JAUNDICE

Question 1

What does the liver produce?

Answer 1

Clotting factors,
Bile acids,
CHO - Glucose, Glycogen
Proteins - Albumin Synthesis
Lipids - Cholesterol, Lipoprotein, TG synthesis
Hormones - Angiotensin, Insulin-LikeGF

Question 2

What is the livers detoxifying role?

Answer 2

Urea production from ammonia
Detoxifying Drugs
Bilirubin metabolism
Breakdown of Insulin and hormones

Question 3

What is the livers immune fx?

Answer 3

Combats infection
Clearing blood
Neutralising Drugs

Question 4

What is the livers storage fx?

Answer 4

Stores Glycogen
Vit A, D, B12 and K
Cu and Fe

Question 5

What do LFT’s test?

Answer 5

Bilrubin,
Aminotransferases
Alkaline Phosphotase
Gamma GT
Albumin
Prothrombin time
Creatinine
Platelet count

Question 6

What is Bilirubin?

Answer 6

Byproduct of heme metabolism from old RBC in spleen

Initially bound to albumin

Question 7

In which condition is Bilirubin elevated prehepatically?

Answer 7

Heamolysis

Question 8

In which condition is Bilirubin elevated hepatically?

Answer 8

Paraenchymal damage

Question 9

In which condition is Bilirubin elevated posthepatically?

Answer 9

Obstruction

Question 10

What are aminotransferases?

Answer 10

Enzymes in heaptocytes

Question 11

What does raised ALT suggest?

Answer 11

There is paraenchymal involvement

Question 12

What are the two main types of Aminotransferase and where are they?

Answer 12

Alanine transferase - Liver

Asparate Transamines - Liver, heart, muscle, kidney and pancreas

Question 13

What is alkaline phosphotase?

Answer 13

Enzyme present in bile duct

Question 14

When is ALP elevated?

Answer 14

Obstruction or liver infiltration

Question 15

Other than the liver where else is ALP found?

Answer 15

Bones, placenta and Intestine

Question 16

What is Gamma GT?

Answer 16

Non specific liver enzyme

Question 17

When is Gamma GT elevated?

Answer 17

With alcohol use or some NSAID like drugs

Question 18

What does low albumin suggest?

Answer 18

Chronic Liver Disease, [can be low in kidney disorders and malnutrition]

Question 19

What in relation to the liver and spleen can make thrombopoetin low?

Answer 19

Cirrhosis can cause splenomegaly

Indirect marker of portal HT

Question 20

What are some symptoms of Liver Failure?

Answer 20

Jaundice,
Ascites,
Variceal Bleeding
Hepatic encaphelopathy

Question 21

When is jaundice detectable?

Answer 21

When Bilirubin levels exceed 34 µmol/L

Question 22

What could jaundices DD be?

Answer 22

Carotenemia