ASSESSMENT OF LIVER FUNCTION

Question 1

Storage functions of the liver

Answer 1

Glycogen, fat-soluble vitamins A, D, E, K

Question 2

Synthetic functions of the liver

Answer 2

Lipids, carbohydrates, proteins (TP, Albumin, Gamma globulin), Coagulation factors (PT)

Question 3

Detoxification function of the liver

Answer 3

Drugs, poisons, metabolic products (NH2, B1)

Question 4

Secretory and excretory function of the liver

Answer 4

Conjugated bilirubin

Question 5

Hepatocellular markers

Answer 5

ALT, AST, LD

Question 6

Hepatobiliary marker

Answer 6

ALP

Question 7

Markers for synthetic liver function

Answer 7

TP, Albumin, Bilirubin

Question 8

Marker for liver detoxification

Answer 8

Ammonia

Question 9

Conditions causing hepatocellular damage

Answer 9

Hepatitis, cirrhosis, fulminant hepatic failure

Question 10

Conditions causing hepatobiliary damage

Answer 10

Biliary obstruction, space-occupying lesions, passive congestion

Question 11

Laboratory findings in hepatitis

Answer 11

AST, ALT, LD, ALP, Bilirubin (B1 and B2) elevated

Question 12

Laboratory findings in cirrhosis

Answer 12

ALP (normal to slightly high), TP and Albumin (low), Bilirubin (B1 and B2) high, Ammonia high

Question 13

Laboratory findings in fulminant hepatic failure

Answer 13

AST very high, ALT, LD, ALP, Bilirubin (B1 and B2), Ammonia high; TP and Albumin low

Question 14

Laboratory findings in biliary obstruction

Answer 14

ALP, Bilirubin (B2) elevated

Question 15

Laboratory findings in space-occupying lesions (tumors)

Answer 15

AST, ALT, Bilirubin (B2) normal to high

Question 16

Laboratory findings in passive congestion

Answer 16

AST, ALT, LD slightly high, ALP and Bilirubin (B2) normal to slightly high

Question 17

Definition of panhepatic cirrhosis

Answer 17

Destruction of >80% of liver tissue, with no regeneration

Question 18

Cause of fulminant hepatic failure

Answer 18

Reye syndrome, hepatitis, cirrhosis

Question 19

Bilirubin 1 (Unconjugated) characteristics

Answer 19

Water insoluble, non-polar, indirect reading, hemobilirubin, free bilirubin/slow, pre-hepatic

Question 20

Bilirubin 2 (Conjugated) characteristics

Answer 20

Water soluble, polar, direct reading, cholebilirubin, one-minute/prompt, post-hepatic/obstructive/regurgitative

Question 21

Where is conjugated bilirubin excreted?

Answer 21

Excreted in urine

Question 22

Which form of bilirubin has a high affinity to CNS?

Answer 22

Unconjugated bilirubin (B1)

Question 23

Delta bilirubin characteristics

Answer 23

Bilirubin tightly bound to albumin, longer half-life of 17 days, formed due to prolonged elevation of conjugated bilirubin in biliary obstruction

Question 24

Use of delta bilirubin in monitoring

Answer 24

Helps monitor the decline of serum bilirubin following gallstone removal

Question 25

Reaction of delta bilirubin with diazo reagent

Answer 25

Reacts in the direct bilirubin assay

Question 26

Formula for computing delta bilirubin

Answer 26

DB = TB – B2 + B1

Question 27

Who is delta bilirubin not calculated for?

Answer 27

Neonates (≤ 14 days old)

Question 28

Reference value for delta bilirubin

Answer 28

< 0.2 mg/dL (<3 µmol/L)

Question 29

Method used to separate delta bilirubin

Answer 29

HPLC