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CCLECT > [CC LECT] Liver Function Test: Part II > Flashcards

[CC LECT] Liver Function Test: Part II Flashcards

1
Q

Sample used in bilirubin methodology

A

Serum

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2
Q

BILIRUBIN METHODOLOGY

After extraction, the blood should be placed
in a ______, using _____ or _______

A

Dark place;

amber bottles of foil or carbon paper

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3
Q

Bilirubin Methodology

If exposed to light: ↓ _____ per hour in bilirubin

A

30-50%

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4
Q

Bilirubin Methodology

If sample is prepared and stored properly:
→ Room temperature: ________

A

2 days

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5
Q

Bilirubin Methodology

If sample is prepared and stored properly:
→ Refrigerator (4˚C): ______

A

1 week

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6
Q

Bilirubin Methodology

If sample is prepared and stored properly:
Freezer (-20˚C): ______

A

Indefinite

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7
Q

T/F: In bilirubin methodology, fasting sample is required

A

False; Fasting sample is preferred but not required

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8
Q

What are the 2 interferences in bilirubin methodology

A

Lipemia and Hemolysis

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9
Q

BILIRUBIN METHODOLOGY

Lipemia: ________ bilirubin concentration

Hemolysis: _______ reaction of bilirubin
with diazo reagent (________ bilirubin)

A

increased

decrease; decrease

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10
Q

Principle in bilirubin assay

A

Van den Berg Reaction

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11
Q

diazotization of bilirubin to form azobilirubin

A

Van den Berg Reaction

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12
Q

Van den Berg Reaction is the – _______ of bilirubin to form ______

A

diazotization; azobilirubin

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13
Q

T/F: the bilirubin assay Only measure conjugated/direct bilirubin and
total bilirubin.

A

True

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14
Q

what is added to measure indirect bilirubin (B1) ?

A

accelerators or accelerants

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15
Q

What are the two methods in bilirubin assay

A
  1. Evelyn and Malloy Method
  2. Jendrassik and Grof Method
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16
Q

T/F: In Evelyn and Malloy Method only conjugated are directly measured

A

True

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17
Q

Principle used in Evelyn and Malloy Method

A

Van den berg reaction

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18
Q

Coupling accelerator used in Evelyn and Malloy Method

A

Methanol

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19
Q

What is the disadvantage of methanol

A

precipitate protein which causes
turbidity = increased absorbance = false
increase in concentration

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20
Q

What are the 3 Diazo reagents used in evelyn and malloy method

A

Diazo A
Diazo B
Diazo blank

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21
Q

Composition of Diazo A

A

0.01% sulfanilic acid + HCl

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22
Q

Composition of Diazo B

A

0.5% sodium nitrite

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23
Q

Composition of Diazo blank

A

1.5% HCl

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24
Q

T/F: Diazo reagents in Evelyn and Malloy Method are performed at pH near 2.0

A

False; 1.0

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25
Q

Diazo reagents in Evelyn and Malloy Method are performed at pH near 1.0 to form the _____

A

final reaction

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26
Q

Final reaction in Evelyn and Malloy Method

A

pink to purple azobilirubin (with
maximal absorption at 560 nm)

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27
Q

Most commonly used method because it is more sensitive than Evelyn and Malloy method

A

Jendrassik and Grof Method

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28
Q

Jendrassik and Grof Method is a popular technique for _______

A

discreet analyzers

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29
Q

Main reagent in Jendrassik and Grof Method

A

Diazo reagent

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30
Q

T/F: the Diazo reagent in Jendrasssik and grof method has the same composition with Evelyn and Malloy method

A

True

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31
Q

Accelerator in Jendrassik and Grof Method

A

Caffeine Sodium Benzoate

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32
Q

Buffer in Jendrassik and Grof Method

A

Sodium Acetate

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33
Q

terminates the accelerator and
destroys excess diazo reagent

A

Ascorbic acid:

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34
Q

provides alkaline pH
after addition of ascorbic acid

A

Alkaline Tartrate Solution

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35
Q

Final reaction in Jendrassik and Grof Method

A

blue azobilirubin (measured at
600nm)

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36
Q

Incubation time for Jendrassik and Grof Method

A

5 mins

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37
Q

State the conditions associated with increased INDIRECT Bilirubin

A

● Gilbert’s Syndrome
● Criggler-Najjar Syndrome
● Hemolytic anemia
● Dubin-Johnson Syndrome
● Hepatocellular disease
● Lucey-Driscoll Syndrome
● G-6-PD deficiency

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38
Q

What is G-6-PD

A

Glucose-6-phosphate dehydrogenase

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39
Q

What is G-6-PD

A

Glucose-6-phosphate dehydrogenase

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40
Q

State the conditions associated with increased DIRECT Bilirubin

A

● Biliary obstruction or cholelithiasis (gall stones)
● Pancreatic (head) cancer
● Dubin-Johnson Syndrome
● Alcoholic and viral hepatitis
● Biliary atresia
● Hepatocellular disease

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41
Q

Urobilinogen is a colorless end product of _________ that is oxidized by intestinal flora to _______

A

Bilirubin metabolism; urobilin

42
Q

The absence of urobilin in the urine or stool
means there is ________

A

complete biliary obstruction

43
Q

Collection of sample in urobilinogen

A

avoid light exposure

44
Q

What is the specimen used in urobilinogen

A

2-hr freshly collected urine or freshly
collected stool.

