Using numbers 1-6, list the metabolism of heme when converted to bilirubin to be excreted in feces.
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1. Heme 2. Biliverdin 3. Bilirubin (w/ albumin) 4. Conjugated bilirubin (in liver) 5. urobilinogen (GI bacteria) 6. Reabsorption in small intestine (made to bile)
Using numbers 1-6, list the metabolism of heme when converted to bilirubin to be reabsorbed in GI tract.
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Make molecules more water soluble
During biotransformation in the liver, what is the overall purpose of this process?
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3
How many phases make up biotransformation in the liver?
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P-450 cytochromes
What catalyzes phase 1 of biotransformation in the liver?
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Adds oxygen
What is the mechanism of action for P-450 cytochromes?
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Conjugation; makes product more water soluble
What major process occurs in phase 2 of biotransformation? What does this do to the phase 1 product?
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excretion of phase 2 product into blood or bile
What major process is occurring in phase 3 of biotransformation in the liver?
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Reduced glutathione (GSH)
What is the starting material of mercapturic acids (phase 2 conjugation)?
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1/2
Out of all the bile produced from hepatocutes, how much bile (relatively) is diverted to the gallbladder between meals (instead of the small intestine through the duodenal papilla)?
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cholesterol
What do hepatocytes make bile acids from?
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1. Bilirubin 2. Cholesterol
What are the 2 major organic solutes that make up bile?
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Normal lipid absorption and digestion
What is the primary function of bile?
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mixed micelles
Bile salts form soluble ___________________ with fat to aid in passage from lumen.
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Cholestyramine (Questran)
What increases excretion of bile in the feces?
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1. Heavy metals 2. Lipophilic compounds
What are 2 main bile excretory products?
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bacteria
Secondary bile acids are formed by dehydroxylation by __________.
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cholesterol
What levels decrease within the blood due to bile acid production?
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secretin
What major player is responsible for secretion of bicarbonate rich fluid?
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somatostatin
What major player is responsible for inhibiting the cAMP pathway in bile duct secretion?
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Secretin; Somatostatin
___________ increases bile duct secretion. ______________ inhibits bile duct secretion.
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cystic fibrosis
What condition decreases bicarbonate in bile secretions?
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Glucagon (pancreatic alpha cells)
What is indicated by number 1 in the image?
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D cell (somatostatin)
What is indicated by number 2 in the image?
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1. Cystic duct to gallbladder 2. Common bile duct to duodenum
What are the 2 parts of the common hepatic duct bifurcation?
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CCK
What mediator relaxes the sphincter of Oddi?
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False
True/False: CCK decreases bile secretion.
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True
True/False: Most bile acids are recycled.
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terminal ileum & colon
What parts of the GI system reabsorb bile acids?
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fat; blood
Bile is used to absorb ____. Bile helps this be absorbed then drops it off in the __________ and cycles back to help more be absorbed.
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gluconeogenesis; glycogenolysis
Between meals in low blood glucose conditions, ____________ occurs to make glucose from amino acids. In addition, _______________ can also occur to breakdown glycogen to glucose.
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glycogen synthesis; fat
After meals, during high glucose conditions, ________ can occur to store glucose for later usage (glycogen). After glycogen is made, unused carbohydrates are converted to _____.
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False
True/False: Glucose entry into the liver depends on insulin.
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glycolysis
Excess glucose can be used in what process?
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fat
During lipogenesis, excess glucose is converted to what?
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1. Albumin 2. Globulins 3. C-reactive protein (CRP) 4. Glutathione
What are 4 major plasma proteins produced by the liver?
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systemic inflammation
C-reactive protein is used to measure what within the body?
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Removing free radicals
What is glutathione responsible for?
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1. Protein S 2. Protein C 3. anti-thrombin III
What are 3 major coagulation inhibitors in hemostasis/fibrinolysis (anti-clot)?
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plasminogen
What is a major player of fibrinolysis?
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angiotensinogen
What is a prohormone plasma protein made by the liver?
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ApoA-I & ApoA-II
What type of apolipoproteins are present with HDL?
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Apo-B100
What type of apolipoproteins are present with LDL?
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Metabolism of amino acids
What is the liver’s role in dealing with amino acids?
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urea
The liver converts amino acids to _______ for excretion in the urine.
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glycogenolysis
What glucose metabolic pathway occurs during fasting?