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CLINICAL CHEMISTRY > Liver Function (Anatomy and Physiology) > Flashcards

Liver Function (Anatomy and Physiology) Flashcards

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1
Q

Largest and complex organ responsible for major metabolic functions in the body

A

Liver

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2
Q

Primary organ that can ONLY EXHIBIT KETOGENESIS

A

Liver

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3
Q

Liver is found at the

A

Right upper quadrant of abdomen

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4
Q

Liver has abundant blood supply approximately

A

1500 ML/MIN

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5
Q

Two major vessels of liver (2)

A

Hepatic Artery
Hepatic Portal Vein

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6
Q

Branch of aorta that provides most of the oxygen requirement; contributes 20% blood supply

A

Hepatic Artery

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7
Q

Drains the gastrointestinal tract and Spleen, Transports most of the recently absorbed materials from the intestines to the liver

A

Hepatic Portal Vein

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8
Q

Metabolic Activity of liver takes place within the___ ; constitutes 80% of organ mass

A

Parenchymal Cells

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9
Q

Aside from Parenchymal cells, liver also contains cells like (2)

A

Kupffer Cells
Stellate cells (major cell type responsible for Fibrosis)

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10
Q

Six-sided functional unit of Liver

A

Liver Lobule

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11
Q

Branches of Hepatic Artery and portal vein
Central Vein
Sinusoids
Hepatocytes and Kupffer cells
Bile canaliculi
Bile ducts

A

Component of Liver Lobule

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12
Q

Bile ducts
Hepatic Portal Vein
Hepatic Artery

A

Portal Triad

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13
Q

It is responsible for METABOLIC, SYNTHETIC, SECRETORY, EXCRETORY FUNCTION

A

Liver

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14
Q

First-Pass
Phagocytosis by KUPFFER CELLS
Metabolism and excretion of drugs
Production of Urea

A

Detoxification

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15
Q

Synthesis of Bile acids and Bile salts

A

Excretory System/Biliary System

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16
Q

Loss of functioning hepatocytes

Cirrhosis and Hepatitis

A

Decreased Levels (bile acids)

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17
Q

Regurgitation from hepatocytes

Biliary Obstruction and Hepatocellular Disease

A

Increased Levels (Bile acids)

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18
Q

Secretion Function

heme waste products (Bilirubin and Porphyrin)

A

Bile pigments

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19
Q

Bilirubin
Ammonia
Lipids
Bile salts
Drug Metabolism

A

Metabolic

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20
Q

Drug Metabolism is tested using

A

Cytochrome p450

  • measure after 1hr
  • Cynthelation Counter
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21
Q

Serum Total Protein
Albumin
AAT
Ceruloplasmin
Coagulation Factors

A

Synthetic Function

Except:
FVIII - produced in Endothelial Cells
FVII - First factor to be increased in Liver disease

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22
Q

Transaminases (AST and ALT)
Biliary Epithelium (ALP, 5-NT, GGT)

A

Hepatic Injury

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23
Q

Carbohydrates
Fats
Lipoproteins
Ketone bodies
Proteins
Hormones ( Somatomedin and Angiotensinogen)

A

Synthesis or Metabolism Function

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24
Q

Fat Soluble and water-soluble vitamins, Glycogen, Iron

A

Storage

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25
Q

B1 —-> B2 reactions is catalyzed by enzyme

A

UDPGT

Uridyl diphosphate Glycuronyltransferase

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26
Q

Structure: Bilirubin
Bound to protein: Yes (albumin)
Type of Compound: Non-Polar
Soluble in water: No
Present in Urine: No
Reaction with Diazotized Sulfanilic Acid: Indirect (Requires accelerator)

Affinity for Brain Tissue: High

A

Unconjugted Bilirubin

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27
Q

Structure: B1, B2, Delta Bilirubin
Bound to protein: No (Except for Delta Bili)
Type of Compound: Polar
Soluble in water: Yes
Present in Urine: Yes
Reaction with Diazotized Sulfanilic Acid: Direct (no accelerator)

