Flashcards in Investigation of the Liver Deck (63)
Hepatocytes constitude what percentage of liver mass?
Each hepatocyte is in contact with what other cells?
Role of SER
Carbohydrate metabolism of the liver
Glycogen storage and synthesis
Glycolysis and gluconeogenesis
Protein functions of the liver
Syynthesis and catabolism
Amino acid metabolism
Lipid functions of the liver
Lipoprotein and cholesterol synthesis
Fatty acid metabolism
Bile acid synthesis
What is excreted by the liver
Bile acid and bilirubin
What does the liver do to drugs?
Detoxification and excretion
Inactivates steroids and excretes iron
What vitamins are stored in the liver
Vit A,D,E and B12
6 LFTs in routine liver panel
ALT (alanine aminotransferase)
GGT (gamma glutamyl transferase)
What would you test to determine the functional production of metabolites?
Urea, plasma proteins
What would you test to measure the clearance of endogenous substances?
What would you test to measure the clearance of exogenous substances?
Measure of the integrity of the hepatocytes- released during damage
2 types of aminotransferases
Which aminotransferase is more specific for the liver?
Where else, other than the liver, is AST found?
In the muscle and RBCs
Tumour markers for primary hepatocellular carcinoma (high levels found in children)
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)
When do you get elevevated ALP (alkaline phosphatase)
Due to increased production by cells lining the bile canaliculi and overflow into blood
4 causes of elevated alkaline phosphatase
Space-occupying lesions (tumours)
Sites of production of ALP
Liver, bone, intestine, placenta
How do you distinguish between ALP isoenzymes
Liver and bone ALP isoenzymes separated by electrophoresis
Enzyme that is elevated due to structural damage, and can support a liver source of raised ALF
Gamma glutamyltransferase (yGT)
When can gamma glutamyltransferase levels be induced?
Enzyme inducing agents e.g. anti-epileptics
Fatty liver e.g. alcohol, diabetes, obesity
Novel biochemical markers of fibrosis
ELF score (PIIINP, TIMP-1, Hyaluronic acid)
Bilirubin is a measure of what?
Excretory capacity of the liver and free flow of bile
What 3 measurements of bilirubin can be taken?
What levels of bilirun defines jaundice