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Apex Review > Liver 2 > Flashcards

Liver 2 Flashcards

1
Q

Hepatocytes produce: (select 3)
a. thrombopoietin
b. alpha-1-acid glycoprotein
c. immunoglobins
d. factor 3
e. factor 7
f. factor 8

A

a. thrombopoietin
b. alpha-1 acid glycoprotein
e. factor 7

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2
Q

The liver plays an essential role in

A

protein synthesis

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3
Q

The liver plays a vital role in metabolism of

A

carbs, proteins, and lipids

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4
Q

The liver produces all of the clotting factors with the exception of

A

factor 3, factor 4, and von Willebrand factor

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5
Q

Vitamin K-dependent clotting factors include

A

factors 2, 7, 9, 10
Proteins C, S, and Z

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6
Q

The liver produces all the plasma proteins with the exception of

A

immunoglobulins

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7
Q

_________ is the most abundant plasma protein.

A

Albumin

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8
Q

Albumin serves as a blood reservoir for _______drugs

A

acidic

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9
Q

Alpha-1 acid glycoprotein is a blood reservoir for _________drugs

A

basic

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10
Q

_____________________increases the duration of succinylcholine and possibly increases the duration of ester- type local anesthetics.

A

Reduce pseudocholinesterase production

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11
Q

Reduced pseudocholinesterase production is only a problem with

A

severe liver disease

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12
Q

____________ is a byproduct of protein metabolism

A

Ammonia

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13
Q

Failure to clear ammonia (hepatic failure or portosystemic shunting) leads to

A

hepatic encephalopathy

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14
Q

__________ is a byproduct of hemoglobin metabolism.

A

Bilirubin

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15
Q

Unconjugated bilirubin is

A

neurotoxic

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16
Q

Unconjugated bilirubin is conjugated with ___________ in the liver, which hastens its elimination from the body

A

glucuronic acid

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17
Q

the liver plays a vital role in __________—

A

drug biotransformation

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18
Q

______________- is produced by the liver sinusoidal cells and endothelial cells (not by hepatocytes)

A

factor 8

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19
Q

In addition to the clotting factors, the liver also produces

A

antithrombin (anticoagulant)
plasminogen (fibrinolytic)
thrombopoietin (stimulates platelet production)

20
Q

The liver is an important regulator of serum

A

glucose

21
Q

Patients with liver failure are at risk of

A

hypoglycemia b/c it the liver is responsible for clearing insulin from the circulation

22
Q

Hyperglycemia leads to the release of _________ by _________- in a metabolic process known as

A

insulin by pancreatic beta cells; glycogenesis

23
Q

Hypoglycemia leads to the release of

A

glucagon via pancreatic alpha cells
epi via the adrenal medulla

24
Q

How is unconjugated bilirubin created?

A

hemoglobin is broken down in spleen to heme–> unconjugated bilirubin

25
Q

Unconjugated bilirubin is lipophilic or hydrophilic?

A

lipophilic

26
Q

What plasma proteins are synthesized in the liver?

A

all of them except for immunoglobulins

27
Q

What is glycogenesis?

A

glucose is stored as glycogen

28
Q

What is glycogenolysis?

A

glycogen is cleaved into glucose

29
Q

What is gluconeogenesis?

A

glucose is magically created from non-carbohydrate sources

30
Q

Match each lab test with its underlying pathology.
transaminases, 5’-nucleotidase, bilirubin, prothrombin time
hepatic clearance, synthetic function, biliary obstruction, hepatocellular injury

A

transaminases- hepatocellular injury
bilirubin- hepatic clearance
5’-nucleotidase- biliary obstruction
prothrombin time- synthetic function

31
Q

Liver function tests can be divided into those that assess:

A

synthetic function
hepatocellular injury
hepatic clearance
biliary duct obstruction

32
Q

Which liver function test assess synthetic function?

A

PT, albumin

33
Q

Which liver function test assess hepatocellular injury?

A

ASL, ALT

34
Q

Which liver function test assess hepatic clearance?

A

bilirubin

35
Q

Which liver function test assesses biliary duct obstruction?

A

alkaline phosphatase, Y glutamyl transpeptidase, 5’-nucelotidase

36
Q

Albumin is not sensitive for acute hepatic injury because

A

it has a half-life of 21 days

37
Q

Prothrombin time is very sensitive for acute hepatic injury because

A

factor 7 has a half-life of only 4-6 hours

38
Q

Normal albumin levels are

A

3.5-5.0 g/dL

39
Q

PT is prolonged by

A

vitamin K deficiency

40
Q

Conditions that reduce albumin include

A

infection
nephrotic syndrome
malnutrition
malignancy
burns

41
Q

Albumin is decreased by

A

impaired synthesis or increased consumption/loss

42
Q

Normal ALT values are

A

10-50 units/L

43
Q

AST/ALT ratio >2 suggests

A

cirrhosis or alcoholic liver disease

44
Q

Marked elevation of both AST & ALT suggests

A

hepatitis

45
Q

Normal AST is

A

10-40 units/L

46
Q

Normal bilirubin is

A

0-11 units/L

47
Q

Confounding factors for elevated bilirubin include

A

hemolysis or hematoma reabsorption

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