
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Definition
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Term
Increased cholesterol and triglycerides in plasma implies what impaired liver function?
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Definition
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Term
Increased level of bile acids in plasma implies what impaired liver function?
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Definition
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Term
| What proteins are exclusively processed or synthesized in the liver? |
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Definition
| Albumin, Coagulation factors II, VII, IX, and X, most plasma Alpha and Beta globins |
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Term
| How are functional concentrations of coagulation factors II VII, IX, and X assessed? |
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Definition
| Measuring Prothrombin Time |
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Term
| What does the liver synthesize in response to infection or inflammation? |
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Definition
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Term
| Inflammation or infective insult increase the releae of acute phase proteins by how much? |
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Definition
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Term
| What are cytokines released by? |
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Definition
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Term
| What are the effects of cytokines? |
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Definition
| Stimulates synthesis of acute phase proteins |
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Term
| What pro-inflmammatory cytokines are released by macrophages in order to stimulate acute phase proteins? |
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Definition
| Interleukin-1, Interleukin-6, Tumor Necrosis Factor |
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Term
| Where are the amino acids necessary for the synthesis of acute phase proteins acquired? |
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Definition
| Proteolysis of Skeletal Muscle |
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Term
| What acute phase proteins are synthesized by the liver? |
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Definition
| Opsonins, Complement Factors, TNF, IL-1 |
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Term
| What is the function of C-reactive proteins? |
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Definition
| Induces phagocytosis of macromolecules released by damaged tissues or infective agents |
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Term
| What are the effects of complement factors? |
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Definition
| Induces lysis and phagocytosis of foreign molecules |
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Term
| How is the immune response of complement factors categorized? |
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Definition
| Nonspecific Immune Response |
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Term
| What are the effects of Tumor Necrosis Factor and Interleukin-1 |
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Definition
| Stimulation of breakdown of specific intracellular proteins by the ubiquitin-proteosome mechanism |
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Term
| What is the function of protease inhibtors? |
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Definition
| Inhibits proteolytic enzymes, promotes fibroblast growth, production of connective tissue |
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Term
| What acute phase proteins are protease inhibitors? |
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Definition
| Alpha1-Antitrypsin and Alpha1-Antichymotrypsin |
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Term
| Measurement of acute phase proteins is used to monitor what? |
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Definition
| Disease progress and response to treatment |
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Term
| What is the primary target of Protease Inhibitor Alpha1-Trypsin? |
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Definition
| Macrophage Derived Elastase |
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Term
| How are genetic deficiencies of Alpha1-Antitrypson manifested? |
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Definition
| Liver disease in infants, Lung Disease in adults |
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Term
| What is the direct effect of low concentration of Alpha1-Antitrypsin? |
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Definition
| Elastase causes tissue destruction |
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Term
| What is the function of Ceruloplasmin? |
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Definition
| Carries copper protein for the liver and plasma |
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Term
| What is the function of Ferroxidase? |
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Definition
| Enzyme necessary for iron storage |
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|
Term
| What is the clinical result of ceruloplasmin deficiency? |
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Definition
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Term
| What genetic disease manifests as ceruloplasmin deficiency and liver/CNS damage? |
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Definition
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Term
| In the fetus, what protein serves similar functions as albumin in the adult? |
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Definition
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Term
| How long does it take for alpha-fetoprotein to be replaced with albumin? |
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Definition
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Term
| What diseases may also lead to elevated serum Alpha-fetoprotein levels? |
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Definition
| Hepatocellular, Ovarian/Testicular, Presacral Carcinomas, Germ Cell Cancer |
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Term
| What is the main purpose of the urea cycle in the liver? |
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Definition
| Conversion of NH3 to Urea |
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Term
| What happens to xenobiotics that are processed by the liver? |
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Definition
| May lose therapeutic effect, may acquire an active form |
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Term
| What is an example of a xeniobiotc that is activated to a carcinogenic forms in the liver? |
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Definition
| Polycyclic Aromatic Hydrocarbons (cigarette smoke, some sauces) |
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Term
| What is the first phase of drug metabolism in the liver? |
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Definition
| Oxidation of Cyt P450 in the presence of NADPH |
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Term
What is the second phase of drug metabolism in the liver?
