BIO 346 Patho II Midterm Review || 100% CORRECT
ANSWERS
Detoxification (filtration) correct answers Filters xenobiotics and prepares them for excretion
Bile formation/excretion (digestion) correct answers In combination with gallbladder and
pancreas, breakdown of bilirubin (glucuronidation)
Metabolic homeostasis (production and storage) correct answers Processing dietary amino
acids, lipids, carbohydrates, vitamins
Glucose regulation
Protein synthesis-clotting factors, albumin, hormones
Nutrient storage (vitamins [A, D, E, K, and B9+B12] & iron)
Drug pharmacokinetics (1st and 2nd pass metablosim) correct answers ADME, what body
does to the drug
Hepatitis correct answers may or may not be reversible (curable)
Cirrhosis correct answers permanent scarring/fibrosis of the liver
The hepatic system is highly vascularized. Within each hepatic lobule, portal triads are made
up of what 3 branches? correct answers Portal vein branch, Hepatic artery branch, Bile duct
branch
Specialized macrophages between the sinusoidal endothelial cells; mostly participate in
phagocytosis, aid bilirubin production, and lipid metabolism correct answers Kupffer cells
Liver-specific natural killer cells (T cell) that adhere to the sinusoidal endothelium; tumor
cell-lysing capability correct answers Pit cells
Space between the sinusoids and hepatocytes; drains interstitial fluid into hepatic lymph
return correct answers Disse space
Multi factorial immune function; store vitamin A; and play a role in collagen production
(important role for fibrosis in cirrhosis) correct answers Stellate cells
The Cytochrome P450 system is vital to hepatic detoxification & xenobiotic metabolism.
What is the most common CYP enzyme? correct answers CYP3A4
What does each letter in A.D.M.E. stand for? correct answers A - absorption
D - distribution
M - metabolism
E - excretion
An AST:ALT ratio of less than 1 typically indicates what type of hepatic injury? correct
answers AST:ALT < 1 --> NAFLD (non alcoholic fatty liver disease)
, Indirect bilirubin is to unconjugated bilirubin as direct bilirubin is to ___________? (think
about how elevations of both, or one point to/give clues to the site of disease/damage within
the body. correct answers Conjugated bilirubin
AST:ALT = 1 correct answers Viral hepatitis or DILI (drug induced liver injury)
AST:ALT > 1 correct answers Cirrhosis
AST:ALT 2:1 correct answers EtOH liver disease
Be able to distinguish between hepatitis A through C. Of these, which hepatitis virus does
NOT have an available vaccine?
a) HAV
b) HBV
c) HCV
d) HDV correct answers c) HCV
Hepatic steatosis refers to fatty liver disease and is one of the main causes of hepatic damage
in the US. Be able to distinguish NAFLD vs NASH. Which is NO longer reversible?
a) NAFLD
b) Hepatitis
c) Steatosis
d) NASH correct answers d) NASH (non- alcoholic steatohepatitis)
AAT deficiency although rare in the US, is likely a very underdiagnosed disease. Thinking
about the pathophysiology behind the disease, what are the two main organs that are affected
by the variant AAT protein? correct answers Lung & liver
Hemochromatosis is primarily a disease/disorder of __________ storage. Think about where
this substance is normally stored in the body. correct answers Iron/Fe
Is hemochromatosis most commonly acute (rapid onset) or chronic (slow build-up)? How can
it be treated? correct answers slow build-up
- It is treated by therapeutic phlebotomy and chelation therapy
Thousands of medications can cause DILI. What is the most common drug associated with
DILI in the US? correct answers Tylenol, APAP, acetaminophen.
Your liver is able to metabolize toxins with minimal damage (such as alcohol or Tylenol) due
to the organ's ability to buffer reactive oxygen species (ROSs) effectively blunting the
oxidative damage. Thinking about this pathway, what finite substance in the liver is one of
the most important in this process of buffering free radicals/ROSs? correct answers
Glutathione
The gallbladder has 3 main functions - all of them deal with bile. Cholelithiasis is caused by
some malfunction in this gallbladder-bile combo. All of the following are mechanisms of
cholelithiasis formation except? correct answers Excessive lipase buildup within the
gallbladder
ANSWERS
Detoxification (filtration) correct answers Filters xenobiotics and prepares them for excretion
Bile formation/excretion (digestion) correct answers In combination with gallbladder and
pancreas, breakdown of bilirubin (glucuronidation)
Metabolic homeostasis (production and storage) correct answers Processing dietary amino
acids, lipids, carbohydrates, vitamins
Glucose regulation
Protein synthesis-clotting factors, albumin, hormones
Nutrient storage (vitamins [A, D, E, K, and B9+B12] & iron)
Drug pharmacokinetics (1st and 2nd pass metablosim) correct answers ADME, what body
does to the drug
Hepatitis correct answers may or may not be reversible (curable)
Cirrhosis correct answers permanent scarring/fibrosis of the liver
The hepatic system is highly vascularized. Within each hepatic lobule, portal triads are made
up of what 3 branches? correct answers Portal vein branch, Hepatic artery branch, Bile duct
branch
Specialized macrophages between the sinusoidal endothelial cells; mostly participate in
phagocytosis, aid bilirubin production, and lipid metabolism correct answers Kupffer cells
Liver-specific natural killer cells (T cell) that adhere to the sinusoidal endothelium; tumor
cell-lysing capability correct answers Pit cells
Space between the sinusoids and hepatocytes; drains interstitial fluid into hepatic lymph
return correct answers Disse space
Multi factorial immune function; store vitamin A; and play a role in collagen production
(important role for fibrosis in cirrhosis) correct answers Stellate cells
The Cytochrome P450 system is vital to hepatic detoxification & xenobiotic metabolism.
What is the most common CYP enzyme? correct answers CYP3A4
What does each letter in A.D.M.E. stand for? correct answers A - absorption
D - distribution
M - metabolism
E - excretion
An AST:ALT ratio of less than 1 typically indicates what type of hepatic injury? correct
answers AST:ALT < 1 --> NAFLD (non alcoholic fatty liver disease)
, Indirect bilirubin is to unconjugated bilirubin as direct bilirubin is to ___________? (think
about how elevations of both, or one point to/give clues to the site of disease/damage within
the body. correct answers Conjugated bilirubin
AST:ALT = 1 correct answers Viral hepatitis or DILI (drug induced liver injury)
AST:ALT > 1 correct answers Cirrhosis
AST:ALT 2:1 correct answers EtOH liver disease
Be able to distinguish between hepatitis A through C. Of these, which hepatitis virus does
NOT have an available vaccine?
a) HAV
b) HBV
c) HCV
d) HDV correct answers c) HCV
Hepatic steatosis refers to fatty liver disease and is one of the main causes of hepatic damage
in the US. Be able to distinguish NAFLD vs NASH. Which is NO longer reversible?
a) NAFLD
b) Hepatitis
c) Steatosis
d) NASH correct answers d) NASH (non- alcoholic steatohepatitis)
AAT deficiency although rare in the US, is likely a very underdiagnosed disease. Thinking
about the pathophysiology behind the disease, what are the two main organs that are affected
by the variant AAT protein? correct answers Lung & liver
Hemochromatosis is primarily a disease/disorder of __________ storage. Think about where
this substance is normally stored in the body. correct answers Iron/Fe
Is hemochromatosis most commonly acute (rapid onset) or chronic (slow build-up)? How can
it be treated? correct answers slow build-up
- It is treated by therapeutic phlebotomy and chelation therapy
Thousands of medications can cause DILI. What is the most common drug associated with
DILI in the US? correct answers Tylenol, APAP, acetaminophen.
Your liver is able to metabolize toxins with minimal damage (such as alcohol or Tylenol) due
to the organ's ability to buffer reactive oxygen species (ROSs) effectively blunting the
oxidative damage. Thinking about this pathway, what finite substance in the liver is one of
the most important in this process of buffering free radicals/ROSs? correct answers
Glutathione
The gallbladder has 3 main functions - all of them deal with bile. Cholelithiasis is caused by
some malfunction in this gallbladder-bile combo. All of the following are mechanisms of
cholelithiasis formation except? correct answers Excessive lipase buildup within the
gallbladder
