10. Glucose metabolism
• The liver performs several roles in
carbohydrate metabolism:
• Gluconeogenesis
• Glycogenolysis
• Glycogenesis
• Glucogenesis
• Glucose buffer function
11. Protein Lipids
• Amino acid synthesis
• Protein metabolism, • Cholesterol synthesis
(synthesis as well as • Lipogenesis, the
degradation) production of triglycerides
(fats).
• Lipoprotein synthesis
• Beta oxidation
12. Synthesis of plasma proteins
Albumin
Acute phase proteins
Clotting factors
Steroid binding and other hormone binding
proteins
HORMONES
Erythropoietin
IGF-1
Thrombopoietin
Angiotensinogen
25 hydrxoy choolecalciferol
13. Hematopoesis
Extramedullary hemopoiesis during first
trimester of gestation
• STORAGE:
Vitamins
Glycogen
Iron
Copper
• Immunity
Kupffer cells
18. Other points in history
• Fever, prodrome (anorexia,vomiting,nausea) –
which disappears with onset of jaundice – acute
viral hepatitis
• Joint pain, diabetes, pigmentation, jaundice –
• Young individual with extrapyramidal symptoms,
neuropsychiatric manifestation, anemia
• Colicky abd pain, jaundice, fever- gall stones
• Rash, arthritis
• Drug history
21. Jaundice Unrelated to
Intrinsic Liver Disease
• Hemolysis (usually T. bili < 4)
• Massive Transfusion
• Resorption of Hematoma
• Ineffective Erythropoesis
• Disorders of Conjugation
• Gilbert’s syndrome
• Intrahepatic Cholestasis
• Sepsis, TPN, Post-operation
22.
23. Alcohol
• A standard drink is any drink that contains
about 14 grams of pure alcohol (about 0.6
fluid ounces or 1.2 tablespoons)
• One "Standard Drink" equals = one 30ml
nip of whisky or other basic spirit = 60ml
fortified wine = 150ml table wine = 250ml
beer = 425ml low alcohol beer
• Strength (ABV) x Volume (ml) ÷ 1000 =
No. of units.
• 40–80 g/d of ethanol produces fatty liver;
160 g/d for 10–20 years causes hepatitis
or cirrhosis. Only 15% of alcoholics
develop alcoholic liver disease.
