CC1 - Liver Synthetic Function Flashcards

1
Q

The chief metabolic organ

A

Liver

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2
Q

The liver is a large organ divided unequally into two lobes by

A

falciform ligament

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3
Q

2 major cell type of liver

A

Hepatocytes (80%)
Kupffer cells

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4
Q

Hepatic macrophage that acts as phagocytes. They also line the sinusoid of the liver.

A

Kupffer cells

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5
Q

They perform the major functions of the liver and also responsible for its regenerative functions

A

Hepatocytes

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6
Q

2 blood suppliers of the liver (1500 mL/min)

A

o Hepatic artery (25%)
o Portal Vein (75%)

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7
Q

Synthetic Function of liver

A

Ability of the liver to synthesized substance.

All proteins are synthesized in the liver except for immunoglobulins. Which are synthesized by the lymphocytes.

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8
Q

Conjugation Function of liver

A

Process in the metabolism of bilirubin

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9
Q

Detoxification and Drug Metabolism of liver

A

Your liver has the ability to protect you from potentially toxic substances absorbed from the
intestine and other toxic metabolic bi-product

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10
Q

Excretory and Secretory function of liver

A

Your liver is involved in the excretion of bile. Bile is involved in the elimination of cholesterol and o t her bi le salts.

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11
Q

Storage Function OF LIVER

A

Your liver serves as your storage for all your fat soluble an d some of the water soluble vitamins and also the storage site for glycogen (ex. of fat soluble Vitamin: A, D, E, K

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12
Q

It tests the validity of the liver to synthesized and quantitates the severity of hepatic dysfunction.

A

LIVER SYNTHETIC FUNCTION TEST

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13
Q

sum of albumin + globulin proteins

A

Total protein

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14
Q

Assessment of nutritional status and presence of severe disease involving the liver, kidney and bone marrow

A

Total protein

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15
Q

TOTAL PROTEIN

Sample :
Interference :
Reference value (serum):

A

Sample : Serum
Interference : hemolysis, ictericia
Reference value (serum): 6.5 8.3g/dL (CF to g/L:10)

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16
Q

Why is plasma not used in total protein?

A

plasma is not used in total protein because it has fibrinogen , and fibrinogen makes results falsely increased (0.2 0.4 g)

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17
Q

Methods for total protein:

 Classical method for protein quantitation
 This process is time consuming.
 Reference method but not routinely used
 Measures the amount of nitrogen in specimen.
 Assumes that nitrogen content of protein is 16
(15.1 16. 8)
 1g of nitro gen = 6.54g of protein

A

Kjeldahl Method

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18
Q

3 steps in Kjeldahl

A

o Digestion
o Distillation
o Titration

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19
Q

Methods for total protein

Principle: Measures protein based on the number of peptide bonds present.

A

Biuret Method

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20
Q

Methods for total protein

 Most widely used method for total protein determination
 Is a colorimetric non enzymatic method
 Absorbance of color is read at 540 nm.
 End color is: deep purple or violet , non-enzymatic
because this does not utilized enzymes
 Biuret reagent has : Alkaline CuSO4 , NaK tartrate (Rochelle salt prevents precipitation of copper NaOH , KI (stabilizer)
 Interferences in biuret method is lipemic sample

A

Biuret Method

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21
Q

Methods for total protein:

Principle : Oxidation of phenolic compounds such as tyrosine, tryptophan, and histidine to give a deep blue color

A

Folin Ciocalteu (Lowry) method

22
Q

 Has t he highest analytical sensitivity
 It can measure very minute amount or concentration of protein
 Main reagent : Phosphotungstic molybdic acid or phenol reagent
 Color enhancer : Biuret reagent

A

Folin Ciocalteu (Lowry) method

23
Q

 Principle : The absorbance of proteins at 210nm is
due to the absorbance of the peptide bonds at
specific wavelength.
 Absorptions at 280nm: tryptophan, tyrosine, and
phenylalanine

A

UV absorption method

24
Q

Based on measurements of refractive index of
serum total proteins

A

Refractometry

25
Measurement depends on formation of a uniform fine precipitate which scatters incident light in suspension (nephelometry) or block light (turbidimetry)
Turbidimetry and Nephelometry Methods
26
Used for detection of proteins as little as 1 ug
Coomasie Brilliant blue Dye
27
Develops violet color by reacting with primary a mines widely used for detection of peptides and amino acids after paper chromatography.
Ninhydrin
28
 Principle : migration of charged particles in an electric field  Negative electrode : cathode and positive electrode : anode
Serum protein electrophoresis
29
Isoelectric property of proteins
Amphoteric - either positive or negative depending on pH condition  No charge at isoelectric point  The acidic and basic amino acid content of proteins determines its net charge.  Buffer : barbital (Veron al) pH 8.6
30
Albumin band (1st band)
a. Reference value: 3.5 5.0g/ dL ( 5 3 65%) b. Fastest band, most anodal c. Nearest to the positive
31
A1 globulin band
a. Reference value: 0.1 0.3g dL ( 2. 5 5%) b. Second fastest and second most anodal c. Alpha 1 antitrypsin (AAT)
32
Alpha globulin band
a. Reference value: 0.6 1.0 g/dL (7 13%)
33
B globulin band
a. Reference value: 0.7 1.1g/d l (8 14%)
34
Y globulin band
a. Reference value: 0 .8 1.6 g/dL (12 22%) b. This includes immunoglobulin
35
Most abundant among proteins Concentration is directly proportional to the severity of hepatic disease Low levels could be caused by decreased synthesis
Albumin
36
Albumin reference value
3.5 5.0 g /dL
37
The liver synthesizes how many grams of albumin per day?
9-12 g
38
Methods of Albumin
o Salt precipitation o Dye binding
39
What is precipitated in Albumin salt precipitation?
GLobulins
40
Most commonly used dye in albumin dye binding method
Bromcresol green (BCG)
41
Most specific dye in albumin dye binding method
Bromcresol purple (BCP)
42
Dye not specific for albumin
Methyl orange
43
Inverted Albumin/Globulin ratio can be seen in
cirrhosis, multiple myeloma , & Waldenstroms macroglobulinemia
44
Albumin globulin ratio Reference value:
1.3 3.1g/dL (C F to G/L:10)
45
Albumin globulin ratio formula
AG ratio = albumin /globulin
46
Globulin value is determined using the formula
Globulin = total protein - albumin
47
Vitamin K response Test
Prothrombin Time
48
Vitamin K dependent clotting factors:
prothrombin group Factor 2, 7,9,10
49
Normal PT after administering Vit K
it means it extrahepatic.
50
In Vitamin K response test if prothrombin time is prolonged, this indicates
that you have problem in the hepatic
51
It differentiates intrahepatic disorders from extrahepatic disorder
Prothrombin Time
52
Prolonged PT
signifies massive cellular damage