Liver Function Test Flashcards
Plasma level of total protein
0.2 to 0.4 g/dl slightly higher than serum due to fibrinogen
the two test that provide the most useful indices for assessing severity of liver disease
(Synthetic Liver Function ) Serum Albumin and Vit. K dependent coagulation factor
how many mg of bilirubin is produce daily in the healthy adult
200-300mg of bilirubin
How many g of albumin daily is produce by the normal liver
12 g
The anatomic unit or functional unit of the liver
Hepatic Lobule
A test for hepatocellular fxn and potency of bile duct
Bromsulfathalein Dye Excretion Test
Ammonia reference value as serum
19-60 ug/dl or 11-35 mmol/L
name 7 enzymes that are secreted in the Liver
ALP , Aminotransferase , 5’ nucleotidase , GGT , OCT , LAP and LD
Enzyme secreted in the liver that is specific for Alcoholic Hepatitis
GGT
Reference value for Total Protein
6.5-8.3 g/dl
Give 1 Clinical significance or disease associated with Gamma Spike
Multiple myeloma
Give 1 Clinical significance or disease associated with alpha 1 globulin flat curve
Juvenile cirrhosis ( AAT deficiency )
Give 1 Clinical significance or disease associated with Beta gamma bridging
Hepatic Cirrhosis
Give 1 Clinical significance or disease associated with alpha 2 globulin band spike
nephrotic syndrome
Is an alternative test to chemical analysis of serum Total Protein
Refractometry
A Method/ Test in Total Protein that is based on the principle that Cupric ion complex the groups involved in the PEPTIDE BOND forming a violet colored chelates which is proportional to the number of peptide bonds present and reflects TOTAL protein level at 545 nm
Biuret Method
Method in Total Protein that has the HIGHEST ANALYTICAL SENSITIVITY
Folin Ciocalteu
Other name of Folin Ciocalteu
Lowry Method
A Method/ Test in Total Protein that is based on the principle OXIDATION OF PHENOLIC CPDS. such as tyrosine , tryptophan and histidine
Folin-Ciocalteu
According to Kjeldahl 1 g of Nitrogen is equivalent to how many grams of Protein?
6.54 g of Protein
A Method/ Test in Total Protein that is based on the principle that the absorbance of protein at 210nm is due to the absorbance of the peptide bond specific wavelength (280 nm)
UV absorption Method
It is the reference method for Total Protein but not routinely use
Kjeldahl Method
Reference value for Albumin
53-65% or 3.5-5.0 g/dl
Reference value for y-Globulin
12-22% or 0.8-1.6 g/dl
Spikes of a1 , a2 and B globulin bands indicates
Inflammation
Globulin is Soluble to ______ and _____.
Weak Salt soln. and Hydrocarbon solvents
Albumin is Soluble to _____ and ______.
Water and Concentrated salt soln
Albumin is Insoluble to _______, _______ and ______
Saturated salt soln
Highly conc. salt soln
Hydrocarbon solvent
Globulin is insoluble to ____, ____ and ______.
Water , Conc and Saturated salt soln.
Is the hereditary absence of albumin ; inability to synthesize albumin
analbuminemia
Most commonly used dye in for Protein
BCG
Most specific dye for Protein
BCP
True or False the presence of penicillin may cause falsely INCREASE RESULT of serum albumin
False it may cause falsely low serum Albumin
It differentiates intrahepatic disorder from extrahepatic obstructive liver disease
Prothrombin time ( Vit. K response Test)
Preferred specimen for Ammonia Determination
Arterial Blood if Venous blood is use tourniquet should be use minimally, and first clenching and relaxing avoided during collection
Formula for Deta Bilirubin
TotalBilirubin - Indirect Bilirubin + Direct Bilirubin
Conversion factor for Bilirubin
17.1
Other name for Hepatic Lobule
Acini
Reference value for Indirect bilirubin
0.2-0.8 mg/dl
Reference value for Direct Bilirubin
0-0.2mg/dl
Reference value for Total Bilirubin
0.2-1.0 mg/dl
Is the presence of two albumin bands instead of a single bnd in electrophoresis
Bisalbuminemia
