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Case 10 - Hepatobiliary System

case-10-hepatobiliary-system

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Name the five areas of portal anastamosis and their clinical presentations of portal hypertension

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In the oesophagus - get

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In the rectum - get

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Paraumbilical region - get

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Two other areas: intraheptic and

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Role of the liver in the fed state

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Converted to glycogen
Converted to pyruvate
Converted to VLDL
Converted to acetyl coA
Converted to TAGs
Glucose from the diet enters the liver
Converted to fatty acids
Converted to glucose 6P
Leave liver

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Liver during fasting state

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Forms ketone bodies which are used for energy in tissues and brain
TAGs in adipocytes form fatty acids which enter liver
Form pyruvate
Form acetyl CoA
Converted to Glucose 6P
Glycogen in liver also produced glucose
Converted to glucose, which enters tissues and brain
Amino acids from muscle converted to gluconeogenic precursors

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Describe drug and hormone metabolism in the liver

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Phase 1 -

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Mostly done by

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but there is some reduction and hydrolysis, done by

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Phase II -

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which is the formation of a link between things e..g glucuronidation, sulphation, amino-acid conjugation, glutathione conjugation.

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Phase III -

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Conjugation makes the drugs more

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and less lipid soluble. Secreted out of cells by active transport, mediated by

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- ATP-binding cassette super-family

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Put the steps of alcohol metabolism in order

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acetaldehyde dehydrogenase.
Alcohol to
acetaldehyde, catalysed by
alcohol dehydrogenase.
Acetaldehyde (toxic) converted to
acetate, catalysed by

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The liver produces fibrinogen and all coagulation factors except which?

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Which haemostasis factors does the liver produce?

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