27 Questions
What is the primary function of the liver in synthesizing vital proteins?
Synthesis of plasma proteins and coagulation proteins
Which substance is produced by the liver and supports detoxification as well as digestion?
Bile
What happens to hemoglobin in the liver as part of its function in detoxification and degradation?
It is degraded to bilirubin
What is the main function of the MARS® membrane?
To prevent albumin-bound toxins from reaching the dialysate's albumin
Why is the patient's albumin not in contact with the adsorbers in the MARS® system?
The membrane is impermeable to albumin-bound toxins
What type of toxins can be removed via dialysis in the MARS® system?
Water-soluble toxins
What distinguishes the MARS® adsorbers from other components of the system?
They remove water-soluble toxins
What stage of hepatic encephalopathy is characterized by clear confusion and awakening in dizziness?
Stage III
Which symptom is commonly seen in failing liver patients due to the inability of the liver to store glycogen?
Hyperglycemia
What does the loss of performance in detoxification lead to in the context of hepatic encephalopathy?
Accumulation of toxins inducing neurological disturbances
What can the failing liver's inability to respond to insulin and store glycogen result in?
Diabetes
How does the Fractionated Plasma Separation and Adsorption (FPSA) system separate the patient's albumin loaded with toxins from the blood?
By using a dialyzer membrane with a higher cut-off
Why is the affinity of toxins to bind to albumin decreased in fluids with shifted pH values?
Because different pH values affect different toxins in varied ways
How is the albumin in the dialysate cleaned in the ADVOS® system?
Through a change of pH value
What is the purpose of the second adsorber in the Prometheus® system?
To specialize in removing bilirubin
What is the main difference between adsorption and absorption?
Absorption involves the adhesion of atoms, ions, or molecules from a gas, liquid, or dissolved solid to a surface, while adsorption involves the entry of atoms, molecules, or ions into some bulk phase.
What is the function of activated carbon in adsorption?
To provide exceptionally high surface area that allows for more than 200 football fields.
Which factor highly influences adsorption according to the text?
Flow rate (contact time)
What characterizes the Vroman effect in relation to adsorption?
It involves proteins with the highest mobility being firstly adsorbed, but later displaced by proteins with a higher binding affinity.
Which system uses a conventional high flux dialyzer to prevent albumin from passing the membrane?
Single Pass Albumin Dialysis (SPAD)
What is the core of the MARS® system that is highly permeable for albumin-bound toxins but not for the albumin itself?
MARS® membrane
Which artificial liver system uses a membrane that also lets water-soluble toxins pass for removal via dialysis?
Molecular Adsorbent Recirculation System (MARS®)
In which system do the adsorbers remove toxins from the dialysate's albumin similar to the Prometheus system?
Molecular Adsorbent Recirculation System (MARS®)
What is the primary function of the MARS® membrane in the MARS® system?
To filter out albumin-bound toxins and let pass water-soluble toxins
How does the dialysate's albumin interact with the MARS® membrane in the MARS® system?
It switches with the patient's albumin to remove albumin-bound toxins
What happens to the patient's albumin in the MARS® system as a result of the MARS® membrane's permeability?
It recirculates for detoxification without contacting the adsorbers
Which statement accurately describes the role of dialysate's albumin in the MARS® system?
It acts as a carrier to transfer albumin-bound toxins through the MARS® membrane.
Study Notes
Liver Functions
- The liver synthesizes vital proteins, including albumin, which plays a crucial role in detoxification and digestion.
- The liver produces bilirubin, a substance that supports detoxification and digestion.
- The liver breaks down hemoglobin as part of its detoxification and degradation function.
MARS System
- The primary function of the MARS membrane is to separate albumin-bound toxins from the blood.
- The patient's albumin is not in contact with the adsorbers in the MARS system to prevent albumin loss.
- The MARS system can remove albumin-bound toxins, including protein-bound toxins, via dialysis.
- The MARS adsorbers are distinguished from other components of the system by their ability to remove albumin-bound toxins.
- The MARS membrane is highly permeable for albumin-bound toxins but not for the albumin itself.
Hepatic Encephalopathy
- Stage 2 of hepatic encephalopathy is characterized by clear confusion and awakening in dizziness.
- The loss of performance in detoxification leads to hepatic encephalopathy.
- The failing liver's inability to respond to insulin and store glycogen can result in hypoglycemia.
FPSA System
- The FPSA system separates the patient's albumin loaded with toxins from the blood using fractionated plasma separation and adsorption.
ADVOS System
- The albumin in the dialysate is cleaned in the ADVOS system.
Prometheus System
- The second adsorber in the Prometheus system removes toxins from the dialysate's albumin.
- The Prometheus system uses a membrane that also lets water-soluble toxins pass for removal via dialysis.
Adsorption
- Adsorption is different from absorption, as it involves the attraction of molecules to a surface.
- The affinity of toxins to bind to albumin is decreased in fluids with shifted pH values.
- Activated carbon is used in adsorption to attract toxins.
- The Vroman effect characterizes the adsorption of molecules to a surface.
- The core of the MARS system is highly permeable for albumin-bound toxins but not for the albumin itself.
- The MARS membrane interacts with the dialysate's albumin to remove toxins.
- The patient's albumin is not affected by the MARS membrane's permeability.
- The dialysate's albumin plays a crucial role in the MARS system by binding to toxins.
Test your knowledge on the features of the Molecular Adsorbent Recirculation System (MARS®) and the design of artificial liver. This quiz covers topics such as the MARS® membrane, recirculation of dialysate's albumin, and the permeability of albumin-bound toxins.
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