MS RLE
Function of Blood from Portal Vein
The portal vein brings nutrient-rich, oxygen-poor TIPS (Transjugular Intrahepatic Portosystemic Shunt)
blood from the GI tract to the liver. A radiologic procedure that creates a shunt between
This blood bathes hepatocytes through sinusoids and the portal and hepatic veins.
is filtered by Kupffer cells, which remove bacteria Reduces portal pressure, used for refractory variceal
and debris. bleeding or ascites.
About 80% of the liver’s blood supply is from the Improves outcomes in patients not responding to
portal vein, with the rest from the hepatic artery. endoscopic or medical therapy.
Hepatocyte Functions Spironolactone
Metabolize carbohydrates (glucose storage and A potassium-sparing diuretic and aldosterone
release), proteins (synthesize albumin, clotting antagonist.
factors), and fats (lipid breakdown, cholesterol Used as first-line treatment for ascites in cirrhosis.
synthesis). Prevents hypokalemia and is often combined with
Detoxify ammonia into urea. furosemide.
Store vitamins A, B-complex, D, iron, and copper.
Produce and secrete bile for digestion. Lactulose Purpose in Hepatic Encephalopathy
Metabolize drugs via the cytochrome P450 system A nonabsorbable disaccharide used to treat hepatic
(first-pass metabolism). encephalopathy.
Lowers ammonia levels by trapping it in the colon and
Role of the Liver in Glucose Metabolism promoting its excretion via feces.
Converts excess glucose into glycogen Produces 2–3 soft bowel movements daily to reduce
(glycogenesis) for storage. ammonia absorption.
Breaks down glycogen into glucose (glycogenolysis)
when needed. Hepatitis A Prevention
Produces glucose from non-carbohydrate sources Transmitted via the fecal–oral route.
like amino acids (gluconeogenesis) during fasting Preventable through vaccination and good hygiene.
or stress. Immune globulin can be used for post-exposure
prophylaxis within 2 weeks.
Bile and Its Pathways
Bile is continuously produced by hepatocytes, stored All Hepatitis Variants
in the gallbladder, and secreted into the intestine. Hepatitis A: Fecal–oral; self-limiting.
It flows from canaliculi → intrahepatic ducts → Hepatitis B: Blood, body fluids; chronic infection
hepatic duct → cystic duct (gallbladder) → possible.
common bile duct → duodenum. Hepatitis C: Bloodborne; high chronicity, now curable.
Aids in fat emulsification and excretion of waste Hepatitis D: Requires HBV coinfection.
products like bilirubin and cholesterol. Hepatitis E: Fecal–oral; serious in pregnancy.
Hepatitis G/GBV-C: Bloodborne; unclear clinical
Purpose of Conjugation of Bilirubin significance.
Bilirubin is a breakdown product of hemoglobin.
The liver conjugates bilirubin, making it water-soluble Diagnostic Test for Liver Abscess
so it can be excreted into bile and then feces. Ultrasound, CT, or MRI for localization.
Unconjugated bilirubin is lipid-soluble and toxic; Percutaneous aspiration to confirm diagnosis and
conjugation prevents accumulation and toxicity. identify organisms.
Blood cultures may be negative.
Liver-Specific Tests and Functions
ALT (Alanine Aminotransferase): Increases with Active Hepatitis Infection Indicator (HBsAg)
hepatocellular injury. Hepatitis B surface antigen (HBsAg) indicates active
AST (Aspartate Aminotransferase): Elevated in liver infection.
and other tissue damage. Persistence beyond 6 months = chronic HBV.
GGT (Gamma Glutamyl Transferase): Elevated in Anti-HBs = recovery or successful vaccination.
alcohol-related and cholestatic liver diseases.
Bilirubin: Increased in jaundice and liver dysfunction. Gallstones
Albumin: Low levels suggest impaired synthetic Solid components (cholesterol or pigment) that form
function. in the gallbladder.
PT/INR: Prolonged in liver disease due to impaired May be asymptomatic or cause biliary colic.
clotting factor production. Can lead to cholecystitis or obstructive jaundice.
Hepatic Jaundice Biliary Colic
Caused by hepatocellular dysfunction (e.g., hepatitis, Intermittent RUQ pain caused by temporary blockage
cirrhosis). of the cystic duct by a gallstone.
Both conjugated and unconjugated bilirubin may be Pain often after fatty meals, can radiate to the right
elevated. shoulder.
Associated symptoms: fatigue, nausea, dark urine,
yellowing of the skin and eyes. Pancreatitis
Inflammation of the pancreas due to autodigestion by
Portal Hypertension pancreatic enzymes.
