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MT2 > LIVER FUNCTION TEST > Flashcards

LIVER FUNCTION TEST Flashcards

1
Q

Liver is located in the _____ portion of the _____ beneath the diaphragm and on top of the _____, _______ and _______

A

upper right; abdominal cavity; stomach, right kidney and intestines.

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2
Q

liver is shape like a ____, the liver is a dark reddish-brown organ that weighs about ___ pounds (1200 and 1600 grams ) and accounts for _____ of an adult’s body weight.

A

cone; 3; 2.5%

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3
Q

liver is unequally divided into ___ lobes

A

two

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4
Q

the chief metabolic organ in the body.

A

liver

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5
Q

liver is a _____ organ and receives ____ mL of blood per minute

A

vascular; 1500

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6
Q

Blood rich in nutrients from the GI tract is carried to the liver by the _______

A

portal vein.

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7
Q

the primary supplier of oxygenated blood.

A

hepatic artery

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8
Q

To complete hepatic circulation blood is ______ from the liver by _______
into the ________

A

drained; hepatic veins; inferior vena cava

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9
Q

anatomic unit of the liver

A

lobule

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10
Q

2 types of liver cells

A

hepatocytes
kupfer cells

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11
Q

large cells that perform the metabolic, detoxification, excretory and synthesis function

A

hepatocytes

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12
Q

active phagocytes that engulf bacteria, aging rbc, toxins and cellular debris

A

kupfer cells

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13
Q

If the liver becomes completely nonfunctional, death will occur from _______ within _______.

A

hypoglycemia; 24 hours

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14
Q

Substances absorbed from the GI tract must first pass through the ______ before it is distributed by the ________

A

liver; general circulation

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15
Q

The liver has a unique capacity to regenerate by _______ and ________ of the remaining tissue in case of tissue injury due to ________ or ______

A

cell division; hypertrophy; biliary obstruction or toxic exposure.

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16
Q

liver dysfunction examples

A
  • Hepatocellular disease
  • Cholestasis (obstruction of bile flow)
  • Cirrhosis
  • Hepatitis
  • Jaundice
  • Liver cancer
  • Steatosis (fatty liver)
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17
Q

liver dysfuncition, genetic disorders

A

Hemochromatosis (iron storage)

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18
Q
  • Noninvasive methods for screening of liver dysfunction
  • Help in identifying general types of disorder
  • Assess severity and allow prediction of outcome
  • Disease and treatment follow u
A

Liver Function Tests

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19
Q

LFT is broadly classified as:

A

1.Tests to detect hepatic injury:
* Mild or severe; acute or chronic
* Nature of liver injury (hepatocellular or cholestasis)

2.Tests to assess hepatic function

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20
Q

Group 1: Markers of Liver Dysfunction

A

▫ Serum bilirubin: total and conjugated
▫ Urine: bile salts and urobilinogen
▫ Total protein, serum albumin and albumin/globulin ratio
▫ Prothrombin Time

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21
Q

Group 2: Markers of hepatocellular injury

A

▫ Alanine aminotransferase (ALT)
▫ Aspartate aminotransferase (AST)

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22
Q

functions of liver

A

synthesis, metabolism, detoxification, excretion or secretion, and storage

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23
Q
  • A steady supply of glucose is necessary to provide energy for metabolic needs through gluconeogenesis, glycolysis
A

Carbohydrate synthesis

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24
Q

Liver is the site of synthesis of plasma proteins (albumin) except immunoglobulins and von Willebrand factor (factor VIII)
- most of the coagulation factors, anticoagulant proteins (factor XIV) and components of the fibrinolytic system are synthesized by hepatic parenchymal cells.

A

Protein Synthesis

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25
Q

Liver is the site of synthesis of plasma proteins (albumin) except ______ and _____

A

immunoglobulins and von Willebrand factor (factor VIII)

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26
Q

most of the coagulation factors,
anticoagulant proteins (factor XIV) and components of the fibrinolytic system are synthesized by ________

A

hepatic parenchymal cells.

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27
Q

The only organ that has the capacity to remove heme waste product from the body

A

liver

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28
Q

Liver serves to protect the body from potentially ________ absorbed from the intestinal tract and ______ by-products of metabolism.

