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CC2 > Liver > Flashcards

Liver Flashcards

0
Q

Location of the liver

A

Beneath and attached to the diaphragm

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1
Q

Size of the liver in a healthy adult

A

1.2-1.5 kg

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2
Q

Liver is divided into 2 lobes, which is divided by?

A

Falciform ligaments

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3
Q

A chronic disease of the liver marked by degeneration of cells inflammation and fibrous thickening of tissue. Typically a result of alcoholism

A

Cirrhosis

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4
Q

Branch of aorta
Supplies an oxygen rich blood from the heart to the liver.
25%

A

Hepatic artery

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5
Q

Supplies nutrient rich blood from the digestive tract

75%

A

Portal vein

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6
Q

How many mL of blood passes through the liver/min

A

1,500 mL

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7
Q

Microscopic units that divides the liver

A

Lobules

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8
Q

Functional unit of the liver

A

Lobules

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9
Q

2 functions of the lobules performed by the liver

A

Secretory and metabolism

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10
Q

2 major cell type of the liver

A

Hepatocyte and Kupffer cells

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11
Q

Makes up of 80% of tot cells of the liver. Performa the major functions associated with the liver. Responsible for the regenerative properties.

A

Hepaticyte

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12
Q

Macrophages (active phagocytosis)

A

Kupffer cells

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13
Q

Biochemical functions:

A

Excretory and Secretory
Synthetic function
Detoxification and drug metabolism

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14
Q

Excretion of the endogenous and exogenous subs into the bile or urine such as the major product, Bilirubin.

A

Excretory and Secretory

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15
Q

Bitter tasting, dark green to yellowish brown fluid, produced by the liver

A

Bile

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16
Q

Principal elements in the bile

Derived from the breakdown of rbc

A

Bilirubin

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17
Q

After 126 days, rbcs are phagocytized and will release hemoglobin. Then hemoglobin will breakdown into?

A

Iron
Heme
Globin

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18
Q

Proteins involved

A

Transferrin
Ligandin
Albumin

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19
Q

Conversion of B1-B2

A

Conjugated

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20
Q

Orange colored product

A

Urobilin or stercobilin

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21
Q

Remaining 20%

A

Enters systematic circulation

Absorbed by the extrahepatic circulation

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22
Q

CHO Metabolism when ingested and absorbed?

A
  • use the glucose for its own cellular energy requirement
  • store glucose as glycogen
  • circulate glucose for the use at the peripheral tissue
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23
Q

Glucose to glycogen

A

Glycogenesis

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24
Q

Breakdown of glycogen to glucose
Degradation
Condition of stress or in fasting when there is increased requirement of glucose

A

Glycogenolysis

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25
Q

Glucose from non sugar carbon

A

Glucogenesis

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26
Q

In Lipid synthesis, liver is responsible for gathering fatty acids from the diet and those produce by the liver itself and breakdown to produce what?

A

Acetyl-CoA

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27
Q

Greatest source of cholesterol comes from what is produced by the liver. How many grams is produced by the liver?

A

1.5 to 2.0 g

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28
Q

Liver is also involve in the metabolism of fluid and other removal from the body through the use of what?

A

Lipoprotein and apoliprotein

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29
Q

In protein synthesis, all protein are synthesized by the liver except for?

A

Immunoglobulin and adult hemoglobin

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30
Q

One of the most important protein synthesized is the?

A

Albumin

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31
Q

Every subs absorb in the GIT must first pass in the liver and it is referred to as?

A

First pass

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32
Q

2 mechanisms if detoxification and drug metabolism

A

Detoxification of foreign material ( drug and poisons) and metabolic products( bilirubin and ammonia)

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33
Q

Responsible for the detoxification of drugs through, OXIDATION, REDUCTION, HYDROLYSIS, HYDROXYLATION, CARBOXYLATION, DEMETHYLATION

A

Drug metabolizing system

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34
Q

Yellow discoloration of skin, mucous membrane due to Bilirubin retention

A

Jaundice

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35
Q

Upper limit if normal total bilirubin

Jaundice not noticeable to the naked eye

A

1.0 -1.5 mg/dL

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36
Q

Jaundice can be seen

A

3.0 mg/dL

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37
Q

Seen in acute and chronic hemolytic anemia
Rarely have more than 5 mg/dL because liver is capable of heading the overload
Unconjugated hyperbilirubinemia
⬆️ B1, NB2

A

Pre-hepatic hyperbilirubinemia

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38
Q

Not water soluble, bound to albumin, not filtered by the kidney therefore not seen in the urine. Only B1 produce

