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Clinical Chemistry MTAP > Liver Function > Flashcards

Liver Function Flashcards

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1
Q

Largest Internal Organ

A

Liver

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2
Q

Weight of Liver

A

1.2 to 1.5 kg

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3
Q

Chief Metabolic Organ in the Body

A

Liver

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4
Q

The smallest functional unit of Liver

A

Hepatic Lobule

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5
Q

Functions of the Liver

A

Synthetic Function
Detoxication Function
Excretion Function

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6
Q

What does the liver synthesize?

A

Enzymes and Proteins
Clotting Factors
Cholesterol

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7
Q

What does the liver detoxify?

A

Alcohol
Drugs
Ammonia

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8
Q

Product of Amino Acid Deamination

A

Ammonia

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9
Q

What does the liver excrete?

A

Bilirubin

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10
Q

Clotting factors that do not produce by the liver

A

Factor lll (Tissue Factor)
Factor IV (Calcium)

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11
Q

Glucose&raquo_space; ATP (breakdown)

A

Glycolysis

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12
Q

Glucose&raquo_space;> Glycogen

A

Glycogenesis

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13
Q

Glycogen&raquo_space;> Glucose

A

Glycogenolysis

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14
Q

Fat, Proteins&raquo_space;> Glucose

A

Gluconeogenesis

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15
Q

Synthesis of bile salts and lipids from acetyl-CoA

A

Lipid metabolism

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16
Q

Allow the substances to reach the circulation “first pass”

Excretion of steroid hormones, drugs, and foreign compounds

A

Detoxification

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17
Q

Where does the detoxification of the liver occurs?

A

Microsomes of the liver via CYTOCHROME P-450 isoenzymes

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18
Q

What does increased ammonia mean?

A

Impaired Liver

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19
Q

Fraction absorbed into the systemic circulation

A

Bioavailability

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20
Q

Major heme waste product
Product of Hemoglobin degradation

A

BILIRUBIN

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21
Q

How many hours does the conversion of HEME to BILIRUBIN take?

A

2-3 hours

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22
Q

B2 + ALBUMIN= ?

A

DELTA BILIRUBIN

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23
Q

Unconjugated bilirubin
Non-polar
Water-insoluble
Indirect Bilirubin
Hemobilirubin

A

B1

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24
Q

aka HEMOBILIRUBIN

A

B1

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25
Q

aka CHOLEBILIRUBIN

A

B2

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26
Q

Does NORMAL urine contain UROBILINIGEN?

A

YES

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27
Q

COLORLESS substance formed in the intestine

A

Urobilinogen

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28
Q

Orange-brown pigment
gives the natural brown color of feces

A

Urobilin

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29
Q

Converts B1 to B2

A

UDPGT

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30
Q

Yellow discoloration of skin, eyes, and mucous membranes

A

JAUNDICE (Icterus)

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31
Q

Normal Value (Jaundice associated)

A

NV= 0.5 – 1.0 mg/dL

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32
Q

Classification of Jaundice

A

Prehepatic, Hepatic and Post hepatic

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33
Q

PRE-HEPATIC is aka?

A

Unconjugated hyperbilirubinemia

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34
Q

Excessive destruction of RBC
↑Total Bilirubin
↑ B1
Normal B2

A

PRE-HEPATIC

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35
Q
  • ACUTE AND CHRONIC HEMOLYTIC ANEMIA
  • HEMOLYTIC DISEASE OF THE NEWBORN
  • HEMOLYTIC TRANSFUSION REACTION
  • MALARIA
A

PRE-HEPATIC

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36
Q

Biliary obstructive disease
↑TB
Normal B1
↑ B2
Bilirubinuria

A

POST-HEPATIC

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37
Q

Physical obstructions which prevent the flow of B2
into bile canal

A

POST-HEPATIC

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38
Q
  • GALL STONES
  • TUMORS
A

POST-HEPATIC

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39
Q

intrinsic liver defect

A

HEPATIC

40
Q

Unconjugated hyperbilirubinemia due to
defective transport system

A

Gilbert syndrome

41
Q

↑Tot. Bili (↑ B1, Normal B2)

A

Gilbert syndrome

42
Q
  • Reduced expression of UGT1A1
A

Gilbert syndrome

43
Q

Conjugation Deficit

A

Crigler-Najjar Syndrome

44
Q

Molecular defect of gene

A

Crigler-Najjar Syndrome

45
Q

absence of UDP-GT in (Crigler)

A

Type 1

46
Q

deficiency of UDP-GT in (Crigler)

A

Type 2

47
Q

↑TB (↑ B1, ↓ B2)

A

Crigler-Najjar Syndrome

48
Q

Excretion deficit

A

Dubin-Johnson

49
Q

Deficiency of MDR2/cMOAT
↑TB(Normal B1, ↑ B2)

A

Dubin-Johnson

50
Q

Bilirubinuria
* Darkly stained granules
* Presence of Delta Bilirubin)

