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CLINICAL CHEMISTRY > Liver Function (Anatomy and Physiology) > Flashcards

Liver Function (Anatomy and Physiology) Flashcards

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1
Q

Largest and complex organ responsible for major metabolic functions in the body

A

Liver

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2
Q

Primary organ that can ONLY EXHIBIT KETOGENESIS

A

Liver

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3
Q

Liver is found at the

A

Right upper quadrant of abdomen

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4
Q

Liver has abundant blood supply approximately

A

1500 ML/MIN

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5
Q

Two major vessels of liver (2)

A

Hepatic Artery
Hepatic Portal Vein

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6
Q

Branch of aorta that provides most of the oxygen requirement; contributes 20% blood supply

A

Hepatic Artery

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7
Q

Drains the gastrointestinal tract and Spleen, Transports most of the recently absorbed materials from the intestines to the liver

A

Hepatic Portal Vein

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8
Q

Metabolic Activity of liver takes place within the___ ; constitutes 80% of organ mass

A

Parenchymal Cells

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9
Q

Aside from Parenchymal cells, liver also contains cells like (2)

A

Kupffer Cells
Stellate cells (major cell type responsible for Fibrosis)

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10
Q

Six-sided functional unit of Liver

A

Liver Lobule

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11
Q

Branches of Hepatic Artery and portal vein
Central Vein
Sinusoids
Hepatocytes and Kupffer cells
Bile canaliculi
Bile ducts

A

Component of Liver Lobule

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12
Q

Bile ducts
Hepatic Portal Vein
Hepatic Artery

A

Portal Triad

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13
Q

It is responsible for METABOLIC, SYNTHETIC, SECRETORY, EXCRETORY FUNCTION

A

Liver

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14
Q

First-Pass
Phagocytosis by KUPFFER CELLS
Metabolism and excretion of drugs
Production of Urea

A

Detoxification

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15
Q

Synthesis of Bile acids and Bile salts

A

Excretory System/Biliary System

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16
Q

Loss of functioning hepatocytes

Cirrhosis and Hepatitis

A

Decreased Levels (bile acids)

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17
Q

Regurgitation from hepatocytes

Biliary Obstruction and Hepatocellular Disease

A

Increased Levels (Bile acids)

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18
Q

Secretion Function

heme waste products (Bilirubin and Porphyrin)

A

Bile pigments

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19
Q

Bilirubin
Ammonia
Lipids
Bile salts
Drug Metabolism

A

Metabolic

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20
Q

Drug Metabolism is tested using

A

Cytochrome p450

  • measure after 1hr
  • Cynthelation Counter
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21
Q

Serum Total Protein
Albumin
AAT
Ceruloplasmin
Coagulation Factors

A

Synthetic Function

Except:
FVIII - produced in Endothelial Cells
FVII - First factor to be increased in Liver disease

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22
Q

Transaminases (AST and ALT)
Biliary Epithelium (ALP, 5-NT, GGT)

A

Hepatic Injury

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23
Q

Carbohydrates
Fats
Lipoproteins
Ketone bodies
Proteins
Hormones ( Somatomedin and Angiotensinogen)

