Clinical Chem 3rd Lec

Question 1

UNITS and VALUES

Answer 1

Plasma bilirubin NR: 4-19 umol/l

Jaundice when > 50umol/l, bilirubin production exceeding hepatic capacity to excrete it

Question 2

TESTS

Answer 2

• Plasma bilirubin
• Plasma enzymes (ALT, AST, ALP, GGT)
• Plasma albumin
• Prothrombin time
• Urinanalysis

Alanine transferase, aspartate transferase, alkaline phosphatase, gamma glutamyltransferase (Liver enzymes)

Question 3

Liver function list

Answer 3

• Carbohydrate metabolism
• Lipid metabolism
• Protein metabolism
• Processing of drugs & -hormones
• Excretion of bilirubin
• Synthesis of bile salts
• Storage
• Phagocytosis
• Activation of vitamin D

Question 4

Bilirubin

Answer 4

Unconjugated - runs in blood, binds to plasma albumin (hydrophobic), lipid soluble, not excreted by kidney

Conjugated - in liver with glucuronic acid and passes into biliary tract into bile, acton on in intestine by bacteria & excreted in urine as urobilin