Liver Function Test Flashcards
Most basic unit of the liver:
(hepatocyte)
what are liver sinusoids
vascular network inside the liver; endothelial blood lakes surrounding liver cell
organs involved in glucose regulation
pancreas and liver (main)
Glucose will be transformed into energy
GLYCOLYSIS
If glucose is not needed, it will be absorbed by the liver cell and transformed into glycogen
GLYCOGENESIS
Glycogen can be mobilized anytime when the body needs substrates or sugars for emergency purposes or in times of lack of nutrition. Glycogen will be broken down and released into the system wherever it is needed
GLYCOGENOLYSIS
Glucose is gained not only by its uptake from the preformed glucose that has been absorbed but it can also be formed by amino acids that are absorbed and transformed
GLUCONEOGENSI
Major vitamins stored by the liver are
vitamins A, B12, and K.
how long can the liver store vitamins given that it is intact
10-12 months
what substances can liver synthesize for local use
amino acids
transaminases (ALT/AST)
alkaline phosphatase
3 main export products of the liver
bile acids
cholesterol
phospholipids
precursor for crystal and gallstone formation in the biliary system if there are not enough bile acids to keep cholesterol in solution
cholesterol
causes of liver disease
- altered circulation
- immunologic reactions
- metabolic defects
- toxins, infections
- neoplasms
- biliary obstruction
Most sensitive, in measuring clearance and excretion functions of the liver
BROMSULPHTHALEIN TEST (BSP) & BILE ACIDS
what does BSP measure
clearance and excretion functions of the liver
First to be knocked out in liver dysfunction
BSP and Bile acids
Check for cholestasis or flow of bile in the liver
bilirubin
Confirms cholestasis
Alkaline phosphatase and 5’ nucleotidase
5’-nucleotidase is used to confirm
ALP of liver origin
used to confirm ALP of liver origin
5’-nucleotidase
what test would you perform if you want to confirm hepatic cell necrosis
ALT and AST
Can pickup liver parenchymal damage or severe form of liver disease
PROTHROMBIN TIME & SERUM AMMONIA
If you want to test for metabolic function of the liver
PROTHROMBIN TIME & SERUM AMMONIA
what is PROTHROMBIN TIME & SERUM AMMONIA for
test for metabolic function and severity of liver disease
where are bile acids stored in a fasting state?
gallbladder
gallbladder empties bile into
duodenum
what would be the result of serum bile acids on patients who do not have intact ileum
decrease of bile acids in the liver
substance that when injected intravenously into the body noted to be cleared right away
Bromsulphthalein
disadvantage of BSP
BSP remains high in the serum. But it cannot differentiate whether the problem is biliary obstruction or a parenchymal liver disease
AST is previously called
SGOT
ALT is previously called
SGPT
why is there high levels of AST and ALT in acute hepatitis
due to acute injury and destruction of the liver cells
why is there lowre levels of AST and ALT in Cirrhosis
liver cells have been replaced by scar tissue thus lower elevation of transaminase, lower levels are due to the chronicity of the disease
why is there elevated AST and ALT in liver metastasis
destruction of liver cells and presence of hyperplastic cells
Used for determination of BILIARY TRACT OBSTRUCTION
alkaline phosphatase
other organs that ALP can be derived
bone, placenta kidneys
why ALP level is high in pregnant px
presence of this enzyme in the placenta
what is used to confirm that ALP is from the liver
GTTP
Gamma-Glutamyl Transpeptidase
what is used to confirm that ALP is from the liver
GTTP
Gamma-Glutamyl Transpeptidase
albumin is synthesized in
hepatocytes
low levels of albumin suggests
chronic liver disease
non hepatic causes of hypoalbuminemia
protein malnutrition
protein losing enteropathies
nephrotic syndrom
prolonged increase in IL-1 and TNF
Most sensitive measure of chronic liver disease problem
Prothrombin time (PT)
single best acute measure of hepatic synthetic function
PT
PT is prolonged in
hepatitis
cirrhosis
Vit K deficiency
why does administration of Vit K in prolonged PT needed to confirm liver disease
If PT improves upod admin of Vit K, it means that there are still enough hepatocytes that can produce coagulation factors
vit k dependent clotting factors
Factors II, VII, IX, X
multifactorial causes of COAGULATION PROBLEMS IN SEVERE LIVER DISEASE
Vit K malabsorption
platelet abnormalities