A

Unconjugated hyperbilirubinemia

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39
Q

Liver problem
Intrinsic liver defect or disease
⬆️B1 and B2

A

Hepatic Jaundice

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40
Q

Elevation of unconjugated bilirubin

hepatic jaundice

A

Gilbert disease
Crigler-Nojjar syndrome
Physiological jaundice of newborn

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41
Q

Elevation of conjugated bilirubin

Hepatic disease

A

Dubor-johnson

Rotor-syndrome

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42
Q

Benign hereditary syndrome/autosomal recessive.
Most common cause of jaundice
No morbidity or mortality
Intermittent unconjugated hyperbilirubinemia
Most frequently diagnosed during adolescent or early adulthood

A

Gilbert’s syndrome

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43
Q

Insertion of two bases into the promote region of the UGTA 1 gene resulting to lower enzymatic act.
Impared cellular uptake of the bilirubin

A

Gilbert’s syndrome

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44
Q

Race, more serious disorder.
Chronic nonhemolytic unconjugated hyperbilirubinemia.
Inherited disorder of bilirubin metabolism resulting from moleculsr defect with the gene involved with bilirubin conjugation.

A

Crigler-Nojjar syndrome

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45
Q

Total absence of B2
Complete absence of enzymatic bilirubin conjugation.
(Crigler-Nojjar syndrome)

A

Type 1

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46
Q

Partial deficiency of UDPGT
Small amount of B2 is produced
( Crigler- Nojjar syndrome)

A

Type 2

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47
Q

Deficiency in the enzyme glucornyl transferase

A

Physiological jaundice of the newborn

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48
Q

Results in cell damage and death.

A

Kernicterus

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49
Q

Treatment for kernicetrus

A

UV radiation to destroy bilirubin as it passes the capillaries of skin.

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50
Q

A familial form of unconjugated hyperbilirubinemia caused by circulating inhibitor of conjugation.

A

Lucey-Driscoll syndrome

51
Q

Rare in inherited disorder

A

Dubin-Johnson syndrome

52
Q

Obstructive in nature

A

Dubin-Johnson Syndrome

53
Q

Removal of conjugated bilirubin from the liver cell and the excretion into the bile are adoptive

A

Dubin-Johnson syndrome

54
Q

Inc. bilirubin in blood and urine

A

Dubin-Johnson syndrome

55
Q

Distinguishing feature of Dubin-Johnson syndrome

A

Dark stained granules (pigmented lysozyme) on a liver biopsy sample

56
Q

Bilirubin tightly bound to albumin

A

Delta bilirubin

57
Q

Normal values of delta bilirubin

A

<3 umol/L

58
Q

Detect causing is unknown

A

Rotor syndrome

59
Q

Less common than dubin-johnson

A

Rotor syndrome

60
Q

Liver biopsy does not show dark pigmented granules

A

Rotor syndrome

61
Q

Possibly virus-induced

A

Rotor syndrome

62
Q

Biliary obstructive disease

A

Post-Hepatic jaundice

63
Q

Since bile is not being brought to the intestines, stool loses its sources of normal pigmention

A

Post-Hepatic jaundice

64
Q

Prevent the flow of conjugated bilirubin into the bile canaliculi

A

Post-Hepatic jaundice

65
Q

Gallstones and tumor

A

Post-Hepatic jaundice

66
Q

Aspartate Amino Transferase is also known as

A

Serum glutamic-oxoloacetic transaminase

67
Q

Aspartate Amino Transferase is distributed mainly.

A

Heart, liver and skeletal muscle

68
Q

Alanine amino transferase is also known as

A

Serum glutamic-pyruvic transaminase

69
Q

Alanine Amino Transferase is found mainly in where?

A

Liver

70
Q

Remained elevated for up to 2-6 weeks in almost all disease of the liver

A

Alanine Amino Transferase

71
Q

Highest levels of alanine amino transferase are found in the acute conditions such as?

A

Viral hepa, drug and toxin-induced liver necrosis and hepatic ischemia.

72
Q

Ability to differentiate hepatobiliary disease from osteogenic bone disease

A

Alkaline Phosphatase

73
Q

Alkaline Phosphatase is seen in where? Which is elevated in Pager’s disease.

