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Clinical Chemistry I > Liver Function > Flashcards

Liver Function Flashcards

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1
Q

Blood is supplied to the liver by the _________ _________ and hepatic portal vein.

A

Hepatic artery

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2
Q

______ flows from hepatocytes, via canaliculi and ductules, to form hepatic ducts.

A

Bile

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3
Q

The liver is organised into functional units are called ___________.

A

Lobules

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4
Q

What shape is each hepatic lobule?

A

Hexagon

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5
Q

____________ are arranged into irregular, branching, interconnecting plates around the hepatic vein.

A

Hepatocytes

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6
Q

Portal ________ lie at each ‘corner’ of the liver lobule.

A

Triads

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7
Q

How do hepatocytes generate energy?

A

Oxidative phosphorylation and fatty acid phosphorylation

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8
Q

____________ contain proteolytic enzymes.

A

Lysosomes

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9
Q

What is the role of hepatic endoplasmic reticulum?

A

Bile acid synthesis and drug metabolism

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10
Q

List two functions of the liver.

A

Bilirubin conjugation and protein synthesis

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11
Q

List three functions of the Golgi complex.

A

VLDL production
Protein glycosylation
Albumin secretion

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12
Q

Gluconeogenesis, glycogenesis and glycogenolysis, together with _________ ______ metabolism are major liver functions.

A

Fatty acid

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13
Q

Name three substances that are detoxified and/or excreted by the liver.

A

Cholesterol, amino acid, and toxins

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14
Q

Red cells are removed from the circulation by the ______________ _________ of the liver and spleen.

A

Reticuloendothelial system

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15
Q

True or false: unconjugated bilirubin is insoluble.

A

True

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16
Q

Unconjugated bilirubin is transported while bound to _________.

A

Albumin

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17
Q

Unconjugated bilirubin can cross the blood-brain barrier, and is therefore potentially _________.

A

Toxic

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18
Q

If not bound to albumin, unconjugated bilirubin is ______-soluble

A

Lipid

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19
Q

Bilirubin is taken up by ____________ and conjugated (in ER) to mono- and diglucuronides.

A

Hepatocytes

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20
Q

Normal bile is comprised of 25% _______________ and 75% diglucuronides.

A

Monoglucuronides

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21
Q

Conjugated bilirubin is soluble, and is converted to _______________ by GIT bacteria.

A

Urobilinogen

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22
Q

True or false: all urobilinogen is reabsorbed.

A

False

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23
Q

Most urobilinogen is oxidised in gut to a brown pigment (______________) and excreted.

A

Stercobilin

24
Q

Unconjugated bilirubin is not filtered by the ______________.

A

Glomeruli

25
Q

If conjugated bilirubin is found in urine, this reflects an increase in plasma concentration, and is ________________.

A

Pathological

26
Q

___________ results when bilirubin > 50µmol/.

A

Jaundice

27
Q

Pre-hepatic jaundice is caused by _____________.

A

Haemolysis

28
Q

___________ jaundice, arises from failure of the conjugating mechanism, e.g., in the case of drugs, prematurity, hepatitis, etc..

A

Hepatic

29
Q

Post-hepatic jaundice occurs when the __________ ________ is blocked. such as with gall stones.

A

Biliary tract

30
Q

List three causes of unconjugated hyperbilirubinaemia.

A

Haemolytic disease of the newborn, increased bilirubin production, and due to low activity of conjugating enzymes at birth

31
Q

HDN carries a risk of ___________.

A

Kernicterus

32
Q

____________ _________________ is caused by leakage of bilirubin from hepatocytes or biliary system into the blood stream.

A

Conjugated hyperbilirubinaemia

33
Q

In conjugated hyperbilirubinaemia, bilirubin may be excreted in urine, forming a deep orange-_________ colour).

A

Brown

34
Q

Outline the principle of the chemical Diazo reaction.

A

Diazotised sulphanilic acid reacts with bilirubin to produce two azodipyroles. The reaction can be ‘accelerated’ to facilitate the reaction of unconjugated (indirect) bilirubin.
Total bilirubin = indirect + direct bilirubin

35
Q

Bilirubin in infants can be measured directly by spectrophotometry, with no interference from ___________ and other pigments.

A

Carotene

36
Q

Fasting, morning sample is preferred to avoid ___________.

A

Lipaemia

37
Q

Bilirubin samples must be protected from ________.

A

Light

38
Q

When is fractionation indicated?

A

In neonates

39
Q

Obstruction in the biliary tract is termed ‘______________’.

A

Cholestasis

40
Q

Acute hepatocellular damage causes changes to ________________.

A

Aminotransferases

41
Q

Chronic liver disease can cause a decrease in albumin and ___________ time.

A

Prothrombin

42
Q

Both aspartate aminotransferase and alanine aminotransferase catalyse the interconversion of amino acids to 2-oxo-acids, by transferring _______ groups.

A

Amine

43
Q

The transaminase reaction is coupled to another reaction, such as ________ _____________, or lactate dehydrogenase.

A

Malate dehydrogenase

44
Q

Which enzyme has a reference range of 0-40 U/L?

A

Aspartate aminotransferase

45
Q

Which enzyme has a reference range of 0-45 U/L?

A

Alanine aminotransferase

46
Q

_________ consumption is measured as a change in absorption at 339 (340) nm, over several minutes.

A

NADH

47
Q

The difference in absorbance per minute is equal to NADH oxidised, and synonymous with __________ ________.

A

Enzyme activity

48
Q

Describe alkaline phosphatase.

A

Catalyses the hydrolysis of many substrates. Distributed widely, in the bone, placenta, kidney, etc.. Most serum ALP is derived from the liver and bone. Several isoenzymes exist, and they can be identified by electrophoresis. Increased in children and adolescents, but lower in adults. Raised especially in cholestatic liver disease, with a moderate or absent elevation in infectious hepatitis. 4-nitrophenyl is converted to 4-nitrophenoxide. Reference range is 35-104 U/L

49
Q

A peptidase, that catalyses the hydrolytic cleavage of peptides to form amino acids. Derived mostly from the liver. Elevated in all forms of liver disease. More sensitive than ALP and aminotransferases. References range for a female is 6-50 U/L, and for a male, 11-85 U/L is normal.

To which enzyme does the passage refer?

A

y-glutamyl transferase

50
Q

_______________ is a feature of chronic liver disease, and severe acute liver disease.

A

Hypoalbuminaemia

51
Q

a-fetoprotein is used to investigate ____________ _____________.

A

Hepatocellular carcinoma

52
Q

What does prothrombin time measure?

A

Coagulation factors that are made by the liver

53
Q

All ___________ assays require a sufficient spectrophotometer, and standardisation and temperature are important.

A

Enzyme

54
Q

True or false: hepatic failure is a medical emergency.

A

True

55
Q

List two potential causes of hepatic failure.

A

Electrolyte imbalances and severe metabolic acid-base disorders

56
Q

The liver is a common site for _________ _________.

A

Tumour metastasis

57
Q

Wilson’s disease pertains to abnormal ________ metabolism.

A

Copper

Clinical Chemistry I (12 decks)

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