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MLS 421 Clinical Chemistry II > Liver Function > Flashcards

Liver Function Flashcards

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1
Q

What is the function of the hepatic artery?

A

Aortic branch which provides oxygen to the liver.

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2
Q

What is the function of the portal vein?

A

Blood supply from the GI tract; transports absorbed materials.

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3
Q

Hepatocytes within the liver include what two types of cells?

A

Kupffer Cells and Sinusoids.

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4
Q

What is the function of Kupffer cells?

A

Phagocytosis of RBC’s.

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5
Q

Hepatocytes make up ___ of the liver’s mass.

A

80%.

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6
Q

What is the function of microvilli within hepatocytes?

A

Works in conjunction with sinusoid space; passes absorbed materials across the cell membrane.

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7
Q

What is the function of the smooth ER within hepatocytes?

A

Bilirubin conjugation; drug detoxification; cholesterol synthesis.

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8
Q

What is the function of the rough ER within hepatocytes?

A

Ribosome synthesis (protein production) which provide albumin, coagulation factors, and enzymes.

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9
Q

What is the function of the bile capillary within hepatocytes?

A

Excretes bile and waste products; acts as an outlet system.

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10
Q

The liver processes dietary and endogenous ___ for energy.

A

Carbohydrates.

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11
Q

How is carbohydrate metabolism effected by liver disease?

A

(1) Hypoglycemia
(2) Diminished tolerance to the administration of glucose, galactose, fructose, or lactose.
(3) Decreased glycogen stores.

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12
Q

What is one of the most important functions of the liver?

A

Bile synthesis.

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13
Q

What is the function of bile?

A

Lipid absorption and digestion.

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14
Q

Where is bile stored?

A

Within the gallbladder.

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15
Q

Fatty liver conditions are from the accumulation of ___.

A

plasma free fatty acids and lipoproteins; triglyceride accumulation.

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16
Q

How does the liver change in moderate severity of fatty liver (liver fibrosis)?

A

Scar tissue begins to form; recovery is possible, but scar tissue remains.

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17
Q

How do laboratory results change with someone who may have fatty liver?

A

Mild elevation of AST and ALT.

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18
Q

Severe or chronic hepatic diseases cause a decrease in what plasma proteins?

A

Albumin, fibrinogen, transferrin, and coagulation proteins.

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19
Q

Measurement of enzymes that are released after an injury are able to help differentiate between what two conditions?

A

Hepatocellular from obstructive disease.

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20
Q

What are the 5 most commonly measured enzymes for the liver?

A

AST, ALT, LDH, ALP, GGT.

21
Q

How does the liver handle xenobiotics (nonmetabolic products)?

A

Converts to more soluble, less toxic compounds; toxic compounds are absorbed from the intestinal tract.

22
Q

How do we get ammonia in the blood?

A

From the urea cycle; amino acid deamination.

23
Q

If there is an increase in ammonia levels, how would this effect the body?

A

Highly toxic; may increase pH in the blood.

24
Q

Which immunoglobulin is secreted by the liver?

A

IgA.

25
Q

Where is free bilirubin converted into conjugated bilirubin?

A

Within hepatocytes.

26
Q

RBCs are broken down within phagocytes where they are converted to ___, ___, and then ___.

A

heme; biliverdin; bilirubin.

27
Q

Within the hepatocyte, bilirubin is conjugated to ___.

A

bilirubin diglucuronide.

28
Q

What are other terms which all mean conjugated bilirubin?

A

(1) Water soluble bilirubin
(2) Direct bilirubin
(3) Bilirubin diglucuronide

29
Q

Within the small intestine bacteria converts bilirubin to ___, then oxidized to ___.

A

urobilinogen; urobilins.

30
Q

Once bilirubin is oxidized to urobilins, how does the body get rid of it?

A

Excreted into the feces or can enter circulation to be removed by the kidney (urine).

31
Q

How is total bilirubin calculated?

A

Unconjugated + Conjugated Indirect + Direct.

32
Q

What is delta bilirubin?

A

Covalently bound monoconjugated bilirubin + albumin.

33
Q

What occurs when we have a large amount of bilirubin being produced, and the liver conjugates it all?

A

It can overflow into the urine because conjugated bilirubin is soluble and can be released into the circulatory system.

34
Q

Reference range of bilirubin.

A

<1.0 mg/dL

35
Q

Predicted value of bilirubin for someone with jaundice.

A

2 - 3 mg/dL.

36
Q

Predicted value of bilirubin for someone with kernicterus (bilirubin deposits in the CNS).

A

15 - 20 mg/dL.

37
Q

___ excess is similar to jaundice in hyperbilirubinemia.

A

Vitamin A.

38
Q

In a patient with pre-hepatic jaundice, what is the predicted laboratory results for the following tests:

(1) Bilirubin: Total & Conjugated
(2) Fecal urobilinogen
(3) Urine urobilinogen

A

(1) Bilirubin: Total & Conjugated - increased
(2) Fecal urobilinogen - increased
(3) Urine urobilinogen - normal to increased

39
Q

What likely condition causes an increase in unconjugated bilirubin and negative conjugated bilirubin?

A

Gilbert’s disease; an issue with bilirubin uptake amongst hepatocytes.

40
Q

What condition would likely cause an increase to conjugated bilirubin and a decrease to unconjugated bilirubin?

A

Crigler-Najjar syndrome; the absence or defect to the enzyme that is responsible for the conjugation of bilirubin.

41
Q

Describe hepatic regurgitation jaundice.

A

Conjugated bilirubin leaks out of the cells leading to conjugated bilirubin spilling into the urine.

42
Q 
A patient with the following symptoms: 
- AST and ALT >10x
- Decreased albumin
- Increased globulins
- Increased conjugated bilirubin
- Increased urine direct bilirubin
What is the likely condition?
A

Hepatic regurgitation jaundice.

43
Q

Describe post-hepatic impairment.

A

Conjugated bilirubin cannot reach the large intestine via bile causing a regurgitation into blood of conjugated bilirubin; excreted through the urine.

44
Q

Post-hepatic conditions would cause a(n) ___ to total and conjugated urine bilirubin; ___ result for fecal and urine urobilinogen; ___ ALP value; ___ to ___ fecal color.

A

Increase; negative; pale; clay.

45
Q

What causes newborn jaundice & kernicterus in newborns?

A

Immaturity of the hepatic system for uptake, conjugation and excretion of bilirubin.

46
Q

Kernicterus causes the albumin binding capacity to exceed ___ mg/dL.

A

15-20.

47
Q

Define cirrhosis.

A

Loss of normal microscopic architecture of the liver with resulting fibrosis (histological changes).

48
Q

What are the expected lab results for a patient with cirrhosis?

  • AST & ALT
  • GGT
  • Albumin
A
  • AST & ALT increased
  • GGT increased
  • Albumin decreased

MLS 421 Clinical Chemistry II (20 decks)

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