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Clinical Chemistry > Liver Function > Flashcards

Liver Function Flashcards

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1
Q

Anatomy of the Liver

Lobes:
Weight:
Two major vessels:

A

Largest and Most versatile organ
2 main lobes separated by falciform ligament
1.2 - 1.5 kg
Major Vessels: Hepatic Artery & Portal Vein

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2
Q

Right lobe is ____ larger than the left lobe

A

6x

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3
Q

Two major Vessels:
_______: Heart ——25% of blood——> Liver

Contributes 25% of blood from the aorta to the liver

A

Hepatic Artery

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4
Q

Two major Vessels
_______: GI tract ——nutrient rich——> Liver

Transports nutrient rich material from digestive tract to the liver

A

Portal Vein

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5
Q

Volume of blood that travels to the liver

A

15000 ml/min

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6
Q

smallest functional unit of the liver

A

Lobules

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7
Q

Cells

___: Hepatocytes
___: Kuppfer cells

A

80%: Hepatocytes

20%: Kuppfer cells

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8
Q

Phagocytic macrophages of the liver

A

Kuppfer cells

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9
Q

Liver cells:
Vascular spaces in the cord:
Phagocytic Macrophage:

A

Liver cells: Heatocytes
Vascular spaces in the cord: Sinusoids
Phagocytic Macrophage: Kuppfer cells

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10
Q

Liver Function

A 
Metabolic
Synthetic 
Secretory and Excretory
Detoxification & Drug  Metabolism
Storage
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11
Q

Liver functions

Excretion: \_\_\_\_\_\_\_\_\_\_\_\_
Synthesis: \_\_\_\_\_\_\_\_\_\_\_\_
Detoxification: \_\_\_\_\_\_\_\_\_
Conjugation:\_\_\_\_\_\_\_\_\_\_\_
Storage: \_\_\_\_\_\_\_\_\_\_\_\_\_\_
A

Excretion: Bilirubin, Bile salts, Bile pigments
Synthesis: CHO, Proteins, Lipids, LPP, Clotting factors, Enzymes
Detoxification: Toxic substance - Drugs, Biproducts
Conjugation: Bilirubin
Storage: Glycogen, Fat soluble vitamins

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12
Q

Main secretory/excretory product of the liver

A

Bile

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13
Q

Principal pigment of the Bile

A

Bilirubin

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14
Q

Bilirubin is derived from the degradation of ___________

A

Hemoglobin

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15
Q

Most important excretory product of the Liver

A

Bilirubin

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16
Q

Bilirubin 1 vs. Bilirubin 2

A

B1

Unconjugated
Non-Polar
Indirect
Water Insoluble
Hemobilirubin

B2

Conjugated
Polar
Direct
Water Soluble
Cholebilirubin
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17
Q

__________ is broken down and is excreted as a waste product

A

Protoporphyrin IX

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18
Q

Transports bilirubin to the liver

A

Albumin

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19
Q

Conversion of Protoporphyrin IX to Biliverdin is catalyzed by _____________

A

Heme Oxygenase

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20
Q

Conjugation site

A

Liver

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21
Q

What specific site in the liver does conjugation occurs

A

Smooth ER of Hepatocytes

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22
Q

Enzyme that converts B1 to B2

A

UDPGT - Uridyldiphosphate glucoronyl transferase

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23
Q

B2

A

Bilirubin diglucuronide

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24
Q

After B2 goes out to the Liver, bilirubin passes to the ___________ & ____________

A

Bile duct and further to the INTESTINES

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25
Q

An ORANGE-BROWN pigment after oxidation of Urobilinogen

A

Urobilin (80%)

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26
Q

Delta Bilirubin

A

Conjugated Bilirubin bound to albumin

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27
Q

Delta Bilirubin is present in severe _____________________

A

Biliary Obstruction

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28
Q

Increase bilirubin level that results to yellow discoloration

A

Jaundice

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29
Q

Laboratory Description with Yellow plasma

A

Icterus

30
Q

Clinically Significant level of Bilirubin in Jaundice

A

> 3.0 mg/dL or 2.0 mg/dL

31
Q

Prehepatic Jaundice: ____________
Hepatic jaundice: ____________
Post Hepatic jaundice: ____________

A

Prehepatic Jaundice: Happens in circulation due to Increase RBC degradation
Hepatic jaundice: defect in the Liver due to decreased conjugation
Post Hepatic jaundice:

32
Q

Prehepatic jaundice is characterized by __________________

A

Unconjugated Hyperbilirubinemia

33
Q

Most common type of Jaundice

A

Gilbert’s Syndrome

34
Q

Due to impaired cellular uptake or entrance of Bilirubin in the liver, causing elevated B1

