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IUCHEM > Liver Function > Flashcards

Liver Function Flashcards

1
Q

Objective 1: Recognize the functions of the following anatomical structures in the liver:
a. Portal vein

A

1a: A vein conveying blood to the liver from the spleen, stomach, pancreas, and intestines

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2
Q

Objective 1: Recognize the functions of the following anatomical structures in the liver:
b. Hepatic artery

A

1b: The major blood vessel that provides oxygen and nutrient-rich blood to the liver

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3
Q

Objective 1: Recognize the functions of the following anatomical structures in the liver:
c. Sinusoids

A

1c: A microvascular structure that serves as the principal site of exchange between the blood and the perisinusoidal space (i.e. space of Disse)

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4
Q

Objective 1: Recognize the functions of the following anatomical structures in the liver:
d. Bile canaliculi

A

1d: Thin tubes that receive the bile secreted by the hepatocytes

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5
Q

Objective 2: List five functions of the liver, according to the lecturer.

A
  1. Metabolic
  2. Detoxification and Excretion
  3. Immunologic
  4. Hematologic
  5. Storage
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6
Q

Objective 5: Recognize general functions of Kupffer cells, dendritic cells, and stellate cells.

A

Kupffer cell: phagocytize complement-coated pathogens from the blood

Dendritic cell: messenger to the cell surface of the T-cells

Stellate cell: quiescent in the normal liver; upon liver damage, they are activated and begin to secrete collagen (which may lead to cirrhosis)

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7
Q

Objective 8: List the three processes the hepatocyte performs to detoxify bilirubin.

A
  1. Uptake
  2. Conjugation
  3. Excretion
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8
Q

Objective 11: Discuss pre-hepatic jaundice in detail, according to:
a. General cause

b.	Four specific causes
A

11a: Caused by any process that causes premature RBC destruction and increased production of unconjugated bilirubin

11b: 1. Hemolysis
2. Ineffective erythropoiesis
3. Increased turnover of non-hemoglobin heme
compounds
4. Hematoma

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9
Q

Objective 11: Discuss pre-hepatic jaundice in detail, according to:
c. An explanation of the typical serum total, unconjugated, and conjugated bilirubin levels; urine bilirubin level; fecal and urine urobilinogen levels

A

11c:
Serum total, unconjugated, and conjugated bilirubin levels: unconjugated - increased, conjugated - normal
Urine bilirubin level: negative (normal)
Fecal and urine urobilinogen levels: increased

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10
Q

Objective 12: Discuss post-hepatic jaundice in detail, according to:
a. General cause
b. Three specific causes
c. An explanation of the typical serum total, unconjugated, and conjugated
bilirubin levels; urine bilirubin level; fecal and urine urobilinogen levels
d. Two enzymes that are elevated to a significant degree

A

12a: Caused by any process that prevents excretion of conjugated bilirubin

12b: 1. Ductal occlusion by stones
2. Spasms or strictures
3. Compression by neoplastic disease

12c:
Serum total, unconjugated, and conjugated bilirubin levels: unconjugated - normal, conjugated - increased
Urine bilirubin level: positive (abnormal)
Fecal and urine urobilinogen levels: decreased to absent

12d: ALP and GGT

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11
Q

Objective 14: List the specific range of total bilirubin levels in the blood at which jaundice is observed.

A

> 2.0-3.0 mg/dL

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12
Q

Objective 15: Recognize seven clinical manifestations of liver disease, according to the lecturer.

A
  1. Jaundice
  2. Portal hypertension
  3. Hepatic failure and encephalopathy
  4. Altered drug metabolism
  5. Endocrine abnormalities
  6. Immunoglobulin abnormalities
  7. Disordered hemostasis
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13
Q

Objective 16: State two common causes of toxic hepatitis, according to the lecturer

A
  1. Acetaminophen (Tylenol)
  2. Amoxicillin/clavulanate (Augmentin) and other
    antibiotics
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14
Q

Objective 17: Differentiate the routes of transmission of Hepatitis A, B, C, D, E, and G

