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CC Lab > Liver Function > Flashcards

Liver Function Flashcards

1
Q

Functions of the liver.
Ma, Dala Sa’g Carrots

A
  1. Metabolism of carbohydrates, lipids, proteins, and bilirubin
  2. Detoxification of harmful substances
  3. Storage of essential compounds; and
  4. Clearing waste products
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2
Q

It is a relatively resilient organ that can regenerate cells that have been removed.

A

Liver

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3
Q

If liver becomes completely nonfunctional, death will occur within approximately 24 hours due to …

A

Hypoglycemia

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4
Q

Weight of the liver in kg

A

approximately 1.2 - 1.5 kg

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5
Q

How many times larger is right lobe when compared to the left?

A

6 times larger

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6
Q

2 major sources where the liver receives blood supply

A
  1. Hepatic artery
  2. Portal Vein
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7
Q

It supplies the oxygen-rich blood from the heart to the liver which is responsible for 25% of the total blood supply to the liver

A

Hepatic artery

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8
Q

This supplies nutrient-rich blood, collected from the digestive tract, which is responsible for providing 75% of the total volume of blood supply to the liver.

A

Portal vein

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9
Q

This is where the two blood supplies eventually merge which is lined by hepatocytes that remove toxic substances from the blood.

A

Hepatic sinusoid

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10
Q

It is through this that the blood leaves the liver.

A

central canal

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11
Q

How many mL of blood passes through the liver per minute?

A

1,500 mL

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12
Q

This is where the excretory system of the liver begins.

A

Bile Canaliculi

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13
Q

This is where excretory products can drain

A

Bile Canaliculi

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14
Q

2 major cell types of the liver.

A
  1. Hepatocytes
  2. Kupffer Cells
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15
Q

A cell that makes up approximately 80% of the volume of the organ which is responsible for the liver’s regenerative properties.

A

Hepatocytes

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16
Q

Cells that are macrophages that line the sinusoids which act as active phagocytes capable of engulfing bacteria, debrix, toxins, etc.

A

Kupffer Cells

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17
Q

First major functions of the liver

A

Excretory and Secretory processes

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18
Q

Major heme waste product

A

Bilirubin

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19
Q

True or False. The liver is one of the organs that get rid of heme waste products.

A

False. It is the only organ.

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20
Q

Components of bile.

A
  1. Bile acids/salt
  2. Bile pigments
  3. Cholesterol
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21
Q

The produces ____L of bile per day and excretes ____L.

A

Produces 3L;
Excretes 1L

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22
Q

Principal pigment in bile and is derived from the breakdown of RBCs.

A

Bilirubin

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23
Q

Hemoglobin is degraded to three

A
  1. Heme
  2. Iron
  3. Globin
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24
Q

Bound by transferrin and returned in the liver/bone marrow for reuse.

A

Iron

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25
Q

Degraded into amino acids to be reused by the body.

A

Globin

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26
Q

The heme portion of hemoglobin is converted to bilirubin within how many hours?

A

2-3 hours

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27
Q

Bilirubin that is bound by albumin which is insoluble in water and cannot be removed until it is conjugated by the liver.

A

Unconjugated Bilirubin

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28
Q

A carrier protein that picks up unconjugated bilirubin released from albumin, responsible for transporting it to the endoplasmic reticulum where it is conjugated.

A

Ligandin

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29
Q

Enzyme for the conjugation (esterification) of bilirubin

A

Uridine Diphosphate Glucuronosyltransferase (UDPGT); or
UDP-glucoronyl transferase enzyme

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30
Q

Water soluble and can be excreted from the hepatocytes into the bile canaliculi.

A

Conjugated bilirubin

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31
Q

A colorless product oxidized to an orange-colored product which is excreted in the feces.

A

Urobilinogen

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32
Q

Oxidized urobilinogen that gives the feces its brown color.

A

urobilin or stercobilin

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33
Q

How many mg of bilirubin is produced per day?

A

200 to 300 mg

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34
Q

Levels of bilirubin in the serum of a healthy adult.