A

Dubin-Johnson

51
Q

Deficiency of Ligandin
↑TB (Normal B1, ↑ B2)
No Dark stained granules

A

Rotor Syndrome

52
Q

SERUM BILIRUBIN: Increase (B1)
URINE BILIRUBIN: Negative
URINE UROBILINOGEN: Increase

A

Prehepatic
(Hemolytic anemia)

53
Q

SERUM BILIRUBIN: Increase (B1, B2)
URINE BILIRUBIN: Positive
URINE UROBILINOGEN: Increase

A

Hepatic (Liver disease)

54
Q

SERUM BILIRUBIN: Increase (B2)
URINE BILIRUBIN: Positive
URINE UROBILINOGEN: Decrease/Normal

A

Posthepatic
(Biliary Obstruction)

55
Q

yellowish discoloration of the skin and the sclera of the eyes

A

JAUNDICE

56
Q

deposition of bilirubin in the brain

A

KERNICTERUS

57
Q

scarring of the liver

A

CIRRHOSIS

58
Q

failure of the common bile duct to form an opening

A

BILIARY ATRESIA

59
Q

inflammation of the gall bladder

A

CHOLECYSTITIS

60
Q

gall stones

A

CHOLELITHISASIS

61
Q

presence of gall stones in the biliary tree

A

CHOLEDOCHOLILITHIASIS

62
Q

Inc. AST, ALT and GGT
Fatty infiltrates in vacuoles of liver

A

Alcoholic Fatty Liver

63
Q

✓ Increased (2X) AST, ALT, GGT, and ALP
✓ Bilirubin 30mg/dL, dec. albumin, inc. PT

A

Alcoholic Hepatitis

64
Q

✓ Increased (3x) AST, ALT, GGT and ALP
✓ Inc. Bilirubin, dec. albumin, inc. PT

A

Alcoholic Cirrhosis

65
Q

DRUG RELATED DISORDERS

A

Acetaminophen
✓ Hepatic necrosis
* Tranquilizers
* Antineoplastic Agents
* Anti-Inflammatory Drugs

66
Q

Stages of Liver Disease

A

Healthy liver
Fatty Liver
Hepatic Fibrosis
Cirrhosis
Liver Cancer

67
Q

METHODS OF BILIRUBIN ANALYSIS

A

Icterus Index
Van Den Bergh’s reaction
Jendrassik-Grof
Evelyn Malloy

68
Q

DIRECT VAN DEN BERGH

A

B2 + Diazo reagent = AZOBILIRUBIN

69
Q

INDIRECT VAN DEN BERGH

A

B1 +Accelerator + Diazo reagent = AZOBILIRUBIN

70
Q

Accelerator of Malloy-Evelyn

A

50% Methanol

71
Q

Accelerator of Jendrassik-Grof

A

Caffeine sodium benzoate

72
Q

Stopper of Malloy-Evelyn

A

None

73
Q

Stopper of Jendrasskik-Grof

A

Ascorbic Acid

74
Q

pH of Malloy-Evelyn

A

1.2

75
Q

pH of Jendrassik-Grof

A

10.6

76
Q

End color of Malloy-Evelyn

A

Pink-purple @ 540 nm

77
Q

End color of Jendrassik-Grof

A

Purple-blue @ 600 nm

78
Q

Icterus Index- Standard

A

(0.1% potassium dichromate) vs. Patient serum sample

79
Q

Van Den Bergh reaction- reagent used:

A

diazotized sulfanilic acid

80
Q

most sensitive and widely used, preferred by automated analyzers, candidate
reference method

A

Jendrassik-Grof

81
Q

before adding accelerator

A

B2 only

82
Q

after adding accelerator

A

TOTAL BILIRUBIN

83
Q

Indirect bilirubin computation

A

TBIL - DBIL = IBIL

84
Q

wavelength of maximum bilirubin absorption

A

450 nm

85
Q

Reagent in Ehrlich’s Test

A

p-Dimethylaminobenzaldehyde (p-DAB)

86
Q

Immunoglobulin present in Primary Biliary Cirrhosis

A

IgM (Anti-mitochondrial antibodies)

87
Q

Immunoglobulin Present in Chronic Active Hepatitis

A

IgG and IgM (Anti-smooth muscle
antibody)

88
Q

Immunoglobulin present in Alcoholic Cirrhosis

A

IgA

89
Q

Hepatic damage

A
  • Cirrhosis (beta-gamma bridging)
  • Hepatitis (increased gamma globulins)
90
Q

Total Protein in Hepatic Damage

A

Normal, decreased
(decreased alpha, alpha 2, beta)

91
Q

Albumin in Hepatic Damage

A

Decreased

92
Q

Globulin in Hepatic Damage

A

Increased

93
Q

Test the ability of the liver to convert ammonia to urea

A

TEST FOR THE DETOXIFICATION FUNCTION OF LIVER

94
Q

✓Inherited deficiencies of the urea cycle
✓Increased Ammonia

A

Reye syndrome

95
Q

Hepatic failure and hepatic coma

A

Increase ammonia

Clinical Chemistry MTAP (7 decks)

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