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
