P39 - Liver Function Flashcards
what percentage of functional hepatocytes must be lost before clinical evidence of hepatic insufficiency
- 80%
hepatic enzymes is not ____ ____ tests
- liver function
bilirubin is produced in
- macrophages
what are the 4 types of bilirubin
- Ba - unconjugated
- Bb - bilirubin monglucuronide
- By - bilirubin diglucuronide
- Bs - delta bilirubin (degraded conjugated bound to albumin)
a measurement of direct bilirubin is all forms except
- unconjugated
hemolysis leads to an ____ formation of bilirubin
- increase
pathogenesis of extravascular hemolysis of erythrocytes and concentration of bilirubin
- is Bu or Bc greater
- increase rate of formation of bilirubin (unconjugated) -> incomplete removal of bilirubin by hepatocytes
- increase conjugation of bilirubin in hepatocytes -> rate of Bc formation exceeds Bc excretion to bile -> conjugated regurgitated to plasma
- [Bu] > [Bc]
decreased uptake of bilirubin pathogenesis effect on concentration of bilirubin
- is Bu or Bc greater
- conversion of stored triglycerides to fatty acids (FA) -> increase fatty acids delivery to hepatocytes -> fatty acids bind to Z-protein -> decrease ligands available for binding unconjugated bilirubin -> decrease uptake of unconjugated bilirubin by hepatocytes
- [Bu] > [Bc]
in horses expect increase [Bt] within ____ hr of fasting and peak concentration within ____ days
- 12-15
- 2-3
pathogenesis of decrease transport of bile and decrease bile flow (cholestasis) [which is rate limiting?]
- is Bu or Bc greater
- decrease transport of bile is rate limiting step
- impaired bile flow -> decrease Bc transport to canaliculi and increase Bc transport to sinusoids -> Bc returns to plasma -> increase Bc interferes with uptake of Bu
- [Bc] > [Bu]
in dogs, effusion of [bilirubin] is greater than ___ serum [bilirubin]
- twice
bile acids are _____ derived anionic acids and associated anions
- cholesterol
bile salts are ____ forms
- anion
in heath there is ____ BA (bile acid) in systemic blood
- very little
- decrease functional mass
- portosystemic shunt
- obstructive cholestasis
- functional cholestasis
can all lead to _____ bile acid (BA) concentration
- increase
- hypercholemia