Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pathology > Liver > Flashcards

Liver Flashcards

1
Q

What globulins are not metabolized in the liver?

A

Gamma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The three most useful liver function tests?

A
  1. Serum bilirubin
  2. Alkaline phosphatase (ALP)
  3. Aminotransferases (AST, ALT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bilirubin metabolism begins with the breakdown of ____ in the reticuloendothelial system (spleen, bone marrow)

A

RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

After hemoglobin is released from the RBC and broken into Heme and Globin molecules, ____ is catabolized to form biliverdin, which is then transformed to bilirubin

A

Heme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The initial form of bilirubin is called ____

A

Unconjugated (indirect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The original unconjugated bilirubin is converted to conjugated in what organ?

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Once conjugated, bilirubin is excreted into the bile ducts and eventually the intestine, where it is converted to ____ by bacterial action

A

Urobilinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

____ is the discoloration of body tissues caused by abnormally high levels of bilirubin

A

Jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The yellow discoloration of jaundice is recognized when the total serum bilirubin exceeds ___ mg/dl

A

2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Physiologic jaundice of a newborn is caused by an immature liver that does not have enough conjugating enzymes. This results in a high circulating blood level of ______ bilirubin

A

Unconjugated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In the liver, unconjugated bilirubin is conjugated with a _____

A

Glucuronide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If the defect in bilirubin metabolism occurs after glucuronide addition (after it is conjugated…), ____ hyperbilirubinemia will result.

A

Direct (conjugated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A classic example of direct hyperbilirubinemia?

A

Obstruction of bile duct by a gallstone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Normally, the unconjugated bilirubin makes up __-__% of the total bilirubin

A

70-85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When more than __% of the total bilirubin is conjugated, it is considered conjugated hyperbilirubinemia

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The three major causes of hyperbilirubinemia?

A
  1. Hemolysis
  2. Intrahepatic biliary tract obstruction
  3. Extrahepatic biliary tract obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

____ jaundice is ultimately caused by hemolysis (most of the time)

A

Prehepatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hemolysis results in increased amounts of ____ bilirubin, as well as higher amounts of urobilinogen (which gets excreted in the urine)

A

Unconjugated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List the 4 causes of hemolysis:

A
  1. Congenital hemolytic anemia
  2. Drug-induced causes
  3. Autoimmune disease
  4. Transfusion reactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

__% of full term newborns are born w/physiological jaundice due to conjugation failure (immature liver and enzymes)

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pre-conjugation bilirubin transport failure is known as ___ syndrome

A

Gilbert’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Post-conjugation bilirubin transport failure is known as ____ syndrome

A

Dubin-Johnson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

List the 4 pathophysiologies of hepatic jaundice:

A
  1. Conjugation failure
  2. Bilirubin transport failure
  3. Diffuse hepatocellular damage or necrosis
  4. Intrahepatic obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Posthepatic jaundice is caused by?

A

Common bile duct obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which type of bilirubin is water soluble?

A

Conjugated

26
Q

In a common bile duct (CBD) obstruction the conjugated bilirubin rises significantly early on d/t the fact that it cannot be excreted into the small intestine. Later, the unconjugated bilirubin starts to rise to closer to a 1:1 ratio. Why?

A

After several days of obstruction, some of the conjugated bilirubin in the blood breaks down to unconjugated

27
Q

What can produce falsely reduced levels of bilirubin?

A

Prolonged exposure (over 1 hour) to sunlight or artificial light

28
Q

Normal total, direct, and indirect levels of bilirubin?

A

Total: 0.1-1.0 mg/dl
Direct: 0.1-0.3 mg/dl
Indirect: 0.2-0.8 mg/dl

29
Q

The _____ reaction measures total and direct reacting bilirubin

A

Van den Bergh

30
Q

Because the liver is the key organ in the synthesis and excretion of cholesterol, ____ (a type of liver disease) will eventually cause cholesterol levels to drop below normal

A

Cirrhosis

31
Q

Enzyme highly elevated in cholestasis

A

Alkaline Phosphatase (ALP)

32
Q

Serum bilirubin >2.5 mg/dl

A

Jaundice

33
Q

Bilirubin >20 mg/dl in infant can cause?

A

Kernicterus (form of brain damage)

34
Q

Cholesterol of 600 mg%

A

Cholestasis

35
Q

Most specific transaminase for liver disease

A

ALT (alanine transaminase)

36
Q

Jaundice w/4+ urobilinogen

A

Prehepatic

37
Q

Liver disease w/hypocholesterolemia

A

Cirrhosis

38
Q

Elevated in hepatic coma

A

Ammonia

39
Q

Disease w/normal LFT’s in 50% of patients

A

Fatty liver

40
Q

Elevated w/necrosis of hepatocytes

A

Transaminases (AST, ALT)

41
Q

Vitamin K is necessary for formation of this

A

Prothrombin

42
Q

Usually normal in liver malignancies

A

Bilirubin

43
Q

Enzyme elevated due to alcohol use

A

GGT

44
Q

This test differentiates cirrhosis and alcoholic hepatitis

A

WBC test

45
Q

This type of viral hepatitis is spread mainly through the fecal-oral route

A

Type A (HAV)

46
Q

What are the three phases of viral hepatitis?

A
  1. Prodromal
  2. Icteric
  3. Recovery
47
Q

Incubation (period between exposure and appearance of first symptoms) is about how long in HAV?

A

2-6 weeks

48
Q

__-__% of patients w/viral hepatitis never develop jaundice

A

75-80%

49
Q

First antibody to increase in HAV?

A

HAV IgM (about 3-4 weeks after exposure)

50
Q

This type of viral hepatitis is mainly transmitted parenterally and through sexual intercourse

A

HBV

51
Q

Incubation time for HBV?

A

6-25 weeks

52
Q

First serological test to become abnormal in HBV?

A

HBsAg (before onset of symptoms)

53
Q

This HBV antibody rises about 2-6 weeks after it’s antigen is present and signifies the end of acute infection and immunity to future infection.

A

HBsAb

54
Q

Antibody detected in “core window” of HBV infection (after HBsAg has disappeared, but HBsAb is not detectable yet)

A

HBcAb (IgG)

55
Q

Consistently high transaminase levels with vague symptoms or none are characteristic. Other LFT’s are unremarkable and jaundice is rare.

A

Chronic hepatitis

56
Q

In alcoholic liver disease (alcoholic hepatitis) will WBC’s be increased, decreased, or normal?

A

Increased

57
Q

There is inflammation and destruction of small bile ducts within the liver portal areas

A

Primary biliary cirrhosis (PBC)

58
Q

Serum antimitochondrial antibodies are elevated in 90% or more of patients w/this liver disease

A

Primary biliary cirrhosis

59
Q

Name for primary liver cancer

A

Hepatoma

60
Q

Elevated in hepatoma?

A

AFP (alpha-fetoprotein)

61
Q

The 3 typical findings in 1/3 of patients w/metastatic carcinoma to the liver?

A
  1. Normal bilirubin
  2. Normal AST
  3. Elevated ALP

Clinical Pathology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions