Liver 2 Flashcards
Hepatocytes produce: (select 3)
a. thrombopoietin
b. alpha-1-acid glycoprotein
c. immunoglobins
d. factor 3
e. factor 7
f. factor 8
a. thrombopoietin
b. alpha-1 acid glycoprotein
e. factor 7
The liver plays an essential role in
protein synthesis
The liver plays a vital role in metabolism of
carbs, proteins, and lipids
The liver produces all of the clotting factors with the exception of
factor 3, factor 4, and von Willebrand factor
Vitamin K-dependent clotting factors include
factors 2, 7, 9, 10
Proteins C, S, and Z
The liver produces all the plasma proteins with the exception of
immunoglobulins
_________ is the most abundant plasma protein.
Albumin
Albumin serves as a blood reservoir for _______drugs
acidic
Alpha-1 acid glycoprotein is a blood reservoir for _________drugs
basic
_____________________increases the duration of succinylcholine and possibly increases the duration of ester- type local anesthetics.
Reduce pseudocholinesterase production
Reduced pseudocholinesterase production is only a problem with
severe liver disease
____________ is a byproduct of protein metabolism
Ammonia
Failure to clear ammonia (hepatic failure or portosystemic shunting) leads to
hepatic encephalopathy
__________ is a byproduct of hemoglobin metabolism.
Bilirubin
Unconjugated bilirubin is
neurotoxic
Unconjugated bilirubin is conjugated with ___________ in the liver, which hastens its elimination from the body
glucuronic acid
the liver plays a vital role in __________—
drug biotransformation
______________- is produced by the liver sinusoidal cells and endothelial cells (not by hepatocytes)
factor 8
In addition to the clotting factors, the liver also produces
antithrombin (anticoagulant)
plasminogen (fibrinolytic)
thrombopoietin (stimulates platelet production)
The liver is an important regulator of serum
glucose
Patients with liver failure are at risk of
hypoglycemia b/c it the liver is responsible for clearing insulin from the circulation
Hyperglycemia leads to the release of _________ by _________- in a metabolic process known as
insulin by pancreatic beta cells; glycogenesis
Hypoglycemia leads to the release of
glucagon via pancreatic alpha cells
epi via the adrenal medulla
How is unconjugated bilirubin created?
hemoglobin is broken down in spleen to heme–> unconjugated bilirubin
Unconjugated bilirubin is lipophilic or hydrophilic?
lipophilic
What plasma proteins are synthesized in the liver?
all of them except for immunoglobulins
What is glycogenesis?
glucose is stored as glycogen
What is glycogenolysis?
glycogen is cleaved into glucose
What is gluconeogenesis?
glucose is magically created from non-carbohydrate sources
Match each lab test with its underlying pathology.
transaminases, 5’-nucleotidase, bilirubin, prothrombin time
hepatic clearance, synthetic function, biliary obstruction, hepatocellular injury
transaminases- hepatocellular injury
bilirubin- hepatic clearance
5’-nucleotidase- biliary obstruction
prothrombin time- synthetic function
Liver function tests can be divided into those that assess:
synthetic function
hepatocellular injury
hepatic clearance
biliary duct obstruction
Which liver function test assess synthetic function?
PT, albumin
Which liver function test assess hepatocellular injury?
ASL, ALT
Which liver function test assess hepatic clearance?
bilirubin
Which liver function test assesses biliary duct obstruction?
alkaline phosphatase, Y glutamyl transpeptidase, 5’-nucelotidase
Albumin is not sensitive for acute hepatic injury because
it has a half-life of 21 days
Prothrombin time is very sensitive for acute hepatic injury because
factor 7 has a half-life of only 4-6 hours
Normal albumin levels are
3.5-5.0 g/dL
PT is prolonged by
vitamin K deficiency
Conditions that reduce albumin include
infection
nephrotic syndrome
malnutrition
malignancy
burns
Albumin is decreased by
impaired synthesis or increased consumption/loss
Normal ALT values are
10-50 units/L
AST/ALT ratio >2 suggests
cirrhosis or alcoholic liver disease
Marked elevation of both AST & ALT suggests
hepatitis
Normal AST is
10-40 units/L
Normal bilirubin is
0-11 units/L
Confounding factors for elevated bilirubin include
hemolysis or hematoma reabsorption
