Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Chemistry > Liver Function > Flashcards

Liver Function Flashcards

1
Q

Liver Function

A

Organ of the RES (Reticuloendothelial System)
Active in Immune Response
Metabolism
Detoxification
Excretion and Secretion
Storage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Liver Metabolism Proteins

A

Made in Liver
Albumin & Amino Acids converted into Alpha & Beta globulins
Coagulation Factors
Carrier proteins
Acute phase reactants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Liver Metabolism Carbohydrates & Lipids

A

Processed in Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Liver Metabolism Bilirubin

A

Made in liver
Waste product of hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Detoxification “First Pass” Conversion

A

Substances absorbed from the GI tract pass through liver and are changed in process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Detoxification Drug Metabolism

A

Substances are converted to more soluble or less toxic forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Forms of conversion

A

Hydrolysis
Hydroxylation
Oxidation
Reduction
Carboxylation
Demethylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Alcohol conversion

A

To Acetaldehyde and then to acetate by alcohol dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ammonia conversion

A

To Urea which is the soluble form and excreted in kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Liver Excretion and Secretion

A

Bile Acids into GI tract and help with digestion
Bilirubin through common bile ducts
Metabolites: Drugs and Hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Liver Storage Metabolites

A

Glycogen
Iron as ferritin
Fat soluble vitamins (A, E, D, K, B12)
Albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bilirubin Metabolism

A

Senscent or damaged RBCs phagocytized by RES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hemoglobin Breakdown

A

Globulin
Iron
Porphyrin ring holding iron molecule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bilirubin Transport

A

Unconjugated bilirubin is loosely bound to albumin once it is formed
- Unconjugated bilirubin is highly insoluble
- Bilirubin-albumin complex is soluble
Complex transported to liver via bloodstream
Bilirubin is converted to a conjugated form in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anatomy of Liver

A

Weighs 3.5 lbs
Situated in top right portion of abdominal cavity
Felt as hard mass just below the bottom right rib
Liver receives blood from two sources
- Venous
- Hepatic
Blood leaves liver via a central vein which drains to hepatic vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Venous Blood

A

Gastrointestinal tract
Containing nutrients from the intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hepatic Artery

A

Supplies oxygenated blood
Branch of the celiac trunk from abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Microscopic Anatomy of Liver

A

Lobule is the functional unit of liver
- Hexagonal shaped
- Made up of hepatocytes
- Arranged in layers
- Sinusoids (small blood vessels) located between hepatocyte sheets
- Kupffer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sinusoids

A

Receive blood from hepatic artery and nutrients from intestines via portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Kupffer cells

A

Specialized macrophages that remove bilirubin-albumin complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Corners of Lobules

A

Branch of hepatic portal vein, hepatic artery, and bile duct
- Bile drains from hepatocytes
- Joins the cystic duct, which leads from gallbladder
- Central canal in middle of each lobule receives blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Small bile ducts

A

AKA Bile Canaliculi
Unite to form the hepatic duct in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cystic duct in liver

A

Leads from gallbladder
Forms the common bile duct
Drains into duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Transport of Unconjugated bilirubin

A

Into the microsomal region of the hepatocyte
Bilirubin-albumin complex is broken down & albumin returned to circulation
Bilirubin is conjugated within the hepatocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Conjugated Bilirubin

A

Bilirubin diglucuronide
Water soluble
Actively removed from hepatocytes into the bile canaliculi and excreted into the bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Enzyme UDPG-transferase

A

Bilirubin diglucuronyl transferase converts bilirubin to conjugated form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Conjugated & Unconjugated Bilirubin

A

Fractionated Bilirubin Assays
Total Bilirubin = Conjugated + Unconjugated Bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Liver Function at Intestines

A

Conjugated bilirubin is excreted into the small intestine with bile salts via the common bile duct
Anaerobic bacteria

29
Q

Anaerobic bacteria on Bilirubin

A

Acts on bilirubin and produces:
Urobilinogen - colorless
Urobilin - brown

30
Q

Urobilinogen

A

50% is reabsorbed by the portal circulation
Filtered by kidney and returned to liver

31
Q

Obstruction stools

A

Turn chalky color
Conjugated bilirubin cannot be removed through the common bile duct
No conversion to urobilin

32
Q

Jaundice Definition

A

Yellow discoloration of skin and sclera
Caused by build-up of bilirubin in circulation and tissues
Sign that liver or bile duct system is not working

33
Q

Types of Jaundice

A

Elevated Bilirubin in circulation
Pre-hepatic
Hepatic
Post-hepatic

34
Q

Pre-hepatic Note

A

Increase breakdown of RBCs = elevation in unconjugated bilirubin

35
Q

Hepatic Note

A

Increase build-up of conjugated bilirubin due to damaged hepatocytes
- Not enough hepatocytes are working

36
Q

Post-hepatic Note

A

Increase in products of bilirubin metabolism due to decrease outflow from common bile duct

37
Q

Pre-hepatic Jaundice

A

Caused by Acute Hemolysis (most common)
- Liver presented with more unconjugated bilirubin than it can handle
- Unconjugated bilirubin builds up in serum
- Conjugated bilirubin may increase due to liver reserve
- No bilirubin detected in urine
- Increase in urine urobilinogen

38
Q

Pre-hepatic Jaundice Tests info

A

Total Serum Bilirubin = Increased
Conjugated Bilirubin = Normal to Increased
Unconjugated Bilirubin = Increased
Urine Urobilinogen = Increased
Urine Bilirubin = Normal
LD = Increased

39
Q

Pre-hepatic Neonatal Physiological

A

Caused by immature liver - UPDG transferase not fully functioning
- Babies naturally have elevated Hct
- Hemolytic Disease of Newborn can complicate this situation and cause more destruction of RBCs
- Kernicterus results from hemolusis

