(2) I. TESTS FOR LIVER SYNTHETIC FUNCTION Flashcards
Quantitates the severity of liver dysfxn
TESTS FOR LIVER SYNTHETIC FUNCTION
TESTS FOR LIVER SYNTHETIC FUNCTION
TAAGP
A. Total Protein
B. Albumin
C. Albumin/Globulin Ratio
D. Prothrombin test
Assessment of nutritional status & presence of severe dsz involving the liver, kidney & bone marrow
Total Protein
TP = ______ + Globulin
TP = Albumin + globulin
Sample spx for total protein
Serum
Why is plasma not used in getting the total protein?
o Plasma contains fibrinogen.
o Use of Plasma: False ↑TP by 0.2-.04g/dL
General interferences for total protein
hemolysis, ictericia
Methods for Total Protein
- Kjeldal
- Biuret
- Folin-Ciocalteu (Lowry)
- UV Absorption
- Refractometry
- Turbidimetry & Nephelometry
- Salt Fractionation
- Coomasie Brilliant Blue Dye
- Ninhydrin
- Serum Protein Electrophoresis (SPE)
- Most abundant among all proteins.
- Concentration is directly proportional to the severity of hepatic disease.
Albumin
Liver synthesizes how many grams of albumin per day?
9-12 g
decreased albumin levels may be due to
decreased synthesis
Methods for Albumin
- Salt precipitation
- Dye-binding
- Globulins are precipitated (since TP = Alb + glob)
- Albumin is quantitated using biuret reaction
SALT Precipitation
Dye binding method for albumin
o most commonly used.
Sensitive dye.
o most specific dye
o not specific for albumin.
o more specific to albumin than methyl orange
Dye binding method for albumin
o Bromcresol Green (BCG): most commonly used.
Sensitive dye.
o Bromcresol purple (BCP): most specific dye
o Methyl Orange: not specific for albumin.
o 2,4’-hydroxyazobenzene-benzoic acid (HABA): more
specific to albumin than methyl orange
Dye binding method for albumin Interferences:
Conj. bilirubin, Aspirin, Penicillin, Sulfonamides
o Performed to check if globulin is higher than albumin aka Inverted A/G ratio
o Computed & not measured.
ALBUMIN/GLOBULIN RATIO
Inverted A/G ratio is seen in:
o Cirrhosis
o Multiple Myeloma
o Waldenstroms macroglobulinemia
Formula for A/G ratio
A/G ratio = A/G
Globulin = TP - Albumin
Vitamin K Response Test
PT test (Prothrombin test)
In CC, 10mg Vit. K is administered (IM) 1-3days prior to PT, why?
Due to Vit. K dependent clotting factors (2, 7, 9, 10).
After administration of Vit. K & still no CF (prolonged PT)
indicates intrahepatic disorder
After administration of Vit. K then normal PT,
indicates extrahepatic disorder
Differentiates intrahepatic disorder from extrahepatic disorder
Vitamin K Response Test (PT test)
Acute/Chronic Hepatitis: prolonged PT signifies
massive cellular damage.
- Globulins are precipitated (since TP = Alb + glob)
- Albumin is quantitated using biuret reaction
SALT Precipitation
