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clinical biochem year 2 > lecture 3 - liver function tests > Flashcards

lecture 3 - liver function tests Flashcards

1
Q

what does the vein carry

A

deoxygenated blood

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2
Q

what is the main process in the liver

A
  1. uptake(portal vein)
  2. metabolism
  3. supply (vena cava)
  4. detoxification
  5. excretion (bile duct -> intestine)
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3
Q

give 3 functions of the liver

A

The uptake of nutrients delivered from the digestive tract via the portal vein

The detoxification of harmful compounds by biotransformation

Fighting infections (Kuppfer cells-macrophages)

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4
Q

what are three types of metabolism

A

carbohydrate

lipid

amino acid and protein

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5
Q

can the liver be regenerated?

A

yes, within 70 days

only organ that can

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6
Q

what happens during carbohydrate metabolism

A
  1. takes up glucose from plasma
  2. convert the to glucose 6-phosphate
  3. stored as glycogen or fatty acid

GLYCOGENESIS

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7
Q

what happens when there’s a major decline of blood glucose

A

secretion of glucose

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8
Q

what does breaking down excess amino acids do

A

release nitrogen

is converted to urea and transported to the kidneys

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9
Q

what is liver the site of

A

synthesis and degradation of most protein and peptides in the blood plasma

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10
Q

what is the deamination process (products)

A

amino acids -> ammonia -> acetyl coA/glucose/ketone

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11
Q

what is the most abundant protein in the blood and where is it made

A

albumin

liver

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12
Q

what does albumin do

A

maintain osmotic pressure

binds drugs

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13
Q

what is biotransformation

A

a metabolic process that helps to facilitate the excretion of both outside and inside substances.

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14
Q

examples that metabolised by biotransformation

A

drugs, ethanol and other foreign substances (xenobiotics)

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15
Q

what are aminotransferases

A

enzymes that loads amino acids onto tRNAs

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16
Q

what are biomarkers

A

A defined characteristic that is measured as an indicator of normal biological processes, pathogenic processes or responses to an exposure or intervention

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17
Q

what is ALT

A

alanine aminotransferase

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18
Q

what is AST

A

aspartate aminotransferase

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19
Q

when are AST and ALT released

A

when there is a damaged hepatocyte

20
Q

what are ALT and AT indicators of

A

hepatocellular damage

21
Q

what are the limitations of ALT and AST

A

not suitable for chronic conditions as may appear normal

AST is non specific for liver disease - can be found in heart/kidney

22
Q

what is prothrombin time

A

time taken for blood to clot

23
Q

what are the limitations of prothrombin time

A

unreliable in patients taking anti-coagulants

indicator of severe live disease or cirrhosis (scarring)

24
Q

what is bilirubin

A

the yellow breakdown product of RBC breakdown

25
Q

how is bilirubin excreted

A

bile and urine

26
Q

what is bilirubin responsible for

A

the yellow colour of bruises,
yellow colour of urine, brown colour of feces

27
Q

what makes bilirubin soluble

A

liver enzymes convert unconjugated bilirubin to conjugated bilirubin

28
Q

what causes jaundice

A

increased bilirubin

29
Q

what is another name of conjugated bilirubin

A

direct bilirubin

30
Q

what is another name for unconjugated bilirubin

A

indirect bilirubin

31
Q

what happens when conjugated bilirubin is normal

A

then the problem is an excess unconjugated bilirubin, and the location of the problem is upstream of bilirubin conjugation in the liver

32
Q

what happens when conjugated bilirubin is elevated

A

then the liver is conjugating bilirubin normally but is not able to excrete

33
Q

what is ALP and what does it do

A

alkaline phosphatase

removes phosphate groups from proteins

34
Q

what are the limitations of ALP

A

bone growth disorders elevate ALP

bone cancers can also raise ALP

35
Q

how is vitamin synthesised

A
  1. Cholesterol precursor activated by UV-light in the skin
  2. This is inactive
  3. Requires hydroxylation by liver and then kidney enzymes
36
Q

what is iron stored as

A

ferritin

37
Q

what is ferritin

A

multi-subunit protein
binds Fe atoms

38
Q

what does excess Fe do

A

its toxic to the liver

39
Q

what is haemochromatosis caused by

A

a genetic mutation in the HFE gene

40
Q

what does excess iron do to the liver

A

impairs liver function

chronic condition

41
Q

what tests do you run for haemochromatosis

A

raised serum ferritin

genetic testing

42
Q

what its Wilsons disease

A

condition that impairs removal of excess copper

43
Q

you got this!!

A
44
Q

how can soluble drugs be removed

A

in its original form by the kidneys

45
Q

how are insoluble drugs removed

A

can have to be modified from soluble to insoluble form so that they can be removed by the liver.

clinical biochem year 2 (9 decks)

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