HIGH YIELD

Question 1

tests of hepatic function can be used to?

Answer 1

diagnose liver disease
distinguish dif types of liver disease
determine the extent of known liver damage
follow response to tx

Question 2

tests based on excretory function?

Answer 2

bilirubin
jaundice
hereditary hyperbilirubinemias

Question 3

bilirubin is transported in the blood as?

conjugated or unconjugated? (describe it too)

Answer 3

unconjugated (indirect), bound to albumin

toxic

Question 4

bilirubin is the degradation product of?

Answer 4

heme

Question 5

what is the intracellular transport of bilirubin?

Answer 5

binds to ligandin and transported to the ER where is undergoes conjugation

Question 6

how is bilirubin conjugated?

what does this become, direct or indirect?

so how is this excreted?

Answer 6

conjugated with 1-2 molecules of glucoronic acid by bilirubin UGT (direct)

direct bilirubin: nontoxic, water soluble, loosely bound to albumin

conjugated bilirubin excreted into the bile adn degraded by urobilinogens and the rest excreted in the feces

Question 7

what levels do jaundice occur?

Answer 7

bilirubin serum levels are >2.0 mg/dL

Question 8

what is this disease?

unconjugated bilirubin accumulates (toxic and non soluble), cannot be renally excreted, kernicterus develops

*name this bilirubin that develops as a result of?

Answer 8

hemolytic disease of the newborn

delta bilirubin-with prolonged conjugated hyperbilirubinemia, a fraction becomes bound to albumin

Question 9

main causes of unconjugated jaundice?

Answer 9

excess production of bilirubin-hemolysis

reduced hepatic uptake

impaired bilirubin conjugation

Question 10

main causes of conjugated jaundice?

Answer 10

decreased hepatic excretion of bilirubin glucoronides

deficiency in canalicular membrane transporters

impaired bile flow