(2) I. TESTS FOR LIVER SYNTHETIC FUNCTION

Question 1

Quantitates the severity of liver dysfxn

Answer 1

TESTS FOR LIVER SYNTHETIC FUNCTION

Question 2

TESTS FOR LIVER SYNTHETIC FUNCTION

Answer 2

TAAGP

A. Total Protein
B. Albumin
C. Albumin/Globulin Ratio
D. Prothrombin test

Question 3

Assessment of nutritional status & presence of severe dsz involving the liver, kidney & bone marrow

Answer 3

Total Protein

Question 4

TP = ______ + Globulin

Answer 4

TP = Albumin + globulin

Question 5

Sample spx for total protein

Answer 5

Serum

Question 6

Why is plasma not used in getting the total protein?

Answer 6

o Plasma contains fibrinogen.
o Use of Plasma: False ↑TP by 0.2-.04g/dL

Question 7

General interferences for total protein

Answer 7

hemolysis, ictericia

Question 8

Methods for Total Protein

Answer 8

1. Kjeldal
2. Biuret
3. Folin-Ciocalteu (Lowry)
4. UV Absorption
5. Refractometry
6. Turbidimetry & Nephelometry
7. Salt Fractionation
8. Coomasie Brilliant Blue Dye
9. Ninhydrin
10. Serum Protein Electrophoresis (SPE)

Question 9

• Most abundant among all proteins.
• Concentration is directly proportional to the severity of hepatic disease.

Answer 9

Albumin

Question 10

Liver synthesizes how many grams of albumin per day?

Answer 10

9-12 g

Question 11

decreased albumin levels may be due to

Answer 11

decreased synthesis

Question 12

Methods for Albumin

Answer 12

1. Salt precipitation
2. Dye-binding

Question 13

• Globulins are precipitated (since TP = Alb + glob)
• Albumin is quantitated using biuret reaction

Answer 13

SALT Precipitation

Question 14

Dye binding method for albumin

o most commonly used.
Sensitive dye.
o most specific dye
o not specific for albumin.
o more specific to albumin than methyl orange

Answer 14

Dye binding method for albumin

o Bromcresol Green (BCG): most commonly used.
Sensitive dye.
o Bromcresol purple (BCP): most specific dye
o Methyl Orange: not specific for albumin.
o 2,4’-hydroxyazobenzene-benzoic acid (HABA): more
specific to albumin than methyl orange

Question 15

Dye binding method for albumin Interferences:

Answer 15

Conj. bilirubin, Aspirin, Penicillin, Sulfonamides

Question 16

o Performed to check if globulin is higher than albumin aka Inverted A/G ratio
o Computed & not measured.

Answer 16

ALBUMIN/GLOBULIN RATIO

Question 17

Inverted A/G ratio is seen in:

Answer 17

o Cirrhosis
o Multiple Myeloma
o Waldenstroms macroglobulinemia

Question 18

Formula for A/G ratio

Answer 18

A/G ratio = A/G
Globulin = TP - Albumin

Question 19

Vitamin K Response Test

Answer 19

PT test (Prothrombin test)

Question 20

In CC, 10mg Vit. K is administered (IM) 1-3days prior to PT, why?

Answer 20

Due to Vit. K dependent clotting factors (2, 7, 9, 10).

Question 21

After administration of Vit. K & still no CF (prolonged PT)

Answer 21

indicates intrahepatic disorder

Question 22

After administration of Vit. K then normal PT,

Answer 22

indicates extrahepatic disorder

Question 23

Differentiates intrahepatic disorder from extrahepatic disorder

Answer 23

Vitamin K Response Test (PT test)

Question 24

Acute/Chronic Hepatitis: prolonged PT signifies

Answer 24

massive cellular damage.

Question 25

* Globulins are precipitated (since TP = Alb + glob) * Albumin is quantitated using biuret reaction

Answer 25

SALT Precipitation