Liver and Bilirubin Intro

Question 1

When do you see signs of hepatic failure

Answer 1

70-80% of functional capacity is lost

Question 2

Hepatocellular diseases

Answer 2

Degenerative
Anomalous
Metabolic
Neoplastic
Inflammatory
Toxic
Trauma

Question 3

Liver enzymes that increase in enzyme activity from hepatocellular damage

Answer 3

ALT
AST
LD
SDH
GMD

Question 4

What liver enzymes are induction enzymes and increased from cholestasis

Answer 4

ALP
GGT

Question 5

What can liver enzymes not tells us

Answer 5

-Functional capacity
-Not prognostic
Best if analyzed sequentially

Question 6

Liver function tests

Answer 6

-Concentration of substances removed (bilirubin, bile acids, ammonia)
-Concentration of substances synthesized (albumin, globulin, urea, cholesterol etc)

Question 7

Bc

Answer 7

Conjugated bilirubin

Question 8

Bu

Answer 8

Unconjugated bilirubin

Question 9

Direct B (Bd) assay

Answer 9

Conjugated bilirubin measurement

Question 10

Indirect B (Bi)

Answer 10

Unconjugated bilirubin measurement

Question 11

Hyperbilirubinemia prehepatic

Answer 11

Increased Bu production-> hemolytic disorders (really severe internal hemorrhage)

Question 12

Hyperbilirubinemia hepatic

Answer 12

-Decreased Bu uptake
-Decreased Bu conjugation
-Functional cholestasis
-Intrahepatic cholestasis

Question 13

Post hepatic hyperbilirubinemia

Answer 13

-Post hepatic obstructive cholestasis

Question 14

Delta bilirubin

Answer 14

Bu and albumin

Question 15

What conditions do you usually see icterus

Answer 15

Acute massive hepatic necrosis or fulminant liver failure
Rare to see in slow and chronic disease