Reference value for a1-globulin
2.5-5% ( 0.1 - 0.3 mg/dl )
Reference value for a2-globulin
7 - 13% ( 0.6 - 1.0 mg/dl )
A globulin that increases as a non-specific response to inflammation
a1-globulin
Rgt use in Kjeldahl Method
Sulfuric Acid , Tungstic Acid
Rgt use in Biuret Method
Alkaline Copper Sulfate
Rochele Salt ( NaK Tartrate)
NaOH , KI2
Biuret Method Detects Protein Concentration ___ mg/dl
10 or 15 mg/dl
Folin Ciocalteau Main Rgt
Phosphotungstic molybdic acid or phenol rgt
Rgt use in Salt Fractionation
Sodium Sulfate
Reference value for A/G ratio
1-3.0 : 1
Final Reaction of Evelyn Malloy Method
Pink to purple azobilirubin
Final Reaction of Jendrassik Method
Pink to Blue Azobilirubin
Buffer use in Jendrassik Method
Sodium Acetate
Jendrassik Grof Method is not affected by Hgb up to ____ mg/dl and pH changes
750 mg/dl
Also known as Conjugation Deficit
Crigler - Naljar Syndrome
Also known as Bilirubin Excretion Deficit
Dublin Johnson Syndrome and Rotor Syndrome
Are often the only indication of cell injury in early or localized Liver Disease
Enzyme Test
Visible Icterisia occurs when bilirubin is ___mg/dl
25mg/L
Also known as Bilirubin Transport Deficit
Gilbert’s Syndrome
In Prothrombin Time Vit. K is administered INTRAMUSCULARLY , ___mg daily for _ to _ days
10mg for 1-3 days
In adults it is the most common cause of Hyperbilirubinemia
Cholelithiasis
Total Bilirubin is measured in how minutes after adding methanol or caffein soln
15mins
Coomassie brilliant blue dye is for dectection of proteins to as little as ___
1ug
Ninhydrin which develops a ___ color by reacting with primary amines is widely used for detection of peptides and amino acid after ____ chromatography
Violet , Paper
Use for amino acid analyses
Ion Exchange Column
Reference value for Delta bilirubin
Is a familial form of unconjugated hyperbilirubinemia caused by a circulating INHIBITOR OF BILIRUBIN CONJUGATION
Lucey-Driscoll Syndrome
Jaundice is clinically evident when bilirubin level exceeds ____
2mg/dl
Delta Bilirubin is not calculated on neonatal patients on how many days
Specific marker of Pre Hepatic and Post Hepatic Jaundice because it is not affected by hemolysis
Measurement of B2 bilirubin
NM use in the Biuret Reaction
545 nm
Evelyn Malloy Method Diazo A Rgt.
0.1% Sulfanilic Acid + HCl
Evelyn Malloy Method Diazo B Rgt.
0.5% Sodium Nitrite
A critically important neurotransmitter in the CNS that is lowered by Ammonia Toxicity
Gamma Amino Butyric Acid ( GABA )
Common Method use in Ammonia
Nesslerization Reaction , Berthelot , Glutamate Dehydrogenase
In Nesslerization Reaction if N2 is low or moderate what is the end color
Yellow End Color
Nesslerization Reaction if N2/ammonia is high the color
Orange Brown Color
Rgt use in Berthelot Reaction
Phenol , Hypochlorite , Na nitroprusside , Indolephenol blue
5 Common Conditions associated with increase Ammonia
Cirrhosis , Hepatitis , Reye Syndrome , Chronic Renal Disease and Acetaminophen poisoning
Reference value for Uribilinogen in Stool
75-275 ehrlich unit / 100g of feces
Reference value for Uribilinogen in Urine
0.1-1.0 ehrlich units / 2hrs or 0.54 ehrlichs/day
Give 2 BSP Administration Method
Rosenthal White and Mac Donald Method
Dose use in Mac Donald Method
5mg/kg body weight of the px
Specimen collection in Rosenthal White Method
after 5mins and after 30mins
Specimen collection in Mac Donald Method
After 45 mins
Dose use of Rosenthal White Method
2mg/kg body weight of the px
Normal value for Macdonald Method
+/- 5% dye retention
Normal Value for Rosenthal white method
After 5mins = 50 % dye retention
After 30mins = 0% dye retention
Evelyn Mally Diazo Blank Rgt.
1.5% HCl
5 Enzyme Markers of Hepatic Parenchymal Diseases
Amino Transferase , LDH , ICD , OCT , SDH
4 Enzyme Markers of Obstructive Hepatic Disorder with Biliary Tree Involvement
5’ - NT , ALP , GGT , LAP