Liver function test

Question 1

• It is the chief metabolic organ in the body
• Receives 15 mL of blood per minute
• It has the capacity to regenerate by cell division
• Liver is the largest internal organ

Answer 1

Liver

Question 2

2 types of cells in liver

Answer 2

• Hepatocytes
• Kupfer cells

Question 3

a phenomenon in which a drug gets metabolized at a specific location in the body that results in a reduced concentration of the active drug upon reaching its site of action or the systemic circulation

Answer 3

first pass phenomenon

Question 4

Functions of the liver

Answer 4

1) Synthetic function
2) Conjugation function
3) Detoxification and Drug Metabolism
4) Excretory and Secretory Function
5) Storage Function

Question 5

Conjugated with the amino acids glycine and taurine forming bile salts

Answer 5

Bile acids

Question 6

It is stored in liver and released when glucose is depleted

Answer 6

Glycogen

Question 7

Four general structures of proteins

Answer 7

a) Primary structure
b) Secondary structure
c) Tertiary structure - 1 polypeptide chain
d) Quaternary structure - 2 or more polypeptide chain

Question 8

It provide the most useful indices for assessing severity of liver disease

Answer 8

• Serum albumin
• Vit. K dependent coagulation factors

Question 9

Important for assessing nutritional status presence of severe diseases involving the liver, kidney and bone marrow

Answer 9

Protein

Question 10

Plasma level of total protein

Answer 10

0.2-0.4 g/dL higher than serum due to fibrinogen

Question 11

Ref. value of total protein

Answer 11

6.5-8.3 g/dL

Question 12

In hydrolysis, It yield to amino acids

Answer 12

Simple Proteins

Question 13

Example of Simple Proteins

Answer 13

1) Fibrous:
- fibrinogen, troponin
2) Globular:
-Hb, plasma proteins
3) Metalloproteins:
- ferritin, ceruloplasmin

Question 14

Proteins with additional nonprotein moiety (prosthetic group)

Answer 14

Conjugated Proteins

Question 15

Example of Conjugated proteins

Answer 15

1) Lipoproteins:
- CM, VLDL, LDL, HDL
2) Glycoproteins:
- haptoglobin, AAT
3) Mucoproteins:
- mucin
4) Nucleoproteins:
- chromatin

Question 16

• Standard reference method
• Based on measurement of nitrogen content
• Used Serum + Tungstic acid => PFF

Answer 16

Kjeldahl (Digestion) method

Question 17

1g Nitrogen =

Answer 17

6.54 grams of proteins

Question 18

Nitrogen content of proteins

Answer 18

15.1-16.8%

Question 19

Reagent of Kjeldahl (Digestion) method

Answer 19

H2SO4 (Sulfuric acid)

Question 20

End product of Kjeldahl (Digestion) method

Answer 20

NH4 (ammonia)

Question 21

• Most widely used method (IFCC recommended)
• Requires at least 2 peptide bond and an alkaline medium

Answer 21

Biuret method

Question 22

Reagent used in Biuret method

Answer 22

• Alkaline CuSO4
• Rochelle salt (NaK tartrate)
• NAOH
• KI

Question 23

Principle in Biuret method

Answer 23

Cupric ion complex the group involved in the peptide bond forming a violet-colored chelate which is proportional to the number of peptide bonds present and reflects the total protein level at 545 nm

Question 24

End product of Biuret method

Answer 24

Violet color (545nm)

Question 25

• Highest analytical sensitivity
• Oxidation of phenolic compounds (tyrosine, tryptophan and histidine)

Answer 25

Folin Ciocalteu (Lowry)

Question 26

Reagents used in Folin Ciocalteu (Lowry)

Answer 26

• Phenol (or phosphotungstic-molybdic acid)
• Biuret (color enhancer)

Question 27

End product of Folin Ciocalteu (Lowry)

Answer 27

deep Blue color

Question 28

• Method in total proteins that absorb light at 280 nm and 210 nm
• absorption of 280 nm is due to tryptophan, tyrosine and phenylalanine
• absorption of 210 nm is due to absorbance of the peptide bonds

Answer 28

UV Absorption Method

Question 29

• Alternative test
• Measurement of RI of solutes in serum

Answer 29

Refractometry

Question 30

Formation of a uniform fine precipitate which block light

Answer 30

Turbidimetry

Question 31

Reagents used in Turbidimetry

Answer 31

Sulfosalicylic acid (SSA) or Trichloroacetic acid (TCA)

Question 32

Formation of a uniform fine precipitate which scatters light

Answer 32

Nephelometric Methods

Question 33

Reagents used in Nephelometric

Answer 33

Sulfosalicylic acid (SSA) or Trichloroacetic acid (TCA)

Question 34

• Globulins are separated from albumin by salting-out (Salt analysis) procedures using sodium salts

Answer 34

Salt fractionation

Question 35

Salt used for analysis in Sodium sulfate

Answer 35

Sodium sulfate

Question 36

Causes fo increased total protein

Answer 36

1) Malignancy
2) Multiple myeloma
3) Waldenstrom’s macroglobinemia

Question 37

Causes fo decreased total protein

Answer 37

1) Hepatic cirrhosis
2) Glomerulonephritis
3) Nephrotic syndrome
4) Starvation

Question 38

Differentiates intrahepatic from extrahepatic liver disease

Answer 38

Prothrombin Time

Question 39

Vitamin K dependent factors

Answer 39

X, IX, VII, II (1972 - mnemonix), Protein C, Protein S

Question 40

Administration of Vitamin K intramuscularly

Answer 40

10 mg daily for 1-3 days

Question 41

• Transport and Oncotic pressure
• levels of protein in plasma decline when severe heaptocellular disease last more than 3 weeks
• inversely proportional to the severity of the liver disease

Answer 41

Albumin

Question 42

Low total protein + low albumin =

Answer 42

Hepatic cirrhosis

Question 43

What is the level of serum albumin?
- Severe dehydration
- Prolonged tourniquet application

Answer 43

Hyperalbuminuria

Question 44

What is the level of serum albumin?
1. Reduced Synthesis
- Chronic liver disease (CLD) - Malabsorption syndrome
- Malnutrition and muscle wasting

2. Increased loss
   - Nephrotic syndrome
   - Massive burns
   - Protein-losing enteropathy
   - Orthostatic proteinuria
3. Increased catabolism
   - Massive burns
   - Widespread malignancy
   - Thyrotoxicosis
4. Inflammation

Answer 44

Hypoalbuminuria

Question 45

total caloric deficiency

Answer 45

Marasmus

Question 46

protein deficiency

Answer 46

Kwashiorkor