FORMATIVE ASSESSMENT 01 – LIVER FUNCTIONS

Paper I:

Which blood vessel supplies oxygenated blood to the liver?

A) Hepatic vein
B) Portal vein
C) Hepatic artery
D) Sinusoid

What is the primary role of sinusoids in the liver?

A) Store bile
B) Transport deoxygenated blood
C) Exchange materials with hepatocytes
D) Detoxify harmful substances

Which of the following is not a function of the liver?

A) Detoxification of alcohol
B) Synthesis of plasma proteins
C) Breakdown of glycogen
D) Production of insulin

What is the role of the hepatic portal vein?

A) Supplies oxygen to liver cells

B) Removes deoxygenated blood from the liver
C) Transports nutrient-rich blood from the gut
D) Synthesizes bile salts

Which substance is produced by the liver to maintain osmotic conditions in the

blood?

A) Insulin
B) Albumin
C) Glucagon
D) Bile salts

How is bilirubin related to jaundice?

A) It is a plasma protein involved in clotting.

B) It is a bile pigment that accumulates in excess.
 1
FORMATIVE ASSESSMENT 01 – LIVER FUNCTIONS

C) It is a nutrient stored by the liver.

D) It is an enzyme involved in detoxification.

Which structure surrounds the hepatic lobules?

A) Sinusoids
B) Hepatic artery branches
C) Bile ducts
D) Central veins

What happens to excess glucose in the liver?

A) It is stored as glycogen.
B) It is converted into urea.
C) It is transported as LDL.
D) It is stored as iron.

Which of the following plasma proteins is not produced by the liver?

A) Albumin
B) Fibrinogen
C) Immunoglobulins
D) α-1-antitrypsin

What process converts amino acids into urea?

A) Transamination
B) Deamination
C) Oxidation
D) Conjugation

Which lipoprotein is considered 'good' for lowering blood cholesterol?

A) LDL
B) HDL
C) VLDL
D) IDL

The breakdown of red blood cells primarily occurs in which liver cells?

A) Hepatocytes
B) Kupffer cells

2
FORMATIVE ASSESSMENT 01 – LIVER FUNCTIONS

C) Sinusoids
D) Canaliculi

What causes the yellowing of the skin in jaundice?

A) Excess bile salt production

B) High levels of bilirubin
C) Increased iron storage
D) Liver enzyme deficiency

What is the consequence of long-term alcohol abuse on the liver?

A) Increased glycogen storage

B) Decreased production of bile
C) Increased antioxidant activity
D) Decreased synthesis of plasma proteins

Which of the following is stored in the liver?

A) Vitamin C
B) Vitamin A
C) Vitamin E
D) Vitamin K

What is the role of the Golgi complex in hepatocytes?

A) Synthesizes plasma proteins

B) Detoxifies harmful substances
C) Exports plasma proteins to the blood
D) Breaks down glycogen

The liver converts ammonia into which less toxic compound?

A) Uric acid
B) Nitric oxide
C) Urea
D) Bilirubin

Which process is used by the liver to release glucose into the blood?
A) Glycogenolysis
B) Gluconeogenesis

3
FORMATIVE ASSESSMENT 01 – LIVER FUNCTIONS

C) Lipolysis
D) Transamination

What structural feature of sinusoids allows for increased permeability?

A) Tight junctions
B) Complete basement membrane
C) Large intercellular gaps
D) Thick endothelial layer

Which substance is involved in the formation of bile salts?

A) Urea
B) Bilirubin
C) Cholesterol
D) Glucose

In which part of the liver are bile salts produced?

A) Sinusoids
B) Hepatic lobules
C) Hepatocytes
D) Kupffer cells

What is the function of cytochrome P450 enzymes in the liver?

A) Detoxification of drugs
B) Synthesis of bile
C) Storage of glycogen
D) Production of plasma proteins

Which nutrient is stored in the liver in the form of ferritin?

A) Iron
B) Glucose
C) Fatty acids
D) Vitamin D
What is the fate of amino acids that are not used for protein synthesis in the
liver?

A) Stored as glycogen

4
FORMATIVE ASSESSMENT 01 – LIVER FUNCTIONS

B) Converted into glucose

C) Deaminated and converted into urea
D) Used in the production of bile

Which of the following is a sign of advanced liver damage due to alcohol

abuse?

A) Increased bile production

B) Fat accumulation in the liver
C) Increased protein synthesis
D) Enlargement of the pancreas

What type of molecule does the liver convert excess carbohydrates into?

