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Clinical Chemistry 1 > C - Chapter X: Liver Function Test > Flashcards

C - Chapter X: Liver Function Test Flashcards

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1
Q

Largest organ ([?] in adult)

A

~1.2 – 1.5 kg

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2
Q

Located in the

A

right upper quadrant of the abdomen

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3
Q

Dual Blood Supply:

A

a) Portal Vein
b) Hepatic Artery

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4
Q

– carries blood from alimentary tract

A

a) Portal Vein

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5
Q

– carries oxygenated blood to the liver

A

b) Hepatic Artery

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6
Q

Receives, processes & stores materials absorbed from the

A

digestive tract

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7
Q

Synthesis:

A

multiple plasma proteins

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8
Q

Main organ of

A

detoxification

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9
Q

Synthesis of bile acids from

A

cholesterol

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10
Q

Major site of

A

catabolism of hormones

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11
Q

– “Icterus”

A

JAUNDICE

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12
Q

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

A

JAUNDICE

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13
Q

PORTAL HYPERTENSION ( mmHg)

A

> 20

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14
Q

PORTAL HYPERTENSION

Increased:

A

sinusoidal infiltration, scarring or hepatic vein obstruction

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15
Q

PORTAL HYPERTENSION

Major Complications:

A

Hepatosplenomegaly, Ascites & Hepatorenal syndrome

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16
Q

Accumulation of substances that are normally metabolized by the liver

A

HEPATIC FAILURE & ENCEPHALOPATHY

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17
Q

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

A

ALTERED DRUG METABOLISM

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18
Q

Hormone imbalance

A

ENDOCRINE ABNORMALITIES

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19
Q

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

A

IMMUNOGLOBULIN ABNORMALITIES

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20
Q

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

A

DISORDERED HEMOSTASIS

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21
Q

CLINICAL MANIFESTATIONS OF LIVER DISEASE

A
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22
Q

DAILY BILIRUBIN PRODUCTION

A

(average 250 – 300 mg)

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23
Q

: Derived from degradation heme from hemoglobin

A

85%

24
Q
A

15%

25
Q

FORMS OF BILIRUBIN

A

UNCONJUGATED
CONJUGATED
DELTA

26
Q

– bound by albumin & transported to the liver

A

 UNCONJUGATED

27
Q

– formed from the reaction of UCB with glucuronic acid

A

 CONJUGATED

28
Q

– conjugated bilirubin bound to Albumin

A

 DELTA

29
Q
  • Both have acceptable precision
A

Jendrassik-Grof & Evelyn-Malloy procedures

30
Q
  • Adapted by many automated instruments
A

Jendrassik-Grof & Evelyn-Malloy procedures

31
Q
  • Most frequently used methods to measure Bilirubin
A

Jendrassik-Grof & Evelyn-Malloy procedures

32
Q

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

A

PRE-HEPATIC JAUNDICE

33
Q

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

A

PRE-HEPATIC JAUNDICE

34
Q

 Unconjugated hyperbilirubinemia

A

PRE-HEPATIC JAUNDICE

35
Q

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

A

HEPATIC JAUNDICE

36
Q

Disorders of Bilirubin Metabolism

A

Gilbert’s Syndrome
Crigler-Najjar Syndrome

37
Q

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

A

Gilbert’s Syndrome

38
Q

 Chronic unconjugated hyperbilirubinemia; rare & more severe disorder

A

Crigler-Najjar Syndrome

39
Q

Molecular defect w/in the gene involved with bilirubin conjugation

A

Crigler-Najjar Syndrome

40
Q

– complete absence of enzymatic bilirubin conjugation

A

Crigler-Najjar Syndrome Type I

41
Q

– mutation causing a severe deficiency of the enzyme for conjugation

A

Crigler-Najjar Syndrome Type II

42
Q

Disorders related to Transport (Transport Defects)

A

Dubin-Johnson Syndrome
Rotor Syndrome

43
Q

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

A

Dubin-Johnson Syndrome

44
Q

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

A

Dubin-Johnson Syndrome

45
Q

Appearance of dark-stained granules on a liver biopsy

A

Dubin-Johnson Syndrome

46
Q

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

A

Rotor Syndrome

47
Q

Liver biopsy does NOT show dark pigmented granules

A

Rotor Syndrome

48
Q

PHYSIOLOGIC JAUNDICE of the NEWBORN

Unconjugated [?]

A

hyperbilirubinemia

49
Q

PHYSIOLOGIC JAUNDICE of the NEWBORN

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

A

Glucuronyl transferase

50
Q

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

A

Kernicterus

51
Q

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

A

POST-HEPATIC JAUNDICE

52
Q

Prevents the flow of conjugated bilirubin into the bile canaliculi

A

POST-HEPATIC JAUNDICE

53
Q

Clay-colored stool

A

POST-HEPATIC JAUNDICE

54
Q
  • results in cell damage & death in the newborn
A

Kernicterus

55
Q

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

A

POST-HEPATIC JAUNDICE

56
Q

 Prevents the flow of conjugated bilirubin into the bile canaliculi

A

POST-HEPATIC JAUNDICE

57
Q

 Clay-colored stool

A

POST-HEPATIC JAUNDICE

Clinical Chemistry 1 (10 decks)

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