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Clinical Chem 2 > liver function > Flashcards

liver function Flashcards

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1
Q

what holds the liver in place

A

ligaments
segments separated by falciform ligament

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2
Q

portal vein blood supply

A

75%

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3
Q

hepatic artery blood supply

A

25%

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4
Q

hepatoctes

A

liver function cells

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5
Q

Kupfer cells

A

liver-specific macrophages

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6
Q

list the biochemical functions of the liver

A
  • excretion/secretion
  • storage
  • metabolism
  • detoxification
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7
Q

what happens to water sol bilirubin

A

conjugated bilirubin
secretated from hepatocyte into bile canaliculi

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8
Q

glycogenesis

A

store glucose as glycogen

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9
Q

glycogenolysis

A

breakdwown of glycogen

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10
Q

gluconeogensis

A

creatoin of glucose from non sugar carbon substrates

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11
Q

lipid metabolism

A

free fatty acids-> acetyl CoA -> trigs, phospholipids, cholesterol

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12
Q

describe the two mechanisms for detoxification of waste products

A
  • binds material irreversibly = inactivated
  • chemically modifies compound to be excreted
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13
Q

describe jaundice generally

A

retention of bilirubin (3-5mg/dL) causing yellowing of skin
- classified based on site of disorder

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14
Q

prehepatic jaundice

A
  • increased amount of bilirbin sent to liver
  • hemolytic anemia (acute/chronic)
  • unconjugated hyperbilirubinemia
  • increased urobilinogen in urine
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15
Q

posthepatic jaundice

A
  • biliary obstructive disease
  • bilirubin conjugated but can’t be excreted
  • bile not through intestines = pale poop
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16
Q

hepatic jaundice

A
  • disorder of bilirubin metabolism
  • transport defects
  • hepatocellular injury or destruction
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17
Q

gilberts syndrome

A
  • hepatic jaundice
  • benign recessive
  • defect conjugation system = intermittent unconjugated hyperbilirubinemia
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18
Q

crigler-Najjar syndrome

A
  • hepatic jaundice
  • nonhemolytic hyperbilirubinemia
  • either absence or defiency of enzyme for conjugation
    –> can’t conjugate bilirubin
19
Q

Dubin-Johnson syndrome

A
  • hepatic jaundice
  • conjugated hyperbilirubinemia
  • ability to remove conjugated bilirubin impacted (can’t remove)
  • delta bilirubin = conjugated and albumin bound
20
Q

rotor syndrome

A
  • hepatic jaundice
  • bilirubin less effectively taken up and removed
  • the movement rotor non functional
  • use of ALP and GGT to differentiate from obstruction
21
Q

physiologic jaundice

A
  • hepatic jaundice
  • common in first week of life
  • deficiency in UDPGT
22
Q

kernicterus

A

physiologic jaundice
unconjugated bilirubin in neonate that can deposite in brain

23
Q

describe Cirrohis

A
  • scar tissue replaces normal tissue
  • blocks flow of blood
  • prevents normal liver function
24
Q

which type of tumor is more common in liver

A

metastatic (vs primary)

25
Q

most common primary cancer in liver

A

hepatocellular carcinoma (HCC)

26
Q

reye’s syndrome

A

found in children following viral syndrome w/ aspirin
-> increase in AST and ALT

27
Q

most common mechanism of alcohol related injury to liver

A

immune mediated injury to hepatocytes

28
Q

fatty liver disease

A
  • from alcohol
  • mild with slight liver marker elevations: AST, ALT and GGT
29
Q

alcoholic hepatitis

A
  • serum proteins decrease (albumin)
  • increase AST, ALT, GGT, ALP and bilirubin
30
Q

AST/ALT ratio in alcoholic hepatitis

A

> 2

31
Q

alcoholic cirrhosis

A
  • increase in liver markers
  • decreased albumin
  • need liver biopsy
32
Q

describe the malloy-evelyn procedure for bilirubin assesment

A
  • diazo reagent
  • methanol accelerator
33
Q

describe the jandrassik- Grof method of bilirubin assesment

A
  • more commonly used
  • diazo binds conjugated bilirubin only
  • caffeine-benzoate accelerator gives total bilirubin
34
Q

what does increased levels of urinary urobilinogen indicate

A

hemolytic disease

35
Q

describe the role of liver enzyme measurment for functionality

A
  • differentiates hepatocellular (functional) from obstructive (mechanical)
36
Q

describe alkaline phosphatase

A
  • differentiates heptobiliary disease and osteogenic bone disease
  • high ALP seen in extrahepatic biliary obstruction
37
Q

describe 5’-nucleotidase

A
  • significantly elevated in hepatobiliary disease
  • not ordered often
38
Q

describe GGT

A
  • biliary obstruction measurment
  • most sensitive hepatic enzyme indicator for liver disease
39
Q

test for assessing synthetic ability of liver

A

serum protein

40
Q

test to measure decreased protein synthesis

A

decreasing albumin

41
Q

what Ig is seen in primary biliary cirrhosis

A

IgM

42
Q

what Ig is seen in alcoholic cirrhosis

A

IgA
- A for alcohol

43
Q

describe nitrogen metabolism testing

A

converts to urea -> ammonia level reflects liver function

Clinical Chem 2 (25 decks)

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