Affinity for Brain Tissue: Low

A

Conjugated Bilirubin

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28
Q

Laboratory Assays to Assess Liver Disease:

Hepatocellular damage

A

AST
ALT

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29
Q

Laboratory Assays to Assess Liver Disease:

Cholestasis

A

ALP (inc. period of growths)
GGT (small liver insults)
5-NT (Specific for hepatobiliary disease)

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30
Q

Laboratory Assays to Assess Liver Disease:

Liver Excretory Function

A

Serum Bilirubin
Urine Bilirubin
Blood Ammonia

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31
Q

Laboratory Assays to Assess Liver Disease:

Assays of biosynthetic function

A

Total Protein, Albumin, Globulins
Coagulation factors

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32
Q

Hemolysis
Hereditary Erythrocytes Enzymopathies

A

Bilirubin

33
Q

Bone cancer, Pregnancy

A

ALP

34
Q

Muscle Damage, Cancer, Pancreatitis, Renal Disease

A

ALT

35
Q

Myocardial Infarction, Skeletal Muscle damage

A

AST

36
Q

Myocardial Infarction, Skeletal Muscle damage, renal disease, cancer

A

LDH

37
Q

Pesticide Poisoning

A

DECREASE CHOLINESTERASE

38
Q

LIVER DISORDERS:

may be acute or chronic or combination of both; damage to and destruction of liver cells

A

Hepatitis

39
Q

LIVER DISORDERS:

regeneration leads to fibrosis, scarring, and destruction of normal liver architecture

A

Cirrhosis

40
Q

destruction of intrahepatic bile ducts; presence of ANTI-MITOCHONDRIAL ANTIBODIES

A

Primary Biliary Cirrhosis

41
Q

LIVER DISORDERS:

Both primary, more frequently secondary to cancer of bowel, stomach, and bronchus

A

Tumors

42
Q

ASMA-CAH

A

Anti-Smooth Muscle Antibody
Chronic Active Hepatitis

43
Q

STAGES OF ALCOHOLIC LIVER DISEASE:

Ethanol in lipid metabolism; decreasing fatty acid oxidation and increasing formation/deposits of TRY in liver

A

Steatosis (1st stage) / Alcoholic Fatty Liver

44
Q

STAGES OF ALCOHOLIC LIVER DISEASE:

Takes place with INFLAMMATION and development of fibrosis or necrosis

A

Steatonecrosis (2nd stage)

45
Q

STAGES OF ALCOHOLIC LIVER DISEASE:

EXTENSIVE development of fibrosis, hepatocelullar carcinoma

A

Alcoholic Cirrhosis

46
Q

yellowish pigmentation of the skin, mucous membrane, and sclera of eyes due to hyperbilirubinemia

A

Jaundice/Icterus

47
Q

Bilirubin exceeds 3.0-5.0

A

Overt Jaundice

48
Q

CLASSES OF JAUNDICE:

Known as Hemolytic or Retention Jaundice

A

Pre-Hepatic

49
Q

CLASSES OF JAUNDICE:

Excessive destruction of RBC
HDN, Erythroblastosis fetalis, Malaria

Hepatic Uptake DECREASED: Prolonged fasting and intake of drugs

A

Pre-Hepatic Jaundice

50
Q

CLASSES OF JAUNDICE:

Also known as Infectious Jaundice

A

Hepatic Jaundice

51
Q

CLASSES OF JAUNDICE:

  • Damage to hepatocytes due to microorganisms or ALCOHOL
  • Starvation and Certain Medications
  • Hepatitis and Cirrhosis
  • Parasitism (FASCIOLA HEPATICA)
A

Hepatic Jaundice

52
Q

HEPATIC JAUNDICE:

Physiologic neonatal jaundice
Gilbert’s disease
Crigler-Najjar Syndrome I and II
Lucey-Driscoll Syndrome

A

Bilirubin Conjugation Decreased

53
Q

Bilirubin Conjugation Decreased:

