Drugs and Diseases: Liver Flashcards
symptoms of jaundice?
yellow skin/sclera from bilirubin
what causes prehepatic jaundice?
hemolysis - sickle cell anemia, malaria
what causes hepatic jaundice?
liver damage - cirrhosis, hepatitis
what causes posthepatic jaundice?
bile duct obstruction - tumor, bile stones
what causes newborn jaundice?
hepatic bilirubin glucuronyl transferase - can’t conjugate bilirubin to glucuronate
what test is used to verify jaundice?
bilirubin level = total bilirubin + direct bilirubin
what does direct bilirubin measure?
conjugated bilirubin level
how can you tell b/w conjugated and unconjugated bilirubin? (where found or not found)
conjugated: in urine
unconjugated: not in urine
what does high bilirubin in urine suggest?
conjugated hyperbilirubinemia
what does absence of bilirubin in urine suggest?
unconjugated hyperbilirubinemia
what is Gilbert syndrome?
glucuronyl transferase deficiency - asymptomatic
-increased unconjugated bilirubin (indirect)
what is Dubin-Johnson syndrome?
impaired biliary secretion
-increased conjugated bilirubin (direct)
what does high bilirubin indicate?
liver damage
what does high serum AST, ALT indicate?
hepatocellular injury
what does high alkaline phosphatase indicate?
cholestasis
what does low albumin indicate?
chronic liver disease
what does increased prothrombin time indicate?
low clotting factor production due to liver disease
what are some manifestations of liver disease? (7 things)
- jaundice, scleral icterus
- spider angioma
- gynecomastia
- encephalopathy
- asterixis
- ascites
- abnormal blood coagulation
what inhibits CYP3A4?
furanocoumarin (in grapefruit) - don’t take w/ statins
what does tylenol + Etoh result in the production of?
NAPQI
what are porphyrias?
defects in heme biosynthesis
what is the most common porphyria?
porphyria cutanea tarda
symptoms of porphyrias in general
- adult onset
- neurovisceral symptoms
- increased ALA or PBG
- accumulations in skin, liver, bone marrow
how can you treat porphyrias?
hematin (exogenous heme -> decrease heme synthesis)
erythropoeitic protoporphyria: deficient enzyme, accumulations, symptoms?
deficient ferrochetalase
accumulate protoporphyrin
photosensitivity
porphyria cutanea tarda: deficient enzyme, accumulations, symptoms?
deficient URO decarboxylase
accumulate uroporphyrinogen III
photosensitivity
what is used to measure Fe status?
ferritin
what is zellweger syndrome?
peroxisome disease - no peroxisome fxn
what is the function of fibrates?
bind PPARs, activate them -> increase TG oxidation -> decrease TG levels