A

0.2 to 1.0 mg/dL

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35
Q

Maximum excreted urobilinogen per day

A

1-4 mg

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36
Q

Second major function of the liver that has the capacity to metabolize biological compounds, including carbohydrates, lipids, and proteins (from the digestive system)

A

Metabolism

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37
Q

When carbohydrates are ingested and absorbed, the liver can process them for 3 ways.

A
  1. Cellular energy requirements
  2. Use at peripheral tissues
  3. Store glucose as glycogen
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38
Q

Principal storage form of glucose

A

glycogen

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39
Q

Approximately ____% of the daily production of cholesterol is produced by the liver.

A

70%, roughly 1.5 to 2.0 grams

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40
Q

One of the most important proteins synthesized by the liver.

A

Albumin

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41
Q

The most critical aspect of protein metabolism

A

transmination and deamination of amino acids

42
Q

Result in the exchange of an amino acid on one acid with a ketone group on another acid.

A

Transmination

43
Q

This degrades the products to produce ammonium ions that are consumed in the synthesis of urea, excreted by the kidneys.

A

Deamination

44
Q

Take note: The liver must be extensively impaired before it loses its ability to perform essential functions

A
45
Q

The thrid major function of the liver wherein it serves as a gatekeeper between substances from the gastrointestinal tract and those released in the circulatory system.

A

Detoxification of waste products

46
Q

Refers to every substance absorbed in the gastrointestinal tract that must pass through the liver before reaching through the rest of the body.

A

first pass

47
Q

2 mechanisms of detoxification of foreign materials (drugs and poisons) and metabolic products (bilirubin and ammonia).

A
  1. Binds the material to reversibly inactivate the compound
  2. Chemically modifies the compound
48
Q

Fourth major function of the liver

A

Drug Detoxification

49
Q

This is where drug detoxification takes place.

A

Liver microsomes via cytochrome-P450 (CYP450) isoenzymes

50
Q

Yellow discoloration of the skin, eyes, and mucous membranes, most often resulting from the retention of bilirubin.

A

Jaundice

51
Q

Upper limit of normal for total bilirubin

A

1.0 to 1.5 mg/dL

52
Q

Jaundice not noticeable to the human eye

A

Overt Jaundice

53
Q

Jaundice is noticeable at what bilirubin level/s?

A

3.0 to 5.0 mg/dL

54
Q

Pertains to a serum or plasma sample with a yellow discoloration due to the elevation of bilirubin levels.

A

Icterus

55
Q

Commonly caused by increased amounnt of bilirubin being presented to the liver, as seen in acute and chronic hemolytic anemia.

A

Prehepatic jaundice

56
Q

Prehepatic jaundice may also be referred to as

A

unconjugated hyperbiliribunemia

57
Q

Occurs when the primary problem causing the jaundice resides in the liver (intrinsic liver defect or disease)

A

Hepatic jaundice

58
Q

Disorders of bilirubin metabolism causing intrinsic liver defect that results in the elevation of inconjugated bilirubin. (C DG Naay Newborn)

A

Crigler-Najjar Syndrome
Dubin Johnson Syndrome
Gilbert’s Disease
Neonatal Physiologic Jaundice of Newborn

59
Q

Elevated conjugated bilirubin in hepatic jaundice
(C Derek Ramsay)

A

Dubin-Johnson & Rotor Syndrome

60
Q

A benign autosomal recessive hereditary disorder that results from a genetic mutation in the UGT1A1 gene that produces the enzyme uridine diphosphate glucuronosyltransferase.

A

Gilbert’s syndrome

61
Q

Location of UGT1A1

A

Chromosome 2

62
Q

Other mutation of the UGT1A1 gene that is a more severe and dangerous form of hyperbilirubinemia

A

Crigler-Najjar Syndrome

63
Q

Of the many causes of jaundice, this is the most common cause which carries no morbidity or mortality in the majority of those affected and carries no clinical consequences

A

Gilbert’s syndrome

64
Q

A syndrome of nonhemolytic unconjugated hyperbilirubinemia resulting from a molecular defect within a gene involved with bilirubin conjugation.

A

Crigler-Najjar Syndrome

65
Q

A type of Crigler-Najjar Syndrome where there is complete absence of enzymatic bilirubin conjugation.

