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Clinical Chemistry MTAP > Liver Function > Flashcards

Liver Function Flashcards

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
aka CHOLEBILIRUBIN
B2
26
Does NORMAL urine contain UROBILINIGEN?
YES
27
COLORLESS substance formed in the intestine
Urobilinogen
28
Orange-brown pigment gives the natural brown color of feces
Urobilin
29
Converts B1 to B2
UDPGT
30
Yellow discoloration of skin, eyes, and mucous membranes
JAUNDICE (Icterus)
31
Normal Value (Jaundice associated)
NV= 0.5 – 1.0 mg/dL
32
Classification of Jaundice
Prehepatic, Hepatic and Post hepatic
33
PRE-HEPATIC is aka?
Unconjugated hyperbilirubinemia
34
Excessive destruction of RBC ↑Total Bilirubin ↑ B1 Normal B2
PRE-HEPATIC
35
- ACUTE AND CHRONIC HEMOLYTIC ANEMIA * HEMOLYTIC DISEASE OF THE NEWBORN * HEMOLYTIC TRANSFUSION REACTION * MALARIA
PRE-HEPATIC
36
Biliary obstructive disease ↑TB Normal B1 ↑ B2 Bilirubinuria
POST-HEPATIC
37
Physical obstructions which prevent the flow of B2 into bile canal
POST-HEPATIC
38
* GALL STONES * TUMORS
POST-HEPATIC
39
intrinsic liver defect
HEPATIC
40
Unconjugated hyperbilirubinemia due to defective transport system
Gilbert syndrome
41
↑Tot. Bili (↑ B1, Normal B2)
Gilbert syndrome
42
* Reduced expression of UGT1A1
Gilbert syndrome
43
Conjugation Deficit
Crigler-Najjar Syndrome
44
Molecular defect of gene
Crigler-Najjar Syndrome
45
absence of UDP-GT in (Crigler)
Type 1
46
deficiency of UDP-GT in (Crigler)
Type 2
47
↑TB (↑ B1, ↓ B2)
Crigler-Najjar Syndrome
48
Excretion deficit
Dubin-Johnson
49
Deficiency of MDR2/cMOAT ↑TB(Normal B1, ↑ B2)
Dubin-Johnson
50
Bilirubinuria * Darkly stained granules * Presence of Delta Bilirubin)
Dubin-Johnson
51
Deficiency of Ligandin ↑TB (Normal B1, ↑ B2) No Dark stained granules
Rotor Syndrome
52
SERUM BILIRUBIN: Increase (B1) URINE BILIRUBIN: Negative URINE UROBILINOGEN: Increase
Prehepatic (Hemolytic anemia)
53
SERUM BILIRUBIN: Increase (B1, B2) URINE BILIRUBIN: Positive URINE UROBILINOGEN: Increase
Hepatic (Liver disease)
54
SERUM BILIRUBIN: Increase (B2) URINE BILIRUBIN: Positive URINE UROBILINOGEN: Decrease/Normal
Posthepatic (Biliary Obstruction)
55
yellowish discoloration of the skin and the sclera of the eyes
JAUNDICE
56
deposition of bilirubin in the brain
KERNICTERUS
57
scarring of the liver
CIRRHOSIS
58
failure of the common bile duct to form an opening
BILIARY ATRESIA
59
inflammation of the gall bladder
CHOLECYSTITIS
60
gall stones
CHOLELITHISASIS
61
presence of gall stones in the biliary tree
CHOLEDOCHOLILITHIASIS
62
Inc. AST, ALT and GGT Fatty infiltrates in vacuoles of liver
Alcoholic Fatty Liver
63
✓ Increased (2X) AST, ALT, GGT, and ALP ✓ Bilirubin 30mg/dL, dec. albumin, inc. PT
Alcoholic Hepatitis
64
✓ Increased (3x) AST, ALT, GGT and ALP ✓ Inc. Bilirubin, dec. albumin, inc. PT
Alcoholic Cirrhosis
65
DRUG RELATED DISORDERS
Acetaminophen ✓ Hepatic necrosis * Tranquilizers * Antineoplastic Agents * Anti-Inflammatory Drugs
66
Stages of Liver Disease
Healthy liver Fatty Liver Hepatic Fibrosis Cirrhosis Liver Cancer
67
METHODS OF BILIRUBIN ANALYSIS
Icterus Index Van Den Bergh's reaction Jendrassik-Grof Evelyn Malloy
68
DIRECT VAN DEN BERGH
B2 + Diazo reagent = AZOBILIRUBIN
69
INDIRECT VAN DEN BERGH
B1 +Accelerator + Diazo reagent = AZOBILIRUBIN
70
Accelerator of Malloy-Evelyn
50% Methanol
71
Accelerator of Jendrassik-Grof
Caffeine sodium benzoate
72
Stopper of Malloy-Evelyn
None
73
Stopper of Jendrasskik-Grof
Ascorbic Acid
74
pH of Malloy-Evelyn
1.2
75
pH of Jendrassik-Grof
10.6
76
End color of Malloy-Evelyn
Pink-purple @ 540 nm
77
End color of Jendrassik-Grof
Purple-blue @ 600 nm
78
Icterus Index- Standard
(0.1% potassium dichromate) vs. Patient serum sample
79
Van Den Bergh reaction- reagent used:
diazotized sulfanilic acid
80
most sensitive and widely used, preferred by automated analyzers, candidate reference method
Jendrassik-Grof
81
before adding accelerator
B2 only
82
after adding accelerator
TOTAL BILIRUBIN
83
Indirect bilirubin computation
TBIL - DBIL = IBIL
84
wavelength of maximum bilirubin absorption
450 nm
85
Reagent in Ehrlich's Test
p-Dimethylaminobenzaldehyde (p-DAB)
86
Immunoglobulin present in Primary Biliary Cirrhosis
IgM (Anti-mitochondrial antibodies)
87
Immunoglobulin Present in Chronic Active Hepatitis
IgG and IgM (Anti-smooth muscle antibody)
88
Immunoglobulin present in Alcoholic Cirrhosis
IgA
89
Hepatic damage
* Cirrhosis (beta-gamma bridging) * Hepatitis (increased gamma globulins)
90
Total Protein in Hepatic Damage
Normal, decreased (decreased alpha, alpha 2, beta)
91
Albumin in Hepatic Damage
Decreased
92
Globulin in Hepatic Damage
Increased
93
Test the ability of the liver to convert ammonia to urea
TEST FOR THE DETOXIFICATION FUNCTION OF LIVER
94
✓Inherited deficiencies of the urea cycle ✓Increased Ammonia
Reye syndrome
95
Hepatic failure and hepatic coma
Increase ammonia

Clinical Chemistry MTAP (7 decks)

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