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Flashcards in Investigation of the Liver Deck (63)
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1

Hepatocytes constitude what percentage of liver mass?

60%

2

Each hepatocyte is in contact with what other cells?

Sinusoid
Bile canaliculus
Neighbouring hepatocyte

3

Role of SER

Bilirubin conjugation
Drug detoxification

4

Carbohydrate metabolism of the liver

Glycogen storage and synthesis
Glycolysis and gluconeogenesis

5

Protein functions of the liver

Syynthesis and catabolism
Clotting factors
Amino acid metabolism
Urea synthesis

6

Lipid functions of the liver

Lipoprotein and cholesterol synthesis
Fatty acid metabolism
Bile acid synthesis

7

What is excreted by the liver

Bile acid and bilirubin

8

What does the liver do to drugs?

Detoxification and excretion
Inactivates steroids and excretes iron

9

What vitamins are stored in the liver

Vit A,D,E and B12
Iron

10

6 LFTs in routine liver panel

Alkaline phosphatase
ALT (alanine aminotransferase)
Bilirubin
Albumin
Total protein
GGT (gamma glutamyl transferase)

11

What would you test to determine the functional production of metabolites?

Urea, plasma proteins

12

What would you test to measure the clearance of endogenous substances?

Bilirubin
Ammonia
Hormones

13

What would you test to measure the clearance of exogenous substances?

Drugs, toxins

14

Measure of the integrity of the hepatocytes- released during damage

Aminotransferases

15

2 types of aminotransferases

Alamine/ALT
Asparate/AST

16

Which aminotransferase is more specific for the liver?

ALT

17

Where else, other than the liver, is AST found?

In the muscle and RBCs

18

Tumour markers for primary hepatocellular carcinoma (high levels found in children)

alpha fetoprotein

19

What are the 2 main results of biliary tract damage

Impaired excretory function (increased conjugated bilirubin)
Increased synthesis of enzymes by cells lining the bile canaliculi (ALP and yGT)

20

When do you get elevevated ALP (alkaline phosphatase)

Due to increased production by cells lining the bile canaliculi and overflow into blood

21

4 causes of elevated alkaline phosphatase

Cholestasis
Infiltrative diseases
Space-occupying lesions (tumours)
Cirrhosis

22

Sites of production of ALP

Liver, bone, intestine, placenta

23

How do you distinguish between ALP isoenzymes

Liver and bone ALP isoenzymes separated by electrophoresis

24

Enzyme that is elevated due to structural damage, and can support a liver source of raised ALF

Gamma glutamyltransferase (yGT)

25

When can gamma glutamyltransferase levels be induced?

Alcohol
Enzyme inducing agents e.g. anti-epileptics
Fatty liver e.g. alcohol, diabetes, obesity
Heart failure
Prostatic disease
Pancreatic disease
Kidney damagw

26

Novel biochemical markers of fibrosis

ELF score (PIIINP, TIMP-1, Hyaluronic acid)

27

Bilirubin is a measure of what?

Excretory capacity of the liver and free flow of bile

28

What 3 measurements of bilirubin can be taken?

Total
Unconjugated
Conjugated

29

What levels of bilirun defines jaundice

>40micromol/l

30

slide 21

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