A

Gilbert’s syndrome

35
Q

Defect in Gilbert’s Syndrome

A

Bilirubin transport deficit

36
Q

A rare, more serious disease with the onset at birth due to complete or partial absence of UDPGT

A

Crigler-Najjar Syndrome

37
Q

Crigler-Najjar Syndrome

A

No UDPGT - Conjugation deficit

38
Q

Type of Crigler-Najjar Syndrome with complete absence of UDPGT

A

Type 1

39
Q

Type II Crigler-Najjar Syndrome

A

Partial deficiency of UDPGT

40
Q

Dubin-Johnson Sydrome

A

Accumulated B2
(+) Dark Stained granules
(+) Delta Bilirubin

41
Q

Bilirubin derangement that is positive for Delta bilirubin

A

Dubin-Johnson Sydrome

42
Q

Bilirubin excretion deficit

A

Dubin-Johnson Sydrome

43
Q

Bilirubin derrangement with unknown cause and no pigmentation in liver biopsy

A

Rotor Syndrome

44
Q

Rotor Syndrome

A

Conjugation Inhibition

45
Q

(+) Kernicterus

A

Crigler-Najjar Syndrome

46
Q

Hyperbilirubinemia in infants affecting CNS/Brain

A

Kernicterus

47
Q

Disorder caused by excessive ingestion of Vitamin A

A

Hypercarotenemia

48
Q

__________ refers to the IRREVERSIBLE SCARRING process by which liver structure is transformed into a ABNORMAL NODULAR architecture.

A

Cirrhosis

49
Q

Classification of Cirrhosis

A
  1. Size of Nodules - (1) Micronodular (2) Macronodular

2. Etiology- Alcohol abuse, Hemochromatosis, Postnecrotic cirrhosis, Primary Bile cirrhosis

50
Q

Sources of Error

Hemolysis: ____________
Lipemia: ______________

A

Hemolysis - Increase Bilirubin

Lipemia - Decrease Bilirubin

51
Q

Most preferred sample for Bilirubin Analysis

A

Fasting Specimen

52
Q

Classic Method of Analysis of Bilirubin

A

Diazo reaction “Ehrlich reaction”

53
Q

Directly measured

A

B2

54
Q

Diazo Reaction Principle

A

Bilirubin is coupled with Diazotized Sulfanilic acid to produce Azobilirubin

55
Q

Total Bilirubin is measured ____ minutes after adding methanol or caffeine solution,

A

15 minutes

56
Q

___________ bilirubin produces color after the addition of alcohol

A

Unconjugated bilirubin

57
Q

Current Principle of Bilirubin Reaction

A

Van Den Bergh Reaction

58
Q

Difference of Van Den Bergh Reaction from Diazo reaction

A

Uses ACCELARATOR (solubilizer)

59
Q

Most commonly used Method in Bilirubin assay

A

Jendrassik and Grof

60
Q

Evelyn Malloy

Accelerator: __________
pH: __________
End color: _________

A

Evelyn Malloy

Accelerator: 50% Methanol
pH: Acidic
End color: Red-Purple

61
Q

Jendrassik-Grof

Accelarator: __________
pH: __________
End color: _________

A

Jendrassik-Grof

Accelarator: Caffeine-Na Benzoate
pH: Alkaline
End color: Blue

62
Q

Jandressik-Grof is performed with ____ aliquots of sample

A

2 aliquots of sample

63
Q

Purpose of accelerator

A

Removes unconjugated bilirubin bound to albumin and make it soluble

64
Q

Jendrassik-Grof

1st aliquot - w/ Diazo : __________
2nd aliquot - w/ Diazo + Accelerator: ___________

A

Jendrassik-Grof

1st aliquot: B2
2nd aliquot: Total Bilirubin

65
Q

Diazo reagent

A

Diazotized Sulfanilic Acid

66
Q

Synthetic Function Tests

A

Total Protein
Albumin
Prothrombin time

67
Q

Conjugation and Excretion Function Tests

A

Bilirubin

68
Q

Major Synthetic Product of Liver

A

Albumin

69
Q

______ of Cholesterol in the circulation is from the Liver

A

70%

70
Q

Decreased Albumin is caused by:

1.
2.

A

Decreased Albumin is caused by:

  1. Decreased Production in the Liver
  2. Excreted in the Kidney
71
Q

Liver enzymes

A 
AST (SGOT)
ALT (SGPT)
ALP
LDH
GGT
5' Nucleotidase

Clinical Chemistry (20 decks)

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