A) Urea
B) Ketone bodies
C) Fatty acids
D) Bile salts

The liver helps regulate blood cholesterol levels by:

A) Storing excess cholesterol as glycogen

B) Converting cholesterol into bile salts
C) Using cholesterol to synthesize glucose
D) Excreting cholesterol through urine

Which process describes the liver’s ability to generate glucose from non
carbohydrate sources?

A) Glycogenolysis
B) Gluconeogenesis
C) Lipogenesis
D) Transamination

During erythrocyte recycling, what is bilirubin ultimately used for?

A) Excreted as a waste product in bile
B) Converted into amino acids
C) Stored as ferritin
D) Synthesized into urea

Which liver function involves the production of fibrinogen?

5
FORMATIVE ASSESSMENT 01 – LIVER FUNCTIONS

A) Detoxification
B) Plasma protein synthesis
C) Glucose metabolism
D) Bile production

Paper II

Explain the role of the liver in regulating blood glucose levels.

The main role of liver is to regulate the chemical composition of the blood by storing excess glucose as
glycogen (glycogeneisis) and converting glycogen back to glucose when it is needed. As well, it also
generates glucose from gluconeogensis.

Describe the structural differences between sinusoids and regular capillaries in

the liver and explain how these differences are related to liver function.

Sinusoids in the liver have bigger gaps and a discontinuos basement membrane unlike regular capillaries.
That the regular capillaries have a basement membrane and endothelial membrane. Therefore, these
aspects allows for a well exchange of large molecules and cells between the blood and hepatocytes, by this
way it facilates detoxification as well as metabolism.

Outline the process of erythrocyte recycling in the liver and its importance in
maintaining homeostasis.

The process of the erythrocyte recycling starts in the liver and it involves kupffer cells breaking down old
red blood cells, recycling ircon, converting heme to bilirubin and finally excreting bilirubin in bile. The
process maintains homeostasis by icon reuse, this way it recycles iron which is crucial for the production
of new red blood cells. As well it eliminates pottentially toxic waste producrts and detoxification.

Explain how the liver detoxifies harmful substances, including a discussion on

the role of cytochrome P450 enzymes.

The liver detoxifying process involves 2 steps. Fistly the use of p450 enzymes where the liver usses the
enzyme called cytochrome p450 to modify harmful substances, for instance drugs and toxins. By this, it
makes them easier to handle. Secondly the conjugation, where the liver attaches other small molecules to
the modified toxins. Therefore the Cytochrome p450 enzyme role is crucial by helping breaking down lots
of harmful subtances that people consume, like medications.

Discuss the impact of alcohol on liver function and outline the stages of liver
damage associated with long-term alcohol abuse.

The impact of alcohol in the liver can severely damage the liver by disrupting its normal functions.
Starting with the fat buildup leading to inflammation, where the damaged liver tissue causes the liver to
become enlarged and ultimately resulting in severe scar tissue known as scar tissue that is created by the
deposition of collagen where tissue is damaged.

Describe how the liver is involved in the metabolism and transport of lipids,
particularly focusing on the roles of LDL and HDL.
The liver regulates cholesterol balance by managing the levels of LDL and HDL, which is crucial. The
LDL (BAD cholesterol) if there is too much of LD, it can lead to plaque buildup in arteries, risking a heart
disease. However, the HDL (good cholesterol) works to collect excess cholesterol from cells and tissues,
then it transports it back to the liver where its reused of excreted in bile.

Explain the process of deamination in the liver and its significance in nitrogen
metabolism.
It begins when the liver removes the amino group from the amino acids and converts it into NH3. aswell,
the remaining ones can then be used for energy production or converted into other compound, for instance
fat. It signifcants is that the NH3 is toxic but then the liver turns it into urea by its cycle and finally is
excreted from the body in urine.

Discuss the cause and symptoms of jaundice, and how it relates to liver function
and erythrocyte recycling.

The cause of Jaundice is caused by an escess of bilirubin in the blood which results from liver dysfunction,
blockage of bile ductsor an increase breakdon of red blood cells. Its symptoms includes the yellowing on
the skin and the color white on the eye.

Analyze the role of the liver in plasma protein synthesis and explain the
functions of different types of plasma proteins produced by the liver.
Its role is synthesizing the plasma proteins that are found in the blood , which these proteins are crucial for
maintaining a blood pressure, clotting and immune responeses. Its functions of different types of plasma
proteins include albumin, that is the most known in the plasma protein, that helps mainting the osmotic
pressure of blood, essential for keeing fluid within blood vessels.Aswell fibrinogen that is key for blood
clotting process.

Describe the process of glycogen storage and release in the liver, including the
hormonal regulation involved.

The liver stores glucose as glycogen when blood sugar levers are high, being a process stimulated by
insulin. Then the blood sugar levels drop and the liver breaks down glycogen intro glucose and finally
releases it into the bloodstream, regulated by glucagon.

Paper III
1. Data Analysis: Hepatic Blood Flow
- Given a hypothetical data set showing changes in blood glucose levels
after a meal, describe how the liver would respond to maintain homeostasis.
Include a discussion of the specific processes involved.

2. Short Answer: Hepatic Circulation

- Explain how the structural organization of hepatic lobules facilitates the
liver's role in nutrient regulation. Use the terms "sinusoids," "portal vein," and
"central vein" in your response.
It facilitates the livers role in nutrient regulation since blood is rich in nutrients from the digestive
tract, enters rthe liver by the portal vein. This blood flows into the hepatic lobules and passes by a
canal of tiny vessels, known as sinusoids. The sinusoids are lined with hepatocytes where the liver is
responsible for processing nutrient.

3. Data Interpretation: Liver Function

- Interpret a graph showing the concentration of plasma proteins in blood
before and after liver damage. Discuss the possible physiological effects of
decreased plasma protein levels on the body.

A substantial decrease in plasma protein levels resulting from liver impairment can have a number
of detrimental impacts on the body's capacity to coagulate blood, fight infections, maintain fluid
balance, and transport essential nutrients.

4. Short Answer: Detoxification Pathways

- Describe the two-phase process by which the liver detoxifies fat-soluble
toxins. Explain the role of cytochrome P450 enzymes and conjugation
reactions in this process.
It detoxifies fat soluble toxins by 2 pahses, Firstly the cytochrome P450 enzymes modify toxins
adding or exponsing reactive pairs, turning into water soluble. Secondly is the conjugation, where
the liver attatches small molecules (e.g: glucuronic) acid to these toxins, ocnsecuently increasing
their solubility. Which makes it easir to excrete in urine.

5. Extended Response: Erythrocyte Recycling

- Outline the process of erythrocyte breakdown in the liver, including the
roles of Kupffer cells, hemoglobin breakdown, and the fate of iron and
bilirubin.

6. Data Analysis: Alcohol Metabolism

- Given a case study of a patient with long-term alcohol abuse, analyze the
changes in liver structure and function. Predict the likely clinical symptoms
based on these changes.
Some structural changes in liver are the accumulation of fat in liver cells, alcoholic hepatitis caused
by inflammation and swelling of liver tissue and Cirrhosis, which is an extensive scarring, causing
permament damage and loss of liver function. On the other hand some functional changes include the
impaired proccesing of nutrients and hormones (metabolism damaged). Some predicts of clinical
symptoms include Jaundice, which is the yellowing in skin and eyes due to bilurunin excess.

7. Application: Jaundice
- Describe how jaundice develops as a result of liver dysfunction. Discuss
how different causes of jaundice (e.g., liver disease vs. gallbladder
obstruction) might present differently in patients.
Jaundice deverlops when there is an excess of bilirubin in the blood, which leads to a yellowing skin
and eyes. It happens normally when the liver is unable to process or excrete the bilirunin. Some of
the causes include liver disease, where conditions like hepatitis damages liver cells, reducing their
ability to process well the bilirubin. It can present in patients with symptoms like dark urine, pale
sools and fatigue.As well the gallbladder obstructions, which is a blockcage in the bile ducts thta
prevents bilirubin from being excreted into the digestive truct. It causes presentation in the patients
include liver disease, dark urine.

8. Experimental Design: Protein Metabolism

- Design an experiment to investigate the effect of varying levels of dietary
protein on urea production in the liver. Include a hypothesis, variables, and a
method for measuring urea levels.
Hypothesis: Increased dietary protein levels cause an increase in urea synthesis in the liver due to
accelerated amino acid deamination. Independent variable: levels of dietary problems, dependent:
urea production in the liver.

9. Data Interpretation: Cholesterol Transport

- Examine a data set showing LDL and HDL levels in patients with different
diets. Explain how the liver contributes to the regulation of blood cholesterol
levels and discuss the implications for cardiovascular health.

10. Application: Carbohydrate Metabolism

- Propose a dietary intervention for a patient with impaired glycogen
storage due to liver damage. Explain how the liver's role in carbohydrate
metabolism influences your recommendations.
10