C - Chapter X: Liver Function Test

Question 1

Largest organ ([?] in adult)

Answer 1

~1.2 – 1.5 kg

Question 2

Located in the

Answer 2

right upper quadrant of the abdomen

Question 3

Dual Blood Supply:

Answer 3

a) Portal Vein
b) Hepatic Artery

Question 4

– carries blood from alimentary tract

Answer 4

a) Portal Vein

Question 5

– carries oxygenated blood to the liver

Answer 5

b) Hepatic Artery

Question 6

Receives, processes & stores materials absorbed from the

Answer 6

digestive tract

Question 7

Synthesis:

Answer 7

multiple plasma proteins

Question 8

Main organ of

Answer 8

detoxification

Question 9

Synthesis of bile acids from

Answer 9

cholesterol

Question 10

Major site of

Answer 10

catabolism of hormones

Question 11

– “Icterus”

Answer 11

JAUNDICE

Question 12

– yellow discoloration of the plasma, skin, sclerae & mucous membranes caused by Bilirubin accumulation

Answer 12

JAUNDICE

Question 13

PORTAL HYPERTENSION ( mmHg)

Answer 13

> 20

Question 14

PORTAL HYPERTENSION

Increased:

Answer 14

sinusoidal infiltration, scarring or hepatic vein obstruction

Question 15

PORTAL HYPERTENSION

Major Complications:

Answer 15

Hepatosplenomegaly, Ascites & Hepatorenal syndrome

Question 16

Accumulation of substances that are normally metabolized by the liver

Answer 16

HEPATIC FAILURE & ENCEPHALOPATHY

Question 17

Liver plays a major role in enzymatic transformation & disposition of drugs

Answer 17

ALTERED DRUG METABOLISM

Question 18

Hormone imbalance

Answer 18

ENDOCRINE ABNORMALITIES

Question 19

The liver efficiently sequesters dimeric IgA & secretes it into the bile

Answer 19

IMMUNOGLOBULIN ABNORMALITIES

Question 20

Chronic liver disease produces alterations in Hemostasis and a generalized hemorrhagic tendenc

Answer 20

DISORDERED HEMOSTASIS

Question 21

CLINICAL MANIFESTATIONS OF LIVER DISEASE

Question 22

DAILY BILIRUBIN PRODUCTION

Answer 22

(average 250 – 300 mg)

Question 23

: Derived from degradation heme from hemoglobin

Answer 23

85%

Answer 24

15%

Question 25

FORMS OF BILIRUBIN

Answer 25

UNCONJUGATED CONJUGATED DELTA

Question 26

– bound by albumin & transported to the liver

Answer 26

 UNCONJUGATED

Question 27

– formed from the reaction of UCB with glucuronic acid

Answer 27

 CONJUGATED

Question 28

– conjugated bilirubin bound to Albumin

Answer 28

 DELTA

Question 29

- Both have acceptable precision

Answer 29

Jendrassik-Grof & Evelyn-Malloy procedures

Question 30

- Adapted by many automated instruments

Answer 30

Jendrassik-Grof & Evelyn-Malloy procedures

Question 31

- Most frequently used methods to measure Bilirubin

Answer 31

Jendrassik-Grof & Evelyn-Malloy procedures

Question 32

 Occurs when the problem causing the jaundice occurs prior to liver metabolism

Answer 32

PRE-HEPATIC JAUNDICE

Question 33

 Caused by an increased amount of bilirubin being presented to the liver (e.g. Acute & Chronic Hemolytic Anemia)

Answer 33

PRE-HEPATIC JAUNDICE

Question 34

 Unconjugated hyperbilirubinemia

Answer 34

PRE-HEPATIC JAUNDICE

Question 35

 Primary problem causing the jaundice resides in the liver (intrinsic liver disease)

Answer 35

HEPATIC JAUNDICE

Question 36

Disorders of Bilirubin Metabolism

Answer 36

Gilbert’s Syndrome Crigler-Najjar Syndrome

Question 37

– intermittent hyperbilirubinemia; cause by reduction in the expression of UGT1A1 gene (thereby reduced conjugating ability of the liver)

Answer 37

Gilbert’s Syndrome

Question 38

 Chronic unconjugated hyperbilirubinemia; rare & more severe disorder

Answer 38

Crigler-Najjar Syndrome

Question 39

Molecular defect w/in the gene involved with bilirubin conjugation

Answer 39

Crigler-Najjar Syndrome

Question 40

– complete absence of enzymatic bilirubin conjugation

Answer 40

Crigler-Najjar Syndrome Type I

Question 41

– mutation causing a severe deficiency of the enzyme for conjugation

Answer 41

Crigler-Najjar Syndrome Type II

Question 42

Disorders related to Transport (Transport Defects)

Answer 42

Dubin-Johnson Syndrome Rotor Syndrome

Question 43

Removal of conjugated bilirubin from the liver cell & the excretion into the bile are defective

Answer 43

Dubin-Johnson Syndrome

Question 44

Caused by deficiency of the canalicular transporter protein (MDR2/cMOAT)

Answer 44

Dubin-Johnson Syndrome

Question 45

Appearance of dark-stained granules on a liver biopsy

Answer 45

Dubin-Johnson Syndrome

Question 46

Hypothesized to be due to a reduction in the concentration or activity of intracellular binding proteins (e.g. Ligandin)

Answer 46

Rotor Syndrome

Question 47

Liver biopsy does NOT show dark pigmented granules

Answer 47

Rotor Syndrome

Question 48

PHYSIOLOGIC JAUNDICE of the NEWBORN Unconjugated [?]

Answer 48

hyperbilirubinemia

Question 49

PHYSIOLOGIC JAUNDICE of the NEWBORN Deficiency in the enzyme [?] (one of the last liver functions to be activated in prenatal life)

Answer 49

Glucuronyl transferase

Question 50

– deposition of bilirubin in the nuclei of brain & nerve cells

Answer 50

Kernicterus

Question 51

Usually results from biliary obstructive disease (e.g. gallstones, tumors)

Answer 51

POST-HEPATIC JAUNDICE

Question 52

Prevents the flow of conjugated bilirubin into the bile canaliculi

Answer 52

POST-HEPATIC JAUNDICE

Question 53

Clay-colored stool

Answer 53

POST-HEPATIC JAUNDICE

Question 54

- results in cell damage & death in the newborn

Answer 54

Kernicterus

Question 55

 Usually results from biliary obstructive disease (e.g. gallstones, tumors)

Answer 55

POST-HEPATIC JAUNDICE

Question 56

 Prevents the flow of conjugated bilirubin into the bile canaliculi

Answer 56

POST-HEPATIC JAUNDICE

Question 57

 Clay-colored stool

Answer 57

POST-HEPATIC JAUNDICE