A

seen in bone

74
Q

Alkaline Phosphatase is released from which is elevated in pregnancy

A

Released from placenta

75
Q

Alkaline Phosphatase is localized at the bile canaliculi and serves as a great marker of;

A

Hepatic biliary obstruction
Stone in common bile duct
Intrahepatic cholestasis

76
Q

Primary biliary cirrhosis

A

Alkaline Phosphatase

77
Q

Very high conc. cases of extrahepatic obstruction

A

Alkaline Phosphatase

78
Q

Elevated in hepatobiliary disease

A

5’Nucleotidase

79
Q

No bone source- useful in differentiating ALP elevation

A

5’Nucleotidase

80
Q

More sensitive to metastatic liver disease

A

5’Nucleotidase

81
Q

Sensitive test for cholestasis caused by chronic alcohol or drug ingestion

A

Gamma-Glutamyltransferase

82
Q

Useful if jaundice is absent for the confirmation of hepatic neoplasm

A

Gamma-Glutamlytransferase

83
Q

High levels may be found in metastatic carcinoma of the liver

A

Lactate-Dehydrogenase

84
Q

Moderate elevation- acute viral hepatitis and cirrhosis

A

Lactate-Dehydrogenase

85
Q

Reference interval for total protein determination

A

6.5-8.3 g/dL

86
Q

Recumbent for protein determination

A

6.0-7.8 g/dL

87
Q

Standard reference method for protein determination

A

Kjedahl Method

88
Q

Not commonly performed method

A

Kjeldahl Method

89
Q

Measures the nitrogen content

A

Kjeldahl Method

90
Q

How many grams of protein if there is 1 gram of nitrogen

A

6.54 grams of protein

91
Q

Most widely used method in protein determination

A

Biuret method

92
Q

Cupric Ions complex the groups involved in the peptide bond forming a violet colored chelate which is proportional to the number of peptide bonds present and reflects the total protein level.

A

Biuret method

93
Q

Migration of charged particles in an electric field.

A

Electrophoresis

94
Q

The single most significant clinical application of serum protein electrophoresis is for the what?

A

Identification of monoclonal spikes of immunoglobulin and differentiating them from polyclonal hypergammaglobulinemia

95
Q

Normal SPE pattern for the fastest band; 1st band

A

Albumin

96
Q

Normal SPE pattern for the 2nd fastest band.

A

Alpha1-Globulin

97
Q

Normal SPE pattern for increasing as a non-specific response to inflammation

A

Alpha 1-Globulin

98
Q

Glycoproteins, AAT, AAG, thyroxine binding-globulin

A

Alpha 1-Globulin

99
Q

Normal SPE pattern for 3 rd band visible.

A

Alpha 2-Globulin

100
Q

Proteins involved in alpha 2-globulin

A

Haptoglobulin, AMG, ceruloplasmin

101
Q

4th band in the normal SPE pattern.

A

Beta-globulin

102
Q

Proteins involved in the beta-globulin

A

Transferrin, beta-lipoprotein, hemopexin, complement system (C3,c4)

103
Q

Slowest band and 5th band in the normal SPE pattern

A

Gamma-Globulin

104
Q

Protein involved in gamma-globulin

A

Immunoglobulin

105
Q

Characteristic Abnormal SEP:

Multiple myeloma

A

Gamma spike

106
Q

Characteristic Abnormal SEP:

Hepatic cirrhosis

A

Beta-gamma bridging

107
Q

Characteristic Abnormal SEP:

Nephrotic syndrome

A

A2-globulin band spike

108
Q

Characteristic Abnormal SEP:

Juvenile cirrhosis

A

A1- globulin flat curve

109
Q

Characteristic Abnormal SEP:

Inflammation

A

Spikes of a1, A2, and globulin bands

110
Q

Presence of free hemoglobin will cause what and where?

A

Will cause blip in the late alpha2 and early beta zone region

111
Q

Presence of small spikes in beta region is due to what?

A

Iron deficiency anemia (transferrin)

112
Q

An alternative test to chemical analysis of serum total proteins

A

Refractometry

113
Q

Measurement of refractive index due to salutes in serum

A

Refractometry

114
Q

Turbidimetric and Nephlometric Method utilizes what?

A

Sulfosalicylic acid and trichloroacetic acid

115
Q

Separation of globulin from albumin by salting out procedures using sodium salts

A

Salt fractionation

116
Q

Salt used for analysis

A

Sodium sulfate

117
Q

Dose administration methods

A

Rosenthal White

Mac Donald Method

118
Q

Dose for Rosenthal White

A

2 mg/kg body weight of the patient

119
Q

Collection for Rosenthal white

A

After 5 minutes and after 30 minutes

120
Q

Normal values for Rosenthal white

A

After 5 minutes-50% dye retention

After 30 minutes- 0% dye retention

121
Q

Dose for Mac Donald method

A

5 mg/kg body weight of the patient

122
Q

Collection for Mac Donald Method

A

After 45 minutes

123
Q

Normal values for Mac Donald Method

A

After 45 minutes - +/- 5% dye retention

124
Q

The reaction of diazotized sulfanilamide acid with bilirubin is to form what, which forms the basis of quantitating the amount of bilirubin in biologic fluids

A

Azobilirubin

CC2 (2 decks)

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