SEM 1 - (CC) LIVER FUNCTION TEST 1 Flashcards
It is the chief metabolic organ in the body with lobules as its microscopic and function units.
Liver
Liver framework is composed of 3 systems, what are those 3?
Hepatocytic
Hepatobiliary
Reticuloendothelial
The liver receives _____ of blood per minute from the portal vein for filtration while it also delivers toxins to the liver for processing and detoxification.
15 mL
In the liver, to eliminate toxins such as alcohol, two enzymes are essential in the pathway, which are?
- alcohol dehydrogenase
and
2, acetaldehyde dehydrogenase.
a unique organ with the capacity to regenerate cells that have been damaged, injured, or removed.
liver
_______ of the remaining tissue in case of tissue injury due to biliary obstruction or toxic exposure is a distinguishing feature of the liver.
Hypertrophy
______ are the primary liver parenchymal cells and play complicated roles in fibrosis and cirrhosis;
Hepatocytes
In hepatocytes ; the targets for most hepatotoxic agents, including what?
hepatitis viruses, alcohol metabolites, and bile acids
Major Cell Types of Liver:
- Hepatocyte
- Kupfer Cell
major liver cell type that represents 80% of the volume of the liver; performs the major hepatic functions; responsible for
the regenerative property.
Hepatocyte
Major live cell type that has the phagocytic role; it is the hepatic macrophage, engulfing organisms and toxins.
Kupfer cell
5 Functions of the Liver:
- Synthetic Function
- Conjugation Function
- Detoxification and Drug Metabolism
- Excretory and Secretory Function
- Storage Function
Synthetic Function of the Liver:
- The liver secretes the ff….
- The normal liver produces about ______ of albumin daily,
- It is also involved in the metabolism of cholesterol into ______
- plasma proteins, carbohydrates, lipids, lipoproteins, clotting factors, ketone bodies, enzymes, and xenobiotics.
- 12 grams
- bile acids.
Conjugation Function of the Liver:
- ____ is the site of liver metabolism.
- ______ of bilirubin is produced daily in the healthy adult.
- Liver
- 200 to 300 mg
Detoxification and Drug Metabolism of Liver:
- Liver serves to protect the body from potentially injurious substances absorbed from the intestinal tract and toxic by-product of metabolism.
- ______ (toxic by-product) is converted to urea in the liver.
Ammonia
Excretory and Secretory Function of Liver
- Excretion of bile involves the elimination of _______, _______ and _____
- Bile acids (_______ and _____) are conjugated with the amino acids _____ and _____ to form bile salts.
- bile acids or salts, pigments, and cholesterol.
- cholic acid and chenodeoxycholic acid ; glycine and taurine
Storage function of liver:
- Storage site for all _____ and _____ vitamins.
- Liver is also the storage depot for ______, which is released when glucose is depleted.
- fat-soluble and water-soluble
- glycogen
MAJOR LIVER FUNCTION TESTS
- TESTS MEASURING THE HEPATIC SYNTHETIC FUNCTION
- TEST MEASURING CONJUGATION AND EXCRETION FUNCTION
- TEST FOR DETOXIFICATION FUNCTION
Liver function test that is useful in quantitating the severity of hepatic dysfunction.
TESTS MEASURING THE HEPATIC SYNTHETIC FUNCTION
In TESTS MEASURING THE HEPATIC SYNTHETIC FUNCTION ;
_____ and ________ provide the most useful indices for assessing severity of liver disease.
Serum albumin and the vitamin-K-dependent coagulation factors
Proteins are abundantly produced in liver except the _______
immunoglobulins
Routine Markers in TESTS MEASURING THE HEPATIC SYNTHETIC FUNCTION
Total protein, albumin, globulin, and albumin/globulin ratio
Secondary Markers in TESTS MEASURING THE HEPATIC SYNTHETIC FUNCTION
Prothrombin TIme
Analysis of proteins is important for assessing nutritional status and presence of severe diseases involving the liver, kidney, and bone marrow.
Total Protein
Plasma levels of total protein is _______ higher than serum due to _______
0.2 to 0.4g/dL ; fibrinogen.
Total protein and albumin are about ____ higher in ambulatory individuals.
10%
Transudates have a total protein of ______ (<50% of the serum total protein);
exudates has _____
<3.0g/dL ; >3g/dL.
Total protein measurement is usually performed in serum which has no _______ and no ________ that may slightly dilute proteins in plasma.
fibrinogen ; anticoagulant
In measuring total proteins in serum, ____ may not be required.
fasting
Total Protein Reference range: _________
6.5-8.3 g/dl
METHODS FOR TOTAL PROTEIN MEASUREMENT
- Kjeldahl Method
- Biuret Method
- Folin-Ciocalteu Method
- Lowry Method
5, Turbidimetric and Nephelometric Method
6, Ultraviolet Absorption Method - Refractometry
- Immunofixation Electrophoresis
- Salt Fractionation
a method for total protein measurement that is a reference method but not routinely used.
Kjeldahl Method
Kjeldahl Method is based on the measurement of __________
nitrogen content of protein.
Kjeldahl Method uses serum samples treated with _________, _______
tungstic acid, forming protein-free filtrate(PFF).
According to Kjeldahl, 1 gram of nitrogen is equivalent to ______ of proteins
6.54 grams
In kjeldahl method, the nitrogen content of proteins is about _____ to ______
15.1% to 16.8%.
Reagent in Kjeldahl Method and its end product
Reagent: Sulfuric acid (digesting agent)
End product: Ammonia
a method for total protein measurement that is most widely used method
Biuret Method
Biuret method of total protein measurement is recommended by the __________ expert panel.
International Federation of Clinical Chemistry (IFCC)
Principle: Cupric ions form a complex with the peptide bonds, forming a violet-colored chelate which is proportional to the number of peptide bonds present and reflects the total protein level at 545 nm.
Biuret Method
Biuret method requires at least two _______ and an _____ medium to measure total protein.
peptide bonds ; alkaline
It is preferred by automated analyzers since protein concentration as low as 10 or 15 mg/dL can be measured.
Biuret Method
_____ and _____ influence the Biuret method, causing falsely elevated total protein
Hemolysis and ictericia
Reagents in Biuret Method
Alkaline copper sulfate, Rochelle salt (Nak Tartrate), NaOH, and Potassium iodide
ref range in biuret method
6.5-8.3 g/dL
a method for total protein measurement that has the highest analytical sensitivity.
Folin-Ciocalteu Method
Principle: Oxidation of phenolic compounds, such a s tyrosine, tryptophan, and histidine, to give a deep blue color
Folin-Ciocalteu Method
Folin-Ciocalteu Method give a _____ color
deep blue
Folin-Ciocalteu Method main reagent and color enhancer
Main reagent: Phosphotungstic-molybdic acid o r phenol reagent
Color enhancer: Biuret reagent
a method for total protein measurement that utilizes the reagents of Folin-Ciocalteu method (phenol) and biuret method where the addition of phenol reagent to the biuret reagents improves the color formation.
Lowry Method
a method for total protein measurement that utilize sulfosalicylic acid and or trichloroacetic acid.
Turbidimetric and Nephelometric Method
Turbidimetric and Nephelometric Method Measurement depends on the formation of a uniform fine precipitate which scatters incident light in suspension (______) or block light (______).
nephelometry ; turbidimetry
Turbidimetric methods is also used in _____ and ______ specimens.
CSF and urine
Principle: The absorbance of proteins at 210 nm is due to the absorbance of the peptide bonds a t specific wavelength.
Ultraviolet Absorption Method