P1.2-LIVER FUNCTION ALTERATIONS

Question 1

Yellow discoloration of the skin, eyes, and mucous membranes

Answer 1

jaundice

Question 2

At what bilirubin levels does overt jaundice become noticeable?

Answer 2

When bilirubin levels reach 3.0-5.0 mg/dL

Question 3

What are the three classifications of jaundice

Answer 3

Prehepatic, hepatic, and posthepatic jaundice

Question 4

Where do abnormalities reside in prehepatic and posthepatic jaundice?

Answer 4

Outside the liver

Question 5

An abnormality that occurs before liver metabolism, leading to unconjugated hyperbilirubinemia.

Answer 5

prehepatic jaundice

Question 6

What are common causes of prehepatic jaundice?

Answer 6

Acute and chronic hemolytic anemias

Question 7

What lab result is typical for prehepatic jaundice

Answer 7

Elevated unconjugated bilirubin (B1).

Question 8

Jaundice caused by intrinsic liver defects affecting bilirubin metabolism or transport.

Answer 8

hepatic jaundice

Question 9

A conjugation deficit where B1 cannot be converted to B2

Answer 9

Crigler-Najjar syndrome

Question 10

What are the types of Crigler-Najjar syndrome?

Answer 10

Type 1 (complete absence of enzymatic conjugation) and

Type 2 (severe enzyme deficiency).

Question 11

What lab result is typical for Crigler-Najjar syndrome?

Answer 11

Elevated unconjugated bilirubin (B1).

Question 12

A genetic mutation in the UGT1A1 gene affecting bilirubin conjugation.

Answer 12

Gilbert’s syndrome

Question 13

What lab result is typical for Gilbert’s syndrome

Answer 13

Elevated unconjugated bilirubin (B1).

Question 14

A bilirubin excretion deficit due to a deficiency in the canalicular multidrug resistance protein

Answer 14

Dubin-Johnson syndrome

Question 15

What lab result is typical for Dubin-Johnson syndrome

Answer 15

Elevated conjugated bilirubin (B2).

Question 16

How does Rotor syndrome differ from Dubin-Johnson syndrome?

Answer 16

Rotor syndrome lacks the dark pigmented granules seen in liver biopsies of Dubin-Johnson syndrome.

Question 17

Jaundice due to a deficiency in the enzyme UDPGT, leading to elevated unconjugated bilirubin (B1).

Answer 17

physiologic jaundice of the newborn

Question 18

What is the treatment for physiologic jaundice of the newborn?

Answer 18

Ultraviolet radiation (phototherapy).

Question 19

A form of unconjugated hyperbilirubinemia caused by an inhibitor of bilirubin conjugation.

Answer 19

Lucey-Driscoll syndrome

Question 20

What lab result is typical for Lucey-Driscoll syndrome?

Answer 20

Elevated unconjugated bilirubin (B1).

Question 21

What causes posthepatic jaundice?

Answer 21

Biliary obstructive diseases, such as gallstones or tumors, preventing the flow of conjugated bilirubin.

Question 22

What is a common symptom of posthepatic jaundice?

Answer 22

Clay-colored stools.

Question 23

A condition where scar tissue replaces normal liver tissue.

Answer 23

cirrhosis

Question 24

What are early signs of cirrhosis?

Answer 24

Often asymptomatic in early stages; symptoms appear as liver function deteriorates.

Question 25

What is the most common cause of cirrhosis in the US?

Answer 25

Chronic alcoholism

Question 26

What are other causes of cirrhosis?

Answer 26

Chronic hepatitis B, C, and D, autoimmune hepatitis, inherited disorders, nonalcoholic steatohepatitis, blocked bile ducts, drugs, toxins, and infections.

Question 27

A disorder characterized by copper accumulation in the liver and other organs, potentially leading to cirrhosis.

Answer 27

Wilson Disease

Question 28

A condition of iron overload, with excess iron accumulating in the liver.

Answer 28

hemochromatosis

Question 29

An inborn error of carbohydrate metabolism that can lead to cirrhosis.

Answer 29

galactosemia

Question 30

How is cirrhosis treated?

Answer 30

Abstaining from alcohol and medications for hepatitis-related cirrhosis.

Question 31

Tumors that begin in liver cells.

Answer 31

primary liver tumors

Question 32

Tumors from other body parts that spread to the liver, more common than primary tumors.

Answer 32

metastatic liver tumors

Question 33

What is the most common primary malignant liver tumor

Answer 33

Hepatocellular carcinoma

Question 34

A disorder associated with elevated ammonia, often following a viral infection, mostly in children.

Answer 34

Reye syndrome

Question 35

What is a key epidemiological factor for Reye syndrome?

Answer 35

Ingestion of aspirin during a viral illness

Question 36

What lab results are typical in Reye syndrome

Answer 36

Mild hyperbilirubinemia, elevated ammonia, and elevated aminotransferases (AST and ALT).

Question 37

What causes drug-induced liver injuries?

Answer 37

Drugs, with alcohol being the most common cause

Question 38

How does alcohol cause hepatic toxicity?

Answer 38

Through metabolism in the liver involving alcohol dehydrogenase and aldehyde dehydrogenase.

Question 39

What are the stages of alcohol-related liver damage?

Answer 39

Alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis.

Question 40

What lab results are typical in alcoholic hepatitis?

Answer 40

Elevated AST, ALT, GGT, ALP, total bilirubin (>30 mg/dL), decreased serum albumin, prolonged PT.

Question 41

What is the definitive diagnosis method for alcoholic cirrhosis?

Answer 41

Liver biopsy

Question 42

Inflammation of liver tissue, often due to viral infections.

Answer 42

hepatitis

Question 43

What are the common viral subtypes causing hepatitis?

Answer 43

HAV, HBV, HCV, HDV, and HEV

Question 44

How are HAV and HEV transmitted?

Answer 44

Fecal-oral route.

Question 45

How are HBV, HCV, and HDV transmitted

Answer 45

Parenteral and sexual routes

Question 46

What symptoms are common in hepatitis?

Answer 46

Jaundice, dark urine, fatigue, nausea, vomiting, and abdominal pain.

Question 47

What indicates chronic hepatitis in HBV and HCV?

Answer 47

Prolonged elevation of serum transaminase levels for longer than 6 months