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|
Definition
| Conjugation to a more soluble compound (ex. glutathione, glucuronic acid) for excretion in blood or bile |
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|
Term
| What are the enzymes used in phase 2 of drug metabolism? |
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Definition
| Glucuronyl Transferases and Glutathione S-transferases |
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|
Term
| What induces Phase II liver enzymes? |
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Definition
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|
Term
| What over-the-counter household drug used as pain medication is an example of a drug that can be hepatotoxic in high doses? |
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Definition
|
|
Term
| What step in drug metabolism is overwhelmed in cases of hepatotoxicity? |
|
Definition
| Conjugation to glucuronic acid and glutathione in Phase 2 |
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|
Term
| What is excess glucuronic acid and glutathione oxidized to by cyt P450? |
|
Definition
| N-acetyl benzoquinoneimine (aka NAPQI or NABQI) |
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|
Term
| What effect does N-acetyl benzoquinoneimine have? |
|
Definition
| Free-Radical-Mediated Peroxidation of Membrane Fats leading to Hepatocellular Damage |
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|
Term
| What is the antidote for NAPQI-induced acetiminophen hepatotoxicity? |
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Definition
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|
Term
| In what time frame is N-acetyle cysteine most effective in countering acetiminophen overdose? |
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Definition
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|
Term
| N-acetyl cysteine stimulates the production of what in acetaminiophen detoxification? |
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Definition
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|
Term
| Benzoate and Slicylate are metabolized to what by liver detoxification? |
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Definition
|
|
Term
| What is the definition of alcoholism? |
|
Definition
| Consumption of alcohol to the point where normal social, sexual, or vocational functioning is significantly impaired |
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Term
| What is the most common cause of liver disease in western society? |
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Definition
|
|
Term
| What are examples of liver damage that can be caused by alcohol? |
|
Definition
| Alcoholic hepatitis, Steatosis (fat deposits), Cirrhosis (liver failure) |
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Term
| The liver is the major site of oxidative breakdown of alcohol into what? |
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Definition
| Acetaldehyde and Acetic Acid (acetate) |
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|
Term
| What catalyzes the synthesis of acetaldehyde from ethanol? |
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Definition
|
|
Term
| What reaction catalyzes the synthesis of acetate from acetaldehyde? |
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Definition
| Acetaldehyde Dehydrogenase |
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|
Term
| What cofactor is required for both steps of ethanol metabolism? |
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Definition
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|
Term
| What is the most sensitive enzyme indicator of damage to the liver from alcohol? |
|
Definition
| Gamma-Glutamyl-Transferase (GGT) |
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|
Term
| Males who carry 2 genes for the slower form of alcohol dehydrogenase exhibit what? |
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Definition
| 30% reduction in heart attack risk compared to fast metabolizers |
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|
Term
| Higher levels of HDL can be seen in men who carry 2 genes associated with what step in ethanol metabolism? |
|
Definition
| Slower form of alcohol dehydrogenase |
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|
Term
| Acetaldehyde dehydrogenase inactivity is common among what demographic? |
|
Definition
|
|
Term
| What is a long term inhibitor of acetaldehyde dehydrogenase? |
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Definition
|
|
Term
| What is the minor pathway (10-15%) of alcohol metabolism used in cases of chronic intake of high doses of alcohol? |
|
Definition
| Microsomal Ethanol Oxidizing System (MEOS) |
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|
Term
| What cytochrome is found in MEOS? |
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Definition
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|
Term
| What organelle carries out MEOS? |
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Definition
|
|
Term
| How does MEOS compare directly with the actions of alcohol dehydrogenase? |
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Definition
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|
Term
| Alcohol abuse results in the accumulation of what substances? |
|
Definition
|
|
Term
| Inhibition of Pyruvate synthesis due to NADH accumulation leads to what? |
|
Definition
| Lactic acidosis, hypoglycemia, hepatic steatosis |
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|
Term
| What are the consequences of high levels of NADH? |
|
Definition
| Inhibition of pyruvate synthesis and beta-oxidation, promotion of FA synthesis (high VLDLs) |
|
|
Term
| By what mechanism does alcohol abuse inhibit pyruvate synthesis? |
|
Definition
| Inhibition of pyruvate carboxylase |
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|
Term
By what mechanism does alcohol abuse lead to hypoglycemia?
|
|
Definition
| High NADH reverses malate dehydrogenase, depleting OAA for gluconeogensis |
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|
Term
| Gouty attacks often follow nights of heavy drinking due to what? |
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Definition
| Lactic acid competes with uric acid for excretion, catabolism of NADH produces uric acid |
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|
Term
| What can lead to inhibition of MEOS? |
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Definition
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|
Term
| Increased activity of cyt P450 hydroxylase system in response to chronic alcohol intake can lead to what? |
|
Definition
| Increased detoxification of hydrocarbon drugs, activation of carcinogens, degradation of steroid hormones |
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|
Term
| How can chronic alcohol consumption lead to sterility or feminization? |
|
Definition
| Increased degradation of steroid hormones due to increase cyt P450 activity |
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|
Term
| A sober alcoholic in insensitive to what drugs? |
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Definition
| Benzodiazapines and barbituates (taken for anxiety and sleep disorders) |
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|
Term
| In what circumstance can benzodiazapines and barbituates becoming increasingly fatal? |
|
Definition
| When taken with alcohol by sober alcoholics due to supersensitivy caused by MEOS inhibition |
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|
Term
| What disease is caused by a thiamine deficiency secondary to alcohol antivitamin action? |
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Definition
|
|
Term
| What are the consequences of Wernicke's Syndrome? |
|
Definition
| Massive CNS impairment due to inability to use glucose, can lead to death |
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|
Term
| Inability to learn new material, mild retrograde amnesia, impaired reasoning ability describes what? |
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Definition
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|
Term
| How are mild cases of Karsakoff's Syndrome treated? |
|
Definition
|
|
Term
| How can light intake of alcohol be beneficial? |
|
Definition
| Antioxidant effects of flavonoid and polyphenol compounds reduce incidence of heart disease |
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|
Term
| What is the is the antioxidant in red wine? |
|
Definition
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|
Term
| A liver panel is performed on what? |
|
Definition
|
|
Term
| What transaminases are markers for liver disease? |
|
Definition
| Aspartate amino transferase (AST) and Alanine transaminase (ALT) |
|
|
Term
| Which transaminase is the best marker for liver disease? |
|
Definition
|
|
Term
| Where is alkaline phosphatase (ALP) found? |
|
Definition
|
|
Term
| Increases in plasma ALP are symptomatic of what? |
|
Definition
| If moderate, hepatitis or cirrhosis, greater in extrahepatic biliary obstruction |
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|
Term
| Gamma-Glutamyl Transferase or 5' Nucleotidase can be evaluated for what? |
|
Definition
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