UDPGT is 30% functional
Defect in Transport protein LIGANDIN
Benign

A

Gilbert’s Disease

54
Q

Bilirubin Conjugation Decreased:

UDPGT deficiency - Conjugation Deficiency

A

Crigler-Najjar Syndrome

55
Q

Bilirubin Conjugation Decreased:

UDPGT deficiency - Conjugation Deficiency
Complete Absence of UDPGT

A

Criggler-Najjar Syndrome I

55
Q

Bilirubin Conjugation Decreased:

UDPGT deficiency - Conjugation Deficiency
Partial Absence of UDPGT

A

Criggler-Najjar Syndrome II

56
Q

Bilirubin Conjugation Decreased:

Circulating inhibitor of conjugation

A

Lucey-driscoll syndrome

57
Q

Bilirubin Conjugation Decreased:

Defect in Chromosome 2

A

Gilbert’s Syndrome
Criggler Syndrome

58
Q

Impairment of Hepatic Excretion:

A

Dubin Johnsons Syndrome
Rotor Syndrome

59
Q

Impairment of Hepatic Excretion:

Presence of DELTA bilirubin; dark stained granules (Lipofuscin) in liver biopsy

A

Dubin Johnsons Syndrome

60
Q

Impairment of Hepatic Excretion:

Reduced/Defective ligandin; UPTAKE/TRANSPORT DEFICIT

A

Rotor Syndrome

61
Q

Also known as Regurgitive, Obstructive, Cholestic Jaundice

A

Post-Hepatic Jaundice

62
Q

Obstruction of Biliary Flow

A

Post-Hepatic Jaundice

63
Q

Intra-hepatic cholestasis
Obstruction of Extra-hepatic biliary Tree
Cholethiasis or Gallstones
Strictures, Spasms, artresia, and Microorganisms
Cancer of Pancreas
ASCARIS LUMBRICOIDES

A

Post-Hepatic Jaundice

64
Q

TB: Increased
B1: Increased
B2: Normal
Urine Bil: Normal
Urine urobilinogen: INCREASED
Stool: Dark Brown

A

Pre-Hepatic

65
Q

TB: Increased
B1: Increased
B2: Increased/Normal
Urine Bil: Variable
Urine urobilinogen: Normal
Stool: Pale/Brown

A

Hepatic

66
Q

TB: Increased
B1: Normal
B2: Increased/Normal
Urine Bil: Positive
Urine urobilinogen: Normal
Stool: Clay

A

Post-Hepatic

67
Q

Buildup of unconjugated bilirubin
2-3 days of neonatal life
Most common cause is HDN

A

Neonatal Jaundice

68
Q

Poorly developed blood brain barrier allowing B1 to cause damage to central nervous system

B1 > 20 mg/dL

A

Kernicterus

69
Q

Treatment for Neonatal Jaundice

A

Phototherapy

70
Q

SUMMARY OF LIVER DISORDERS :

AST/ALT 10-110 x ULN

A

Acute Viral Hepatitis

71
Q

SUMMARY OF LIVER DISORDERS :

AST/ALT: Slight persistent elevation
Total Protein: Decreased

A

Chronic Hepatitis

72
Q

SUMMARY OF LIVER DISORDERS :

GGT 2-3 x ULN
Lipid: Elevated

A

Alcoholic Liver Disease

73
Q

SUMMARY OF LIVER DISORDERS :

Albumin, Cholesterol: Decreased
PT: Prolonged

A

Cirrhosis

74
Q

SUMMARY OF LIVER DISORDERS :

Total bilirubin and B1: Elevated

A

Primary Biliary Cirrhosis

75
Q

SUMMARY OF LIVER DISORDERS :

GGT up to 20 x ULN
ALP: elevated

A

Hepatic Tumors

76
Q

SUMMARY OF LIVER DISORDERS :

GGT and ALP markedly Elevated

A

Cholestasis

77
Q

recovery from viral infection and aspirin ingestion in children, neurologic abnormalities, accumulation of ammonia in CNS

A

Reye’s Syndrome

CLINICAL CHEMISTRY (29 decks)

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