Chp 49 Hepatic Tegrity.docx - 400 Test 5 Chapter 49 \u2013 Hepatic Disorders 1 REVIEW OF THE LIVER \u2013 Metabolic Factory Waste Disposal Plant

Chp 49 Hepatic Tegrity.docx - 400 Test 5 Chapter 49 –...

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400 Test 5: Chapter 49 – Hepatic Disorders 1REVIEW OF THE LIVER – Metabolic Factory & Waste Disposal PlantCarbohydrate/glucose metabolismoIt stores excess glucose from meals as glucagon reserves and fatsso when blood glucose drops it turns some of the glucagon stores into glucoseProtein metabolismoMajor source of protein!oProvides amino acidsoIt is the only sourcethat makes albumin, which is considered our protein, and is necessary for normal fluid and electrolyte balance – so when a person has low albumin you may see them with third spacing and ascitesoMakes several clotting proteins; Vitamin Kfat soluble vitamin, so we need adequate excretion/secretion of bile for absorption,which is one of the functions of the liveroCatabolizes protein for energy use and glucose productionFat metabolismoTriglycerides metabolized in the liver into fatty acids to be used for energy (they’re metabolized to ketones)they combine with cholesterol to form bileProduction of bile saltsoPlays a role with cholesterol, phospholipids, bilirubin, water Bilirubin metabolismoBilirubin is a by product of heme portion of RBCs that is released when the RBCs are destroyed oLiver filters the blood and extracts the unconjugated bilirubinoIt then combines it with glucuronic acid and it becomes conjugated or water-soluble and is then secreted into the bileDetoxificationoVery important oParticularly with ammonia (NH3) it’s produced in the gut from bacteria in the GI and it’s a major toxic product processed by the liveroIt is passed through the inner hepatic circulation where it is detoxified and converted into urea and then it’s excreted by kidneys in the urine and that’s why urine is yellow!Activates estrogen, testosterone, ADH, aldosterone oSo when we have problems with the liver it can cause high levels of hormones to circulate in the body or deficiencies because ofthe imbalance of theses hormonesVery important in metabolizing certain medicationsoBarbituatesoAmphetaminesoSedativesStorage of minerals & vitaminsoVitamin A ,D, B12 stored in large quantities for a long time in the liver to prevent deficienciesoIron and copper tooBlood reservoiroVery important roleoTremendous vascular supply in supply storage of liverEx: if trauma, pt needs extra vascular blood volumeliver can release to help body compensate until it can be restoredDon’t memorize every little thing just have a general understanding!Patients with liver failure often require vitamin therapy. Which vitamin does the liver require for synthesis of prothrombin?A.Vitamin B12B.Vitamin AC.Vitamin DD.Vitamin K AnswerVitamin K—promotes synthesis of prothrombin; if unable to clot – give vitamin KPhysiological Changes with AgingLiver decreases in size and hepatic blood flow decreasesResults of liver function tests do not normally change in the elderly
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  • Spring '19
  • liver disease, acute hepatitis

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