lecture 3 - liver function tests Flashcards

1
Q

what does the vein carry

A

deoxygenated blood

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2
Q

what is the main process in the liver

A
  1. uptake(portal vein)
  2. metabolism
  3. supply (vena cava)
  4. detoxification
  5. excretion (bile duct -> intestine)
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3
Q

give 3 functions of the liver

A

The uptake of nutrients delivered from the digestive tract via the portal vein

The detoxification of harmful compounds by biotransformation

Fighting infections (Kuppfer cells-macrophages)

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4
Q

what are three types of metabolism

A

carbohydrate

lipid

amino acid and protein

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5
Q

can the liver be regenerated?

A

yes, within 70 days

only organ that can

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6
Q

what happens during carbohydrate metabolism

A
  1. takes up glucose from plasma
  2. convert the to glucose 6-phosphate
  3. stored as glycogen or fatty acid

GLYCOGENESIS

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7
Q

what happens when there’s a major decline of blood glucose

A

secretion of glucose

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8
Q

what does breaking down excess amino acids do

A

release nitrogen

is converted to urea and transported to the kidneys

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9
Q

what is liver the site of

A

synthesis and degradation of most protein and peptides in the blood plasma

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10
Q

what is the deamination process (products)

A

amino acids -> ammonia -> acetyl coA/glucose/ketone

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11
Q

what is the most abundant protein in the blood and where is it made

A

albumin

liver

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12
Q

what does albumin do

A

maintain osmotic pressure

binds drugs

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13
Q

what is biotransformation

A

a metabolic process that helps to facilitate the excretion of both outside and inside substances.

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14
Q

examples that metabolised by biotransformation

A

drugs, ethanol and other foreign substances (xenobiotics)

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15
Q

what are aminotransferases

A

enzymes that loads amino acids onto tRNAs

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16
Q

what are biomarkers

A

A defined characteristic that is measured as an indicator of normal biological processes, pathogenic processes or responses to an exposure or intervention

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17
Q

what is ALT

A

alanine aminotransferase

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18
Q

what is AST

A

aspartate aminotransferase

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19
Q

when are AST and ALT released

A

when there is a damaged hepatocyte

20
Q

what are ALT and AT indicators of

A

hepatocellular damage

21
Q

what are the limitations of ALT and AST

A

not suitable for chronic conditions as may appear normal

AST is non specific for liver disease - can be found in heart/kidney

22
Q

what is prothrombin time

A

time taken for blood to clot

23
Q

what are the limitations of prothrombin time

A

unreliable in patients taking anti-coagulants

indicator of severe live disease or cirrhosis (scarring)

24
Q

what is bilirubin

A

the yellow breakdown product of RBC breakdown

25
how is bilirubin excreted
bile and urine
26
what is bilirubin responsible for
the yellow colour of bruises, yellow colour of urine, brown colour of feces
27
what makes bilirubin soluble
liver enzymes convert unconjugated bilirubin to conjugated bilirubin
28
what causes jaundice
increased bilirubin
29
what is another name of conjugated bilirubin
direct bilirubin
30
what is another name for unconjugated bilirubin
indirect bilirubin
31
what happens when conjugated bilirubin is normal
then the problem is an excess unconjugated bilirubin, and the location of the problem is upstream of bilirubin conjugation in the liver
32
what happens when conjugated bilirubin is elevated
then the liver is conjugating bilirubin normally but is not able to excrete
33
what is ALP and what does it do
alkaline phosphatase removes phosphate groups from proteins
34
what are the limitations of ALP
bone growth disorders elevate ALP bone cancers can also raise ALP
35
how is vitamin synthesised
1. Cholesterol precursor activated by UV-light in the skin 2. This is inactive 3. Requires hydroxylation by liver and then kidney enzymes
36
what is iron stored as
ferritin
37
what is ferritin
multi-subunit protein binds Fe atoms
38
what does excess Fe do
its toxic to the liver
39
what is haemochromatosis caused by
a genetic mutation in the HFE gene
40
what does excess iron do to the liver
impairs liver function chronic condition
41
what tests do you run for haemochromatosis
raised serum ferritin genetic testing
42
what its Wilsons disease
condition that impairs removal of excess copper
43
you got this!!
44
how can soluble drugs be removed
in its original form by the kidneys
45
how are insoluble drugs removed
can have to be modified from soluble to insoluble form so that they can be removed by the liver.