Med. Surg. 3:Hepatic Structure, Function, and Pathophysiology: Liver Anatomy, Hepatocyte Regeneration, Glycogenesis, Glycogenolysis, Gluconeogenesis, Lipid Metabolism, Plasma Proteins, Albumin, Vitamin K, Coagulation, Aldosterone Metabolism, Bile Producti

Med. Surg. 3:Hepatic Structure, Function, and Pathophysiology: Liver Anatomy, Hepatocyte Regeneration, Glycogenesis, Glycogenolysis, Gluconeogenesis, Lipid Metabolism, Plasma Proteins, Albumin, Vitamin K, Coagulation, Aldosterone Metabolism, Bile Production, Bilirubin, Steatorrhea, Jaundice, Ammonia Detoxification, Urea Cycle, Hepatic Encephalopathy, Ascites, Portal Hypertension, Liver Function Tests, ALT, AST, ALP, Hepatitis A, Hepatitis B, Viral Transmission, Vaccination, Immune Globulin, Risk Populations, Alcohol-Induced Injury, Drug-Induced Hepatotoxicity, Cholestasis, Cirrhosis Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Liver Largest internal organ in the body, 3 pounds! The liver can replace damaged tissue with new cells! No assistive machinery available to help the liver like we have for the heart or kidneys. What are the major functions of the liver? Converts glucose to glycogen (glycogenesis). Maintains normal glucose levels by converting glycogen to glucose (glycogenolysis). Regulates fat and lipid metabolism. When does the liver do most of its work? At night. The liver forms triglycerides, which is why we give most cholesterol meds at night. Glycogenesis glucose to glycogen Glycogenolysis glycogen to glucose Glyconeogenesis Process of producing glucose from fat and protein. What vitamin is necessary for synthesis of prothrombin? Vitamin K. With liver failure, Vitamin K will not work. With liver failure, PT/INR will be prolonged. What hormone (that increases sodium and water retention) is broken down in the liver? Aldosterone. The liver produces what type of proteins? Plasma proteins (60% are albumin). Without plasma proteins will have decreased colloidal oncotic pressure. In liver failure, we will see low levels of what vitamins? A, D, B12, and iron. What two substances that are metabolized in the liver often cause liver damage in excess? Medications (i.e. Acetaminophen, NSAIDs) Alcohol The liver filters what bodily fluid? Filters blood, phagocytizes aged erythrocytes and cleanses blood of bacteria and toxins. The liver produces bile salts. What does bile do? Aids in digestion. –Bile emulsifies fats. –Large portion of bile is bilirubin – the by-product of RBC death. What substance gives feces its brown color? Bilirubin. What results if the liver cannot excrete bile? Steatorrhea Jaundice (icterus) Dark Urine Steatorrhea Bulky, foul smelling, oily, clay colored stool that floats. How does the liver removes naturally occurring ammonia from bodily fluids? Converts ammonia to urea for excretion in the urine. What are three marked signs of impaired liver function? Elevated BP Peripheral edema Ascites Increased ammonia due to the livers inability to excrete ammonia can cause... Hepatic encephalopathy. Liver Function Tests (LFTs) ALT: Alanine transamine AST: Aspartate transamine ALP: Alkaline phosphatase ALT Alanine transamine is an LFT that is more specific for the liver. AST Aspartate transamine is found in many cells throughout the body. - Extremely high levels are typical of acute viral hepatitis, toxic/drug necrosis, shock/ischemia to the liver. ALP Alkaline phosphatase. – Anything that affects bile metabolism, secretion or excretion leads to bile acids being backed up in the liver, leading to increased ALP. – Sensitive indicator of cholestasis, primary biliary cirrhosis, cholangitis. – Also elevated with primary liver cancer and liver metastasis.