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Chemistry Module 2 > Liver Functions (Part 3) > Flashcards

Liver Functions (Part 3) Flashcards

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1
Q

Three stages of Alcoholic Liver Disease

A
  1. Alcoholic fatty liver
  2. Alcoholic hepatitis
  3. Alcoholic cirrhosis
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2
Q

Earliest stage of alcoholic liver disease, few symptoms; advanced cases may have hepatomegaly, vomiting, and jaundice

A

Progressive clinical characteristics used to make a diagnosis of:
- Alcoholic fatty liver

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3
Q

Alcohol liver disease with acute liver necrosis and inflammation; hepatomegaly, jaundice, and ascites

A

Progressive clinical characteristics used to make a diagnosis of:
- Alcoholic hepatitis

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4
Q

Alcohol liver disease with jaundice, ascites, hepatosplenomegaly, malnutrition, and edema

A

Progressive clinical characteristics used to make a diagnosis of:
- Alcoholic cirrhosis

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5
Q

Relative increase above the upper limit of normal for enzyme in hepatocellular disease
- Alkaline phosphatase (ALP)

A

1-3X ULN

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6
Q

Relative increase above the upper limit of normal for enzyme in hepatocellular disease
- Aspartate aminotransferase (AST)

A

> 8X ULN

ALT>AST

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7
Q

Relative increase above the upper limit of normal for enzyme in hepatocellular disease
- Alanine aminotransferase (ALT)

A

> 8X ULN

ALT>AST

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8
Q

Relative increase above the upper limit of normal for enzyme in hepatocellular disease
- Lactate dehydrogenase (LD)

A

Increased LD-4 and LD-5

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9
Q

Relative increase above the upper limit of normal for enzyme in BILIARY OBSTRUCTION
- Alkaline phosphatase (ALP)

A

10-12X ULN

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10
Q

Relative increase above the upper limit of normal for enzyme in BILIARY OBSTRUCTION
- Gamma glutamyltransferase (GGT)

A

5-30X ULN

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11
Q

Why is this analyte altered in liver disease and is it increased or decreased:
- Serum albumin

A

Decreased

- because made in the liver

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12
Q

Why is this analyte altered in liver disease and is it increased or decreased:
- Prothrombin time (PT)

A

Increased

- trouble clotting

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13
Q

Why is this analyte altered in liver disease and is it increased or decreased:
- Serum lipids

A

Decreased

- because synthesized in liver, cannot make cholesterol

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14
Q

Why is this analyte altered in liver disease and is it increased or decreased:
- Ammonia

A

Increased

- detox method interrupted

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15
Q

Why is this analyte altered in liver disease and is it increased or decreased:
- Bile acids

A

Increased

- in blood, pruritis (itching)

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16
Q

Why is this analyte altered in liver disease and is it increased or decreased:
- Delta bilirubin

A

Increased

- in cholestatic disease, in recovery would decrease

17
Q

What are the three Bilirubin Methods?

A
  1. Jendrassik-Grof
  2. Evelyn Malloy
  3. Direct Spectrophotometry
18
Q

WHAT TEST?
Principle: sample is mixed with sodium acetate, caffeine sodium benzoate, and diazotixed sulfanilic acid. After incubation, ascorbic acid and alkaline tartrate are added. The absorbance is read at 600nm

A

Jendrassik-Grof Bilirubin

finding only Total Bilirubin

19
Q

WHAT TEST?
Principle: sample is mixed with a dilute acid solution and diazo reagent. After incubation, ascorbic acid and alkaline tartrate are added. The absorbance is read at 600nm

A

Jendrassik-Grof Bilirubin

(finding only direct bilirubin

20
Q

In Jendrassic-Grof, diazotized sulfanilic acid is added as a reagent in finding TOTAL bilirubin. What is its purpose?

A

Reacts with bilirubin to form colored azobilirubin

21
Q

In Jendrassic-Grof, ascorbic acid is added as a reagent in finding both TOTAL and DIRECT bilirubin. What is its purpose?

A

Stops reaction and destroys excess diazo reagent

22
Q

In Jendrassic-Grof, alkaline tartrate is added as a reagent in finding both TOTAL and DIRECT bilirubin. What is its purpose?

A

Changes pH and converts purple azobilirubin to blue azobilirubin

23
Q

In Jendrassic-Grof, sodium acetate is added as a reagent in finding TOTAL bilirubin. What is its purpose?

A

buffers reaction

24
Q

In Jendrassic-Grof, caffeine sodium benzoate is added as a reagent in finding TOTAL bilirubin. What is its purpose?

A

Accelerates coupling of bilirubin to diazo reagent. (It allows direct and indirect to react so you get total bilirubin not just direct)

25
Q

Jendrassic-Grofspecimen specimen requirements

A

use serum or heparinized plasma***?

26
Q

Jendrassic-Grof reference ranges

  • Total:
    - Adult
    - Infant
A

Total Adult: 0.2-1.0 mg/dL

Total Infant: 4.0-8.0 mg/dL

27
Q

Jendrassic-Grof reference ranges

  • Conjugated:
    - Adult
    - Infant
A

Conj Adult: 0.0-0.4 mg/dL

Conj Infant: 0.0-0.2 mg/dL

28
Q

Jendrassic-Grof reference ranges

  • Unconjugated:
    - Adult
    - Infant
A

Unconj Adult: 0.2-0.6 mg/dL

Unconj Infant: 4.0-7.8 mg/dL

29
Q

WHAT TEST?
Principle: Direct bilirubin is measured first: sample plus water plus diazotixed sulfanilic acid is incubated, then absorbance is taken at 600 nm. Next total bilirubin is measured by adding methanol to the above reactants, incubate then read at 600nm

A

Evelyn and Malloy Bilirubin

30
Q

In Evelyn and Malloy Bilirubin, Diazotized sulfanilic acid is added as a reagent in finding DIRECT bilirubin. What is its purpose?

A

Reacts with bilirubin to form colored azobilirubin

31
Q

In Evelyn and Malloy Bilirubin, Methanol is added as a reagent in finding TOTAL bilirubin. What is its purpose?

A

Accelerates coupling of indirect bilirubin to diazo (allows indirect bilirubin to react)

32
Q

Evelyn and Malloy Bilirubin specimen requirements

A

?

33
Q

WHAT TEST?
Principle: this method is reasricted to blood specimens from a healthy newborns in which unconjgated bilirubin is the predominant species. Measure blood at two wavelengths (455 and 575nm) to correct for oxyhemoglobin that also absorbs at 455nm

A

Bilirubin by Direct Spectrophotometry

34
Q

WHAT TEST?

Principle: Take 2-oxoglutarate plus NH4 plus NADPH. Measure absorbance at 340nm

A

Ammonia

35
Q

Ammonia specimen requirements

A

Place specimen on ice after drawing and analyze within 20 minutes. Ammonia in freshly-drawn blood rises 2 to 3 fold if left at room temp. Plasma is specimen of choice.

36
Q

Ammonia ref range

A

14-45 ug/dl

37
Q

WHAT TEST:

principle: Urobilinogen plus Ehrlich’s reagent leads to a red color read spectrophotometrically

A

Fecal and Urine Urobilinogen

38
Q

Fecal and Urine Urobilinogen specimen requirements

A

Fresh urine collected over 2 hour period or 24- hour specimen collected in a dark bottle with 5 grams sodium bicarbonate to minimize oxidation and toulene to minimize bacterial growth and to protect from oxygen in the air

39
Q

Fecal and Urine Urobilinogen ref ranges

A

0.1-1.0 EU/hours or 0.0-4.0 EU/day

Chemistry Module 2 (10 decks)

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