40
Q

Kernicterus

A

Deposition of bilirubin in lipid portion of brain tissue
Results in mental retardation

41
Q

Treatment for Neonatal Jaundice

A

Phototherapy

42
Q

Other Causes of Pre-hepatic Jaundice

A

Crigler-Naijar
Gilbert’s Disease
Dubin-Johnson

43
Q

Crigler-Naijar

A

Failure to conjugate bilirubin
- Congenital lack of UPDG transferase
- Type 1: Child usually dies in first months of life (>50% mortality)
- Severe mental retardation
- Chronic persistent jaundice
- Type 2: milder form

44
Q

Gilbert’s Disease

A
  • Defect in ability to transport unconjugated bilirubin into the microsomal region
  • May have mild jaundice
  • Most individuals are asymptomatic
45
Q

Dubin-Johnson

A
  • Defect in transport system of conjugated bilirubin from microsomal region to bile acnaliculi
  • May have upper right quadrant pain
  • Non-specific jaundice
  • Not life-threatening
46
Q

Hepatic Jaundice

A
  • Diffuse hepatocellular damage or necrosis
  • Viral or Toxic hepatitis
  • Cirrhosis
  • Intra-hepatic destruction from pressure or edema
47
Q

Viral or Toxic Hepatitis

A

Selective areas of hepatocytes are inflamed blocking the out flow of conjugated bilirubin into the bile canaliculi

48
Q

Cirrhosis

A

Nodular damage throughout the liver
Also blocks outflow of bilirubin into the bile canaliculi

49
Q

Hepatic Jaundice Tests Info

A

Total Serum Bilirubin = Increased
Conjugated Bilirubin = Increased
Unconjugated Bilirubin = Normal to Increased
Urine Urobilinogen = Increased
Urine Bilirubin = Increased
AST/ALT = Increased (10-100x)
Alk Phos = Increased but <5x N
GGT = Increased >10x N in alcoholic cirrhosis

50
Q

Viral Hepatitis AST/ALT

A

ALT > AST

51
Q

Post-Hepatic Jaundice

A

Obstruction of common bile duct
Caused by stones, spasms, strictures or neoplasms (tumor)

52
Q

Post-Hepatic Jaundice Tests Info

A

Total Serum Bilirubin = Increased
Conjugated Bilirubin = Increased
Unconjugated Bilirubin = Normal to Increased
Urine Urobilinogen - Decreased
Urine Bilirubin = Increased
AST/ALT = Normal to Increased, up to 5x Normal
Alk Phos = Increased, >5x Normal

53
Q

Jendrassik Grof Method

A

Most used method, Detects:
Total Bilirubin
Direct Bilirubin

54
Q

Total Bilirubin Tests

A

Total Bilirubin + diazonium salt +caffeine = Diazo Bilirubin (pink color)
Note: Hemolysis interferes with color spectrum

Diazo Bilirubin + alkaline tartrate = Green
Note: causes shift in color spectrum due to pH change

55
Q

Direct Bilirubin (Conjugated) Tests

A

Direct bilirubin + diazonium salt + HCL = Diazo Bilirubin (pink color)
Note: Hemolysis interferes with color spectrum

Diazo Bilirubin + alkaline tartrate = green
Note: causes shift in color spectrum due to pH change

56
Q

Indirect Bilirubin Test

A

Calculated
Total - Direct = Indirect

57
Q

Other Bilirubin Tests

A

Evelyn Malloy Method (reference or research now)
- Original Method
- Tartrate step not added so hemolysis was problem
Automated Methods
- Modification of Jendrassik Grof

58
Q

Liver Isoenzymes

A

LD - Rarely Performed Test
5 LDs tests

59
Q

Normal LD

A

LD1 < LD2

60
Q

Acute Myocardial Infarction LD

A

LD1 and LD2 eleveated
LD1 > LD2 - referred to as 1:2 flip

61
Q

Liver Disease LD

A

LD5 is elevated
LD3 and LD4 slight elevation

62
Q

Acute Mycardial Infarction with 2nd Liver Involvement LD

A

LD1 and LD2 elevated
LD1 > LD2
LD5 elevated

63
Q

Alkaline Phosphatase Isoenzymes

A

Heterogeneous group of enzymes from various tissues
Migrate with alpha-2 globulins
Hard to differentiate
- Heat stability is best method (10 min at 56 C)
- Removes Bone Alk Phos, Liver Alk Phos remains
- Other heat stable AP isoenzymes (Placental Alk Phos and Tumor Markers - Regan and Nagao AP)

64
Q

Alk Phosphate Increases in

A

Intestine = Active disease
Bone = Active disease
Liver = Active disease
Fast Liver = Liver and Liver metastases
= Bone and Malignant Bone Disease
Post Bone = Placental

65
Q

Intestine Alk Phos

A

<20% of total
More frequently noted in patients with blood group O and B who secrete H-blood group substance
Increased postprandially and after a fatty meal
Increased cirrhosis, malignancy, diabetes, chronic renal failure

66
Q

Placental Alk Phos

A

Increased during the later stages of pregnancy
Heat stable like liver Alk Phos
- Low levels of heat stable isoenzyme + poor prognosis for fetus

67
Q

Bone Alk Phos

A

Elevated in Osteoblastic activity
Normal to increased in growing children
Greatly Increased in Paget’s Disease or Renal Rickets
Increased in Bone cancer or osteomalacia
Decreased in children with cretinism or hypophosphatemia

68
Q

Liver Alk Phos

A

Increased in Acute hepatitis, cirrhosis, fatty liver, drug induced liver disease, obstruction, metastatic humar
Increased fast fraction in metastatic carcinoma
- Sometimes seen in viral hepatitis and alcoholic cirrhosis

Chemistry (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions