8. Liver and Gallbladder - Alcon

• Hepatic macrophage system serve as blood cleansing function

  • blood flow passing through intestinal capillaries will pick up bacteria
• Kupffer cell - macrophage that line the hepatic venous sinuses

  • Function - clean blood as it passes through the sinuses
• Liver has high blood flow and low vascular resistance
• Liver function as blood reservoir - it is expandable organ
• If portal system is block - will lead to portal hypertension

  • return of blood will be impeded
• what type of vitamin is stored the most in the liver?

  vit A
• iron in the body is stored in the liver in the form of ferritin
• apoferritin is iron carrying protein
• the liver detoxifies many drugs into bile
• liver damage can lead to accumulation of endocrine hormones
• first pass effect is often associated with the liver, as this is a major site of drug metabolism
• First-Pass Effect - results in a reduced concentration of the active drug
• liver possesses a remarkable ability to restore itself after significant hepatic tissue loss except if infected by virus or inflammation
• during liver regeneration - hepatocytes are estimated to replicated
• When liver parenchymal cells are destroyed, they are replaced with fibrous tissue - can cause decrease of blood flow
• Common cause of cirrhosis - chronic alcoholism or excess fat accumulation in the liver
• increase serum aminotransferases = damage to tissue

  • allow ALT or AST to leak into serum
• ALT - will be detected in the blood if there is liver damage
• increase ALP = cholestatic disorder
• GGT levels is to identify the source of an isolated elevation in the serum ALP level

  • high in people who drinks alcohol
• Serum Albumin - marker of hepatic synthetic function with chronic liver disease and cirrhosis
• what is an unreliable marker of hepatic synthetic function in acute liver injury?

  serum albumin
• Most useful of acute liver disease?

  Prothrombin Time (PT)