A

Type 1

66
Q

A type of Crigler-Najjar Syndrome where there is a mutation causing the deficiency of the enzyme responsible for bilirubin. conjugation

A

Type 2

67
Q

Characterized by elevated unconjugated bilirubin
(U Got Cancelled)

A

Gilbert’s Syndrome
Crigler-Najjar

68
Q

Deficiency of the canalicular multidrug resistance/multispecific organic anionic transporter protein (MDR2/cMOAT)

A

Dubin-Johnson Syndrome

69
Q

Liver’s ability to uptake and conjugate bilirubin is functional but removal and excretion are defective.

A

Dubin-Johnson Syndrome

70
Q

Its distinguishing feature is the appearance of dark stained granules

A

Dubin-Johnson Syndrome

71
Q

Caused by mutations in the SLCO1B1 and SLCO1B3 genes on chromosome 12

A

Rotor Syndrome

72
Q

Genes that provide instructions for making proteins found on liver cells.

A

SLCO1B1 and SLCO1B3

73
Q

Common complication encountered during the neonatal period (first week) characterized by the deficiency of UDPGT

A

Physiologic jaundice/neonatal hyperbilirubinemia

74
Q

Causes posthepatic jaundice

A

Liver cirrhosis
Bile duct obstruction
GI obstruction

75
Q

A condition where scar tissue replaces normal, healthy liver tissue which blocks the flow of blood to the organ, preventing the liver from functioning properly

A

Cirrhosis

76
Q

Most common cause of Cirrhosis

A

Chronic alcoholism

77
Q

Cancer that begins in in the liver cells

A

Primary liver cancer

78
Q

Occurs when tumors from other parts of the body metastasize to the liver.

A

Metastatic liver cancer

79
Q

Most common primary liver malignancy

A

Hepatocellular carcinoma

80
Q

A group of disorders caused by infectious, metabolic, toxic or drug-induced disease found almost exclusively in children.

A

Reye’s syndrome

81
Q

Of all the drugs associated with hepatic toxicity, this is the most important.

A

Ethanol

82
Q

Bilirubin with a diazotized sulfanilic acid solution

A

Diazo reaction

83
Q

Method to measure Total Bilirubin

A

Bilirubin + diazotized sulfanilic acid + accelerator
would yield
2 azobilirubin

84
Q

Method to measure Conjugated Bilirubin

A

Bilirubin + diazotized sulfanilic acid
would yield
2 azobilirubin

85
Q

Method to measure Indirect Bilirubin

A

Total bilirubin - Conjugated bilirubin = unconjugated bilirubin

86
Q

A polar and water-soluble compound found in plasma in the free state.

A

Conjugated bilirubin

87
Q

Tips:
Vowels - indirect, unconjugated, insoluble
Consonants - direct, conjugated, water-soluble

A
88
Q

Specimen for Total Bilirubin

A

serum/plasma

89
Q

Preferred spx for Malloy-Evelyn procedure because of the addition of alcohol

A

serum

90
Q

Why is a fasting sample preferred?

A

Lipemia will increase bilirubin conc.

91
Q

These samples should be avoided because it decreases the reaction of bilirubin with the diazo reagent

A

Hemolyzed samples

92
Q

Bilirubin is sensitive to and is destroyed by

A

light

93
Q

Separated serum/plasma from cells and stored in the dark is stable for

A

2 days at RT
1 week at 4oC
Indefinitely at -20oC

94
Q

Most common accelerator to solubulize unconjugated bilirubin

A

Methanol

95
Q

Reagent for Malloy-Evelyn Procedure

A

Diazotized sulfanilic acid

96
Q

Malloy-Evelyn procedure is performed at what pH? Resulting to what color of the azobilirubin? With a maximal absorption of how many nm?

A

1.2
red-purple
560 nm

97
Q

Bilirubin pigments react with diazo reagent (sulfanilic acid with hydrochloric acid and sodium nitrate)

A

Jendrassik-Grof Method

98
Q

Jendrassik-Grof results in the production of

A

purple product: azobilirubin

99
Q

Its addition in the Jendrassik-Grof method will solubilize the water-insoluble fraction of bilirubin

A

caffeine-benzoate

100
Q

Final product of Jendrassik-Grof

A

Blue (measured at 600 nm)

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