A

A: Fecal-oral
B: Blood & body fluid
C: Blood & body fluid
D: Requires a co-infection with Hepatitis B
E: Fecal-oral, blood & body fluid, zoonotic
G: Parenterally (other than via the GI tract)

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15
Q

Objective 18: List two viral hepatitis types that require co-infections with other hepatitis viruses

A
  1. Hepatitis D
  2. Hepatitis G
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16
Q

Objective 19: Discuss the cause, symptoms, and one unique non-enzymatic laboratory test which is increased in Reye’s Syndrome

A

A two-phase illness associated with a previous viral illness for which aspirin or salicylate-containing medications were given

Increased plasma ammonia

17
Q

Objective 20: Recognize six causes of cirrhosis, according to the lecturer

A
  1. Hepatitis B
  2. Hepatitis C
  3. Toxic alcohol administration (alcoholism)
  4. Wilson’s disease
  5. Alpha-1-antitrypsin deficiency
  6. Hemochromatosis
18
Q

Objective 21: Differentiate the progressive clinical characteristics used to make a diagnosis of:
a. Alcoholic fatty liver
b. Alcoholic hepatitis
c. Alcoholic cirrhosis

A

a. Few symptoms – advanced cases may have hepatomegaly, vomiting, and jaundice

b. Acute liver necrosis and inflammation, hepatomegaly, jaundice, and ascites

c. Hepatosplenomegaly, ascites, edema, malnutrition, and jaundice

19
Q

Objective 22: List expected plasma ceruloplasmin levels and serum and urine copper levels in Wilson’s
disease

A

Low plasma ceruloplasmin
Increased serum and urine copper

20
Q

Objective 23: Discuss primary hemochromatosis, according to:
a. Metal involved
b. Expected iron, ferritin, and total iron binding capacity levels
c. Treatment

A

a. Iron
b. Increased serum iron
Increased ferritin
Increased TIBC
c. Therapeutic phlebotomy until ferritin is reduced to
normal

21
Q

Diazotized sulfanilic acid

A

Reacts with bilirubin to form colored azobilirubin

22
Q

Ascorbic acid

A

Stops reaction and destroys excess diazo reagent

23
Q

Alkaline tartrate

A

Changes pH and coverts purple azobilirubin to blue azobilirubin

24
Q

Sodium acetate

A

Buffers reaction

25
Q

Caffeine sodium benzoate

A

Accelerates coupling of bilirubin to diazo reagent (unique to Jendrassik-Grof bilirubin analysis)

26
Q

Methanol

A

Accelerates coupling of indirect bilirubin to diazo reagent (unique to Evelyn-Malloy bilirubin analysis)

27
Q

Objective 24: Differentiate the causes of primary biliary cirrhosis and primary sclerosing cholangitis

A

Primary biliary cirrhosis: has an autoimmune etiology leading to scarring of the bile ducts

Primary sclerosing cholangitis: scarring and strictures present in the bile ducts due to inflammation

28
Q

Objective 25: Discuss the mechanism, significance, and treatment for neonatal physiologic jaundice

A

Mechanism: Due to the lack of UDP-glucuronyl transferase in the immature liver

Significance: Kernicterus may occur if not resolved – excess unconjugated bilirubin in the blood that has the ability to cross the blood-brain barrier and destroy brain tissue due to its toxicity

Treatment: UV light source or RBC exchange, in extreme cases

29
Q

Objective 26: Explain why each of the following analytes are altered in liver disease and whether the
analytes typically increase or decrease:

a. Serum albumin
b. Prothrombin time (PT)
c. Serum lipids
d. Ammonia
e. Bile acids

A

a. Produced in the liver; will be decreased
b. Coagulation enzymes are produced in the liver,
Vitamin K is stored in the liver; Blood will take longer
to clot
c. Produced in the liver; will be decreased
d. Converted to urea by the liver; will be increased
e. Byproduct of cholesterol production (in the liver); will
be decreased

30
Q

Objective 27: Differentiate the water solubilities of direct and indirect bilirubin.

A

Direct (conjugated) bilirubin: water soluble
Indirect (unconjugated) bilirubin: water insoluble

IUCHEM (20 decks)

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