45
Q

Method used in urobilinogen

A

Ehrlich’s method

46
Q

Reagent of ehrlich method (urobilinogen)

A

p-dimethylaminobenzaldehyde
(DMAB)

47
Q

Reference value for urine in urobilinogen

A

0.1-1.0 Ehrlich Unit/2 hour or 0.54 Ehrlich Unit/day urine

48
Q

Reference value for stool in urobilinogen

A

75-275 Ehrlich Unit/100g of feces

49
Q

1 Erlich unit is approximate of how many mg of urobilinogen

A

1mg

50
Q

Test for hepatocellular function and potency of bile
duct

A

BROMOSULFONTHALEIN (BSP) DYE EXTRACTION
TEST

51
Q

T/F: BROMOSULFONTHALEIN (BSP) BYE EXTRACTION
TEST HAS physiologic function

A

F; No physiologic function

52
Q

Why is BROMOSULFONTHALEIN (BSP) BYE EXTRACTION
TEST rarely performed ?

A

because it involves the
administration of the dye

53
Q

2 Methods of Administration in BROMOSULFONTHALEIN (BSP) BYE EXTRACTION TEST

A
  1. Rosenthal White Method
  2. Mac Donald Method
54
Q

Rosenthal White Method is aka

A

Double-Collection Method

55
Q

BSP Dose in Rosenthal White Method

A

2 mg/Kg body weight

56
Q

How many specimen collection is performed in Rosenthal White Method

A

2

5 minutes after BSP administration
30 minutes after BSP administration

57
Q

Rosenthal White Method:

Reference value:
→ After 5 minutes: _____
→ After 30 minutes: ______

A

→ After 5 minutes: 50% dye retention
→ After 30 minutes: 0% dye retention

58
Q

Mac Donald Method is aka

A

Single-Collection Method

59
Q

BSP Dose in Mac Donald Method

A

5 mg/Kg body weight

60
Q

Specimen collection in Mac Donald Method

A

after 45 minutes of
administration

61
Q

Mac Donald Method

Reference value:
→ After 45 minutes: ____

A

+/- 5% Dye Retention

62
Q

What are the two test for detoxification function

A

Enzyme and ammonia

63
Q

It is used to assess the extent of liver damage.

A

ENZYME TESTS

64
Q

T/F: All enzymes are extracellular

A

F; intracellular

65
Q

Indicator of cell injury in early or localized liver
disease (hepatocellular/functional disease)

A

Enzyme tests

66
Q

1st marker for detoxification

A

Enzyme tests

67
Q

T/F: More enzyme in circulation = severity of the
damage in the live

A

true

68
Q

What are the 6 Hepatic enzymes

A
  1. Alanine aminotransferase (ALT)
  2. Aspartate aminotransferase (AST)
  3. Gamma-glutaryl transferase
  4. 5’-nucleotidase
  5. Lactate dehydrogenase
  6. Ornithine carbamoyl transferase
69
Q

What are the enzymes increased in case of drug toxicity

A

ALT & AST

70
Q

T/F; both ALT and AST are increased in case of drug toxicity but ALT is greater)

A

True

71
Q

Diagnostic marker of hepatic failure

A

Ammonia

72
Q

Ammonia is produced by what

A

Produced by catabolism of amino acids and by
bacterial metabolism in the intestine

73
Q

Ammonia is detoxified into _____ (liver), then eliminated by the _____ (urine)

A

urea; kidneys

74
Q

2nd marker for detoxification and cirrhosis

A

AMMONIA

75
Q

first marker for cirrhosis

A

Albumin

76
Q

Reference value of ammonia

A

19-60 ug/dL

77
Q

Preferred specimen in ammonia

A

Arterial blood

78
Q

T/F heparin, and EDTA are used in ammonia

A

True

79
Q

T/F; the specimen used in ammonia should NOT be kept in ice water during transport

A

False; SHOULD BE Kept in ice water during transport

80
Q

T/F: fist clenching should be avoided as it can increase ammonia

A

True

81
Q

Specimen precautions in ammonia

A

Smoking
Exercise
Probing of vein
Under filing of tube
Hemolysis

82
Q

T/F: the patient and the medtech should not smoke within ____ hours

A

24

82
Q

T/F: the patient and the medtech should not smoke within ____ hours

A

24

83
Q

Rate of increase in ammonia

A

100-200 ug/L/cigar

84
Q

stress in skeletal muscles can (increase, decrease) ammonia

A

inrease

85
Q

Common methods in ammonia

A

Berthelot, Glutamate Dehydrogenase & Kjeldahl Method

86
Q

Digestion method is aka

A

Kjeldahl reaction

87
Q

In digestion method, ______ in a _____ filtrate of the specimen is converted to ______ using hot concentrated _______ in the presence of _______

A

Nitrogen ion
protein-free
ammonia
sulfuric acid
catalyst

88
Q

Example of catalyst used in digestion method

A

copper sulfate, mercury, and selenium

89
Q

End product in Digestion Method (Kjeldahl reaction)

A

Ammonia

90
Q

measures ammonium content

A

Nesslerization Reaction

91
Q

What are the two direct colorimetric methods

A

Nesslerization Reaction
Berthelot Reaction

92
Q

End product of Nesslerization Reaction

A

Ammonium mercuric iodide

93
Q

What is the end color in nesslerization reaction if the N2
is Low to Moderate

A

● Yellow end-color

94
Q

What is the end color in nesslerization reaction if the N2
is High

A

Orange-brown end-color

95
Q

End product of Berthelot reaction

A

: Indophenol blue

96
Q

Most common method used in automated
analyzer

A

Glutamate Dehydrogenase

97
Q

Decrease in absorbance at 340 nm as NADPH is
consumed (oxidized)

A

Glutamate Dehydrogenase

98
Q

↓absorbance = ____ ammonia

A

↑

99
Q

End product of glutamate dehydrogenase

A

Glutamate

CCLECT (4 decks)

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