A

injurious substances ; toxic

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29
Q

Excess proteins cannot be stored in the body. _____ takes place and this involves the removal of the amino group (NH2) from an amino acid resulting in the formation of __________.

A

Deamination ; ammonia

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30
Q

Ammonia a (toxic by-product) is consequently converted into _____ which is less toxic.

A

urea

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31
Q

The latter (urea) is then removed by the _______

A

kidneys (Ornithine cycle)

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32
Q

The liver breaks down other toxic substances such as ________, _____ released by pathogens, ______ and ________.

A

hydrogen peroxides, toxins, alcohol and food additives

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33
Q

bile composition

A

bile acids, phospholipids, cholesterol, bilirubin, inorganic salts, small amount of copper and other metals.

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34
Q

bile acids is also called as _____

A

bile salts

35
Q

phospholipids in the bile is mainly ________

A

phosphatidylcholine

36
Q

bilirubin in the biles is mostly in its ________ form

A

conjugated

37
Q

the inorganic salts in the bile includes _______, _______, and _________

A

potassium, sodium, and bicarbonates

38
Q

These bile acids are conjugated with the amino acids _______ and ______ forming bile salts

A

glycine and taurine

39
Q

The bile is then stored in the _________ till needed. Once it is needed, it moves the
_______ and helps with the _______ and ________.

A

gallbladder ; duodenum ; digestion and excretory process

40
Q

liver is the storage site for all _______ vitamins and _______ vitamins.

A

fat-soluble ; water soluble

41
Q

Liver also is the storage depot for ________, which are released when glucose is depleted.

A

glycogen

42
Q

end product of hemoglobin metabolism

A

Bilirubin

43
Q

principal pigment in bile

A

Bilirubin

44
Q

Major metabolite of heme

A

Bilirubin

45
Q

bilirubin is formed from the destruction of _____

A

heme

46
Q

heme is the iron-binding tetrapyrrole ring found in __________, __________ and _________.

A

hemoglobin, myoglobin and cytochrome

47
Q

______ mg of bilirubin is produced daily in the health adult.

A

250-350 mg

48
Q

___% of bilirubin is derived from turnover of senescent rbc.

A

85%

49
Q
  • also known as B1
  • water insoluble
  • indirect
  • pre-hepatic
  • hemobiliribun
  • NV: 0.2 to 0.8 mg/dL or 3 to 14 umol/L
A

Unconjugated Bilirubin

50
Q
  • also known as B2
  • water soluble
  • direct
  • post-hepatic/obstructive and regurgitative bilirubin
  • cholebilirubin
  • NV: 0 to 0.2 mg/dL or 0 to 3 umol/L
A

Conjugated Brilirubin

51
Q

Conjugated bilirubin tightly bound to albumin. It is formed due to the prolonged elevation of conjugated bilirubin in biliary obstruction.

A

Delta bilirubin

52
Q
  • It has the longer half life than other forms of bilirubin.
  • It is computed by using this formula TB – DB = IB
  • Not calculated on neonatal patients.
A

Delta bilirubin

53
Q

Delta bilirubin normal value

A

<0.2 mg/dL

54
Q

Jaundice is also called as _______ or ______

A

Icterus or Hyperbiluribinemia

55
Q

Characterized by yellow discoloration of the skin, sclerae, and mucus membrane.

A

Jaundice

56
Q

In jaundice, bilirubin greater than _ or __ mg/dL is already a clinical significant.

A

2 or 3 mg/dL

57
Q

occurs when there is excessive erythrocyte destruction as seen in:
* Hemolytic Anemia
* Spherocytosis
* Toxic Condition
* Hemolytic Disease of the Newborn
* Gilbert’s, Crigler-Najjar syndrome

A

Prehepatic Jaundice

58
Q

occurs when liver cells malfunction and cannot take up, conjugate, or secrete bilirubin.

A

Hepatic Jaundice

59
Q

such conditions is seen in hepatic jaundice

A

Viral hepatitis, Toxic Hepatitis, Intrahepatic Cholestasis.

60
Q
  • Bilirubin Transport Deficit from the sinusoidal membrane to the microsomal region
  • Impaired cellular uptake of Bilirubin
  • Mild increased of B1
A

GILBERT SYNDROME

61
Q
  • There is partial or complete conjugation deficit of UDP- Glucoronyl Transferase which causes deposition of bilirubin in the brain (kenicterus) resulting to motor dysfunction and retardation.
  • moderate to extremely increased level of B1
A

CRIGLER NAJJAR SYNDROME

62
Q

deposition of bilirubin in the brain

A

kernicterus

63
Q

partial or complete conjugation deficit of UDP- Glucoronyl Transferase in Crigler Najjar Syndrome, causes deposition of bilirubin in the brain (kenicterus) resulting to ______________

A

resulting to motor dysfunction and retardation.

64
Q
  • Bilirubin Excretion Deficit
  • Blockage of the excretion of bilirubin 2 into the canaliculi caused by hepatocyte membrane defect.
  • Elevated B2 and mild increase of B1
A

DUBIN JOHNSON SYNDROME

65
Q
  • Level of UDP-Glucoronyl Transferase is low at birth.
  • Takes several days for the liver to synthesize an adequate amount of enzyme to catalyze bilirubin conjugation.
  • Increased level of B1
A

NEONATAL PHYSIOLOGICAL JAUNDICE

66
Q
  • may be caused by hepatocyte injury such as cirrhosis which results from scarring of liver tissue caused by excessive alcohol ingestion, hepatitis, hematochromatosis.
A

INTRAHEPATIC CHOLESTASIS

67
Q

INTRAHEPATIC CHOLESTASIS is associated also to the different conditions such as:

A
  • Neoplasm
  • Bile Duct Injury (Rotor Syndrome)
  • Reye Syndrome (Neurologic abnormalities including Seizures or Coma)
  • Drug Related Disorders (Acetaminophen, Antibiotics, Antineoplastics)
  • Acute and Chronic Hepatitis
68
Q

Reye Syndrome is a neurologic abnormalities including _____ or _____

A

Seizures or Coma

69
Q

in intrahepatic cholestasis, drug related disorders includes the triple A drugs

A

Acetaminophen, Antibiotics, Antineoplastics

70
Q

bile duct injury is also known as

A

rotor syndrome

71
Q

occurs when an obstruction blocks the flow of bile into the intestines this is referred as extrahepatic cholestasis.

A

Post-hepatic Jaundice

72
Q

obstruction blocks the flow of bile into the intestines

A

extrahepatic cholestasis

73
Q
  • Gallstone obstructing the common bile duct.
  • Neoplasm such as carcinoma of the pancreas.
  • Inflammatory conditions such as cholangitis or acute pancreatitis.
  • Significant increased level of B2 in serum.
  • Increased level of B1 in serum.
  • Increased level of B2 in urine.
  • Decreased urine and fecal urobilinogen.
  • Stool appear pale in color.
A

Post-hepatic Jaundice

74
Q

In Post-hepatic Jaundice, __________ obstructing the common bile duct

A

Gallstone

75
Q

In Post-hepatic Jaundice, there is a ______ such as carcinoma of the pancreas

A

Neoplasm

76
Q

In Post-hepatic Jaundice, there is inflammatory conditions such as ________ or __________

A

Cholangitis or Acute Pancreatitis

77
Q

In Post-hepatic Jaundice, there is a significant _____ level of B2 in serum

A

Increased

78
Q

In Post-hepatic Jaundice, there is an ______ level of B1 in serum

A

Increased

79
Q

In Post-hepatic Jaundice, there is an ________ level of B2 in urine

A

Increased

80
Q

In Post-hepatic Jaundice, there is a decreased _______ and ________

A

urine and fecal urobilinogen

81
Q

In Post-hepatic Jaundice, the stool appear _____ in color

A

pale

82
Q

such syndromes are increased in B1

A

Gilberts Syndrome
Criggler Najjar Syndrome
Hemolytic Anemia
Hepatocellular dse.
Lucey Driscoll Syndrome
G-6-PD Deficiency

83
Q

such syndromes are decreased in B2

A

Billary Obstruction
Pancreatic Cancer
Dubin Johnson
Alcoholic and Viral Hepatitis
Billary Atresis
Hepatocellular Disease

MT2 (45 decks)

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