Assessment of Liver Function Flashcards
A disorder described as increased bilirubin production due to increased destruction of RBCs
Hemolytic Disorders
Transport defect coupled with a mild UDPGT deficiency wherein only 30% enzyme activity is present.
Gilbert Syndrome
Presence of circulating inhibitor of bilirubin conjugation. Called “Transient familial neonatal hyperbilirubinemia”; Treated with phototherapy
Lucey-Driscoll Syndrome
Transient UDPGT deficiency; treated with phototherapy
Physiologic jaundice of the Newborn
Predisposes a newborn to kernicterus
Crigler-Najjar syndrome
Combined hepatocellular hyperbilirubinemia; decreased conjugation; failure of enterohepatic circulation; Interference in bile flow
Viral hepatitis, Cirrhosis, Hepatic Carcinoma
A secretory defect. Failure to convey the conjugated bilirubin to the bile canaliculi
Dubin Johnson syndrome, Rotor syndrome
A syndrome due to deficiency of canalicular transporter protein. Dark pigmentation due to lipofuscin.
Dubin Johnson syndrome
A syndrome with unknown cause of secretory defect. No dark pigmentation observed
Rotor Syndrome
Obstruction of gallstones due to cholelithiasis or tumors that block the bile duct. High urine bilirubin, low urine urobilinogen.
Biliary obstruction
is a chemical reaction used to measure bilirubin levels in blood. More specifically, it determines the amount of conjugated bilirubin in the blood.
Van der Bergh reaction
What are the 4 main functions of liver
Storage, Synthetic/Metabolism, detoxification, secretory/excretory
What does the liver store
Glycogen and fat-soluble vitamins
What does the liver metabolize?
lipids, proteins, lipoproteins, carbs, and coagulation factors
What does the liver detoxify?
drugs, poisons, and metabolic products
What does the liver secrete?
Conjugated bilirubin
Highly elevated in hepatitis?
AST, ALT, and ALP; Bilirubin
Which analytes are elevated in cirrhosis?
Bilirubin, Ammonia, ALP
Elevated in biliary obstruction
Bilirubin, ALP
an enzyme which breaks down heme to become biliverdin
Heme oxygenase
An enzyme present in bilirubin conjugation in the smooth ER of hepatocytes
UDPGT
UDPGT stands for:
Uridine diphosphate glucuronyl transferase
What form of bilirubin is secreted in urine in normal condition?
Urobilinogen
Conjugated bilirubin covalently bound to albumin, preventing its excretion in urine
Delta bilirubin
True or False: Both conjugated and unconjugated bilirubin is elevated in the combination case of viral hepatitis, cirrhosis, and hepatic carcinoma
True
True or False: Conjugated bilirubin is elevated in Dubin-Johnson Syndrome and Rotor Syndrome
True
The other name for conjugated bilirubin is…
B2/ diglucuronide
B1 is also known as:
Bilirubin monoglucuronide
What is kernicterus?
a type of brain damage that can result from high levels of bilirubin in a baby’s blood. It can cause athetoid cerebral palsy and hearing loss. It also causes problems with vision and teeth and sometimes can cause intellectual disabilities.
What are the reagents in Evelyn-Malloy technique?
0.1% sulfanilic acid in HCl and Sodium nitrite, diazo rgt
Reagents in Jendrassik-Groff technique
ascorbic acid, alkaline tartrate buffer, and diazo rgt
Color reaction in Evelyn-Malloy technique
Red-purple
Color rxn in Jendrassik-Groff technique
Blue
Accelerator in Evelyn-Malloy technique
Methanol
Accelerator in Jendrassik-Groff technique
Caffeine (Sodium benzoate)
Absorbance in Evelyn-Malloy technique
560 nm
Absorbance in Jendrassik-Groff technique
600 nm
pH reaction of Evelyn-Malloy Technique
Acidic
pH of Jendrassik-Groff technique
Alkaline
the formula for Indirect bilirubin
Total Bilirubin - Direct Bilirubin
Absorbance measurement at 450 nm to determine the total bilirubin concentration in the serum of newborns
Direct spectrophotometric method
Oxidation of bilirubin to a colorless product and measurement of the change in absorbance
Enzymatic method
Conversion factor for bilirubin
17.1
Rf value for B1
0.2-0.8 mg/dL
Rf value for B2
0-0.2 mg/dL
Rf value for Total Bilirubin
0.2-1.0 mg/dL
Rf value for Overt jaundice
> 3 mg/dL
Rf value for panic value
> 15 mg/dL
Rf value for Kernicterus and death
> 20 mg/dL
