Liver Function Flashcards
Objective 1: Recognize the functions of the following anatomical structures in the liver:
a. Portal vein
1a: A vein conveying blood to the liver from the spleen, stomach, pancreas, and intestines
Objective 1: Recognize the functions of the following anatomical structures in the liver:
b. Hepatic artery
1b: The major blood vessel that provides oxygen and nutrient-rich blood to the liver
Objective 1: Recognize the functions of the following anatomical structures in the liver:
c. Sinusoids
1c: A microvascular structure that serves as the principal site of exchange between the blood and the perisinusoidal space (i.e. space of Disse)
Objective 1: Recognize the functions of the following anatomical structures in the liver:
d. Bile canaliculi
1d: Thin tubes that receive the bile secreted by the hepatocytes
Objective 2: List five functions of the liver, according to the lecturer.
- Metabolic
- Detoxification and Excretion
- Immunologic
- Hematologic
- Storage
Objective 5: Recognize general functions of Kupffer cells, dendritic cells, and stellate cells.
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)
Objective 8: List the three processes the hepatocyte performs to detoxify bilirubin.
- Uptake
- Conjugation
- Excretion
Objective 11: Discuss pre-hepatic jaundice in detail, according to:
a. General cause
b. Four specific causes
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
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
11c:
Serum total, unconjugated, and conjugated bilirubin levels: unconjugated - increased, conjugated - normal
Urine bilirubin level: negative (normal)
Fecal and urine urobilinogen levels: increased
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
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
Objective 14: List the specific range of total bilirubin levels in the blood at which jaundice is observed.
> 2.0-3.0 mg/dL
Objective 15: Recognize seven clinical manifestations of liver disease, according to the lecturer.
- Jaundice
- Portal hypertension
- Hepatic failure and encephalopathy
- Altered drug metabolism
- Endocrine abnormalities
- Immunoglobulin abnormalities
- Disordered hemostasis
Objective 16: State two common causes of toxic hepatitis, according to the lecturer
- Acetaminophen (Tylenol)
- Amoxicillin/clavulanate (Augmentin) and other
antibiotics
Objective 17: Differentiate the routes of transmission of Hepatitis A, B, C, D, E, and G
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)
Objective 18: List two viral hepatitis types that require co-infections with other hepatitis viruses
- Hepatitis D
- Hepatitis G
Objective 19: Discuss the cause, symptoms, and one unique non-enzymatic laboratory test which is increased in Reye’s Syndrome
A two-phase illness associated with a previous viral illness for which aspirin or salicylate-containing medications were given
Increased plasma ammonia
Objective 20: Recognize six causes of cirrhosis, according to the lecturer
- Hepatitis B
- Hepatitis C
- Toxic alcohol administration (alcoholism)
- Wilson’s disease
- Alpha-1-antitrypsin deficiency
- Hemochromatosis
Objective 21: Differentiate the progressive clinical characteristics used to make a diagnosis of:
a. Alcoholic fatty liver
b. Alcoholic hepatitis
c. Alcoholic cirrhosis
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
Objective 22: List expected plasma ceruloplasmin levels and serum and urine copper levels in Wilson’s
disease
Low plasma ceruloplasmin
Increased serum and urine copper
Objective 23: Discuss primary hemochromatosis, according to:
a. Metal involved
b. Expected iron, ferritin, and total iron binding capacity levels
c. Treatment
a. Iron
b. Increased serum iron
Increased ferritin
Increased TIBC
c. Therapeutic phlebotomy until ferritin is reduced to
normal
Diazotized sulfanilic acid
Reacts with bilirubin to form colored azobilirubin
Ascorbic acid
Stops reaction and destroys excess diazo reagent
Alkaline tartrate
Changes pH and coverts purple azobilirubin to blue azobilirubin
Sodium acetate
Buffers reaction
