Lesson 1A (Part 2)

Question 1

What are 4 normal variants of the liver?

Answer 1

1. Diaphragmatic Slips
2. Reidels lobe
3. Papillary Process Caudate
4. Long left lobe

Question 2

Diaphragmatic Slips

Answer 2

Invagination of dome of the diaphragm that causes a pseudomass on the liver

• associated with diaphragmatic muscle bundles that attach the central tendon to the thoracic cage
• appearance changes with respiration

Question 3

Reidels lobe

Answer 3

Is a tongue-like, inferior projection of the right lobe of the liver

Question 4

Papillary Process Caudate

Answer 4

Represents a division of the inferior caudate lobe of the liver

Question 5

What is an artifact of the the liver?

Answer 5

Mirror image

Question 6

What is the mirror image artifact caused by?

Answer 6

The diaphragm

Question 7

What are the liver function tests? (4)

Answer 7

1. Alpha-fetoprotein
   - AFP
2. Alkaline phosphate
   - ALP
3. Alanine aminotransferase
   - ALT
4. Aspartate aminotransferase
   - AST

Question 8

Alpha fetoprotein

Answer 8

A protein normally synthesized by the liver, yolk sac and GI tract of the fetus

Question 9

What is a nonspecific marker for malignancy?

Answer 9

Alpha fetoprotein

- AFP

Question 10

Alkaline phosphate

Answer 10

An enzyme produced primarily by liver, bone and placenta

Question 11

Where is ALP excreted through?

Answer 11

The bile ducts

- want to look at the GB or the ducts to make sure they are not blocked

Question 12

What is elevated levels of alkaline phosphatase associated with?

Answer 12

Obstructive jaundice

Question 13

Alanine aminotransferase

Answer 13

An enzyme found in high concentration in the liver and lower concentrations in the heart, muscle and kidneys

Question 14

What does ALT remain elevated longer than?

Answer 14

AST

Question 15

What is ALT used to asses?

Answer 15

Jaundice

Question 16

What are elevated levels of alanine aminotransferase associated with? (3)

Answer 16

1. Cirrhosis
2. Hepatitis
3. Biliary obstruction

Question 17

What is mild elevated levels of ALT associated with?

Answer 17

Liver metastases

Question 18

Aspartate aminotransferase

Answer 18

An enzyme present in many kinds of tissue that is released when cells are injured or damaged

Question 19

What is AST used to diagnose?

Answer 19

Liver disease before jaundice occurs

Question 20

What is elevated levels of aspartate aminotransferase associated with? (3)

Answer 20

1. Cirrhosis
2. Hepatitis
3. Mononucleosis

Question 21

What is considered a normal clotting time?

Answer 21

10-15 seconds

Question 22

What enzyme is produced by the liver to help with clotting?

Answer 22

Prothrombin

Question 23

What does the production of prothrombin depend on?

Answer 23

The amount of vitamin K

Question 24

What is elevated levels of prothrombin associated with? (4)

Answer 24

1. Cirrhosis
2. Malignancy
3. Malabsorption of vitamin K
4. Clotting failure

Question 25

What are decreased levels of prothrombin associated with? (5)

Answer 25

1. Subacute or acute cholecystitis 2. Internal biliary fistula 3. Carcinoma of the GB 4. Biliary duct injury 5. Prolonged extrahepatic biliary obstruction

Question 26

Fistula

Answer 26

Opening from one thing to another

Question 27

What is an example of a fistula?

Answer 27

A tear

Question 28

Leukocytosis

Answer 28

A white blood cell count above the normal range

Question 29

What is leukocytosis a sign of?

Answer 29

Inflammatory or infection response | - includes parasitic infections

Question 30

What does a decrease in serum albumin suggest?

Answer 30

A decrease in protein synthesis