Defined as elevated pressure in the portal venous Acute: sudden, often due to gallstones or alcohol.
system, often due to cirrhosis. Chronic: irreversible fibrosis and enzyme
Function of Blood from Portal Vein
The portal vein brings nutrient-rich, oxygen-poor TIPS (Transjugular Intrahepatic Portosystemic Shunt)
blood from the GI tract to the liver. A radiologic procedure that creates a shunt between
This blood bathes hepatocytes through sinusoids and the portal and hepatic veins.
is filtered by Kupffer cells, which remove bacteria Reduces portal pressure, used for refractory variceal
and debris. bleeding or ascites.
About 80% of the liver’s blood supply is from the Improves outcomes in patients not responding to
portal vein, with the rest from the hepatic artery. endoscopic or medical therapy.
Hepatocyte Functions Spironolactone
Metabolize carbohydrates (glucose storage and A potassium-sparing diuretic and aldosterone
release), proteins (synthesize albumin, clotting antagonist.
factors), and fats (lipid breakdown, cholesterol Used as first-line treatment for ascites in cirrhosis.
synthesis). Prevents hypokalemia and is often combined with
Detoxify ammonia into urea. furosemide.
Store vitamins A, B-complex, D, iron, and copper.
Produce and secrete bile for digestion. Lactulose Purpose in Hepatic Encephalopathy
Metabolize drugs via the cytochrome P450 system A nonabsorbable disaccharide used to treat hepatic
(first-pass metabolism). encephalopathy.
Lowers ammonia levels by trapping it in the colon and
Role of the Liver in Glucose Metabolism promoting its excretion via feces.
Converts excess glucose into glycogen Produces 2–3 soft bowel movements daily to reduce
(glycogenesis) for storage. ammonia absorption.
Breaks down glycogen into glucose (glycogenolysis)
when needed. Hepatitis A Prevention
Produces glucose from non-carbohydrate sources Transmitted via the fecal–oral route.
like amino acids (gluconeogenesis) during fasting Preventable through vaccination and good hygiene.
or stress. Immune globulin can be used for post-exposure
prophylaxis within 2 weeks.
Bile and Its Pathways
Bile is continuously produced by hepatocytes, stored All Hepatitis Variants
in the gallbladder, and secreted into the intestine. Hepatitis A: Fecal–oral; self-limiting.
It flows from canaliculi → intrahepatic ducts → Hepatitis B: Blood, body fluids; chronic infection
hepatic duct → cystic duct (gallbladder) → possible.
common bile duct → duodenum. Hepatitis C: Bloodborne; high chronicity, now curable.
Aids in fat emulsification and excretion of waste Hepatitis D: Requires HBV coinfection.
products like bilirubin and cholesterol. Hepatitis E: Fecal–oral; serious in pregnancy.
Hepatitis G/GBV-C: Bloodborne; unclear clinical
Purpose of Conjugation of Bilirubin significance.
Bilirubin is a breakdown product of hemoglobin.
The liver conjugates bilirubin, making it water-soluble Diagnostic Test for Liver Abscess
so it can be excreted into bile and then feces. Ultrasound, CT, or MRI for localization.
Unconjugated bilirubin is lipid-soluble and toxic; Percutaneous aspiration to confirm diagnosis and
conjugation prevents accumulation and toxicity. identify organisms.
Blood cultures may be negative.
Liver-Specific Tests and Functions
ALT (Alanine Aminotransferase): Increases with Active Hepatitis Infection Indicator (HBsAg)
hepatocellular injury. Hepatitis B surface antigen (HBsAg) indicates active
AST (Aspartate Aminotransferase): Elevated in liver infection.
and other tissue damage. Persistence beyond 6 months = chronic HBV.
GGT (Gamma Glutamyl Transferase): Elevated in Anti-HBs = recovery or successful vaccination.
alcohol-related and cholestatic liver diseases.
Bilirubin: Increased in jaundice and liver dysfunction. Gallstones
Albumin: Low levels suggest impaired synthetic Solid components (cholesterol or pigment) that form
function. in the gallbladder.
PT/INR: Prolonged in liver disease due to impaired May be asymptomatic or cause biliary colic.
clotting factor production. Can lead to cholecystitis or obstructive jaundice.
Hepatic Jaundice Biliary Colic
Caused by hepatocellular dysfunction (e.g., hepatitis, Intermittent RUQ pain caused by temporary blockage
cirrhosis). of the cystic duct by a gallstone.
Both conjugated and unconjugated bilirubin may be Pain often after fatty meals, can radiate to the right
elevated. shoulder.
Associated symptoms: fatigue, nausea, dark urine,
yellowing of the skin and eyes. Pancreatitis
Inflammation of the pancreas due to autodigestion by
Portal Hypertension pancreatic enzymes.
Defined as elevated pressure in the portal venous Acute: sudden, often due to gallstones or alcohol.
system, often due to cirrhosis. Chronic: irreversible fibrosis and enzyme