A

Synthesis or Metabolism Function

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24
Q

Fat Soluble and water-soluble vitamins, Glycogen, Iron

A

Storage

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25
B1 ----> B2 reactions is catalyzed by enzyme
UDPGT Uridyl diphosphate Glycuronyltransferase
26
Structure: Bilirubin Bound to protein: Yes (albumin) Type of Compound: Non-Polar Soluble in water: No Present in Urine: No Reaction with Diazotized Sulfanilic Acid: Indirect (Requires accelerator) Affinity for Brain Tissue: High
Unconjugted Bilirubin
27
Structure: B1, B2, Delta Bilirubin Bound to protein: No (Except for Delta Bili) Type of Compound: Polar Soluble in water: Yes Present in Urine: Yes Reaction with Diazotized Sulfanilic Acid: Direct (no accelerator) Affinity for Brain Tissue: Low
Conjugated Bilirubin
28
Laboratory Assays to Assess Liver Disease: Hepatocellular damage
AST ALT
29
Laboratory Assays to Assess Liver Disease: Cholestasis
ALP (inc. period of growths) GGT (small liver insults) 5-NT (Specific for hepatobiliary disease)
30
Laboratory Assays to Assess Liver Disease: Liver Excretory Function
Serum Bilirubin Urine Bilirubin Blood Ammonia
31
Laboratory Assays to Assess Liver Disease: Assays of biosynthetic function
Total Protein, Albumin, Globulins Coagulation factors
32
Hemolysis Hereditary Erythrocytes Enzymopathies
Bilirubin
33
Bone cancer, Pregnancy
ALP
34
Muscle Damage, Cancer, Pancreatitis, Renal Disease
ALT
35
Myocardial Infarction, Skeletal Muscle damage
AST
36
Myocardial Infarction, Skeletal Muscle damage, renal disease, cancer
LDH
37
Pesticide Poisoning
DECREASE CHOLINESTERASE
38
LIVER DISORDERS: may be acute or chronic or combination of both; damage to and destruction of liver cells
Hepatitis
39
LIVER DISORDERS: regeneration leads to fibrosis, scarring, and destruction of normal liver architecture
Cirrhosis
40
destruction of intrahepatic bile ducts; presence of ANTI-MITOCHONDRIAL ANTIBODIES
Primary Biliary Cirrhosis
41
LIVER DISORDERS: Both primary, more frequently secondary to cancer of bowel, stomach, and bronchus
Tumors
42
ASMA-CAH
Anti-Smooth Muscle Antibody Chronic Active Hepatitis
43
STAGES OF ALCOHOLIC LIVER DISEASE: Ethanol in lipid metabolism; decreasing fatty acid oxidation and increasing formation/deposits of TRY in liver
Steatosis (1st stage) / Alcoholic Fatty Liver
44
STAGES OF ALCOHOLIC LIVER DISEASE: Takes place with INFLAMMATION and development of fibrosis or necrosis
Steatonecrosis (2nd stage)
45
STAGES OF ALCOHOLIC LIVER DISEASE: EXTENSIVE development of fibrosis, hepatocelullar carcinoma
Alcoholic Cirrhosis
46
yellowish pigmentation of the skin, mucous membrane, and sclera of eyes due to hyperbilirubinemia
Jaundice/Icterus
47
Bilirubin exceeds 3.0-5.0
Overt Jaundice
48
CLASSES OF JAUNDICE: Known as Hemolytic or Retention Jaundice
Pre-Hepatic
49
CLASSES OF JAUNDICE: Excessive destruction of RBC HDN, Erythroblastosis fetalis, Malaria Hepatic Uptake DECREASED: Prolonged fasting and intake of drugs
Pre-Hepatic Jaundice
50
CLASSES OF JAUNDICE: Also known as Infectious Jaundice
Hepatic Jaundice
51
CLASSES OF JAUNDICE: - Damage to hepatocytes due to microorganisms or ALCOHOL - Starvation and Certain Medications - Hepatitis and Cirrhosis - Parasitism (FASCIOLA HEPATICA)
Hepatic Jaundice
52
HEPATIC JAUNDICE: Physiologic neonatal jaundice Gilbert's disease Crigler-Najjar Syndrome I and II Lucey-Driscoll Syndrome
Bilirubin Conjugation Decreased
53
Bilirubin Conjugation Decreased: UDPGT is 30% functional Defect in Transport protein LIGANDIN Benign
Gilbert's Disease
54
Bilirubin Conjugation Decreased: UDPGT deficiency - Conjugation Deficiency
Crigler-Najjar Syndrome
55
Bilirubin Conjugation Decreased: UDPGT deficiency - Conjugation Deficiency Complete Absence of UDPGT
Criggler-Najjar Syndrome I
55
Bilirubin Conjugation Decreased: UDPGT deficiency - Conjugation Deficiency Partial Absence of UDPGT
Criggler-Najjar Syndrome II
56
Bilirubin Conjugation Decreased: Circulating inhibitor of conjugation
Lucey-driscoll syndrome
57
Bilirubin Conjugation Decreased: Defect in Chromosome 2
Gilbert's Syndrome Criggler Syndrome
58
Impairment of Hepatic Excretion:
Dubin Johnsons Syndrome Rotor Syndrome
59
Impairment of Hepatic Excretion: Presence of DELTA bilirubin; dark stained granules (Lipofuscin) in liver biopsy
Dubin Johnsons Syndrome
60
Impairment of Hepatic Excretion: Reduced/Defective ligandin; UPTAKE/TRANSPORT DEFICIT
Rotor Syndrome
61
Also known as Regurgitive, Obstructive, Cholestic Jaundice
Post-Hepatic Jaundice
62
Obstruction of Biliary Flow
Post-Hepatic Jaundice
63
Intra-hepatic cholestasis Obstruction of Extra-hepatic biliary Tree Cholethiasis or Gallstones Strictures, Spasms, artresia, and Microorganisms Cancer of Pancreas ASCARIS LUMBRICOIDES
Post-Hepatic Jaundice
64
TB: Increased B1: Increased B2: Normal Urine Bil: Normal Urine urobilinogen: INCREASED Stool: Dark Brown
Pre-Hepatic
65
TB: Increased B1: Increased B2: Increased/Normal Urine Bil: Variable Urine urobilinogen: Normal Stool: Pale/Brown
Hepatic
66
TB: Increased B1: Normal B2: Increased/Normal Urine Bil: Positive Urine urobilinogen: Normal Stool: Clay
Post-Hepatic
67
Buildup of unconjugated bilirubin 2-3 days of neonatal life Most common cause is HDN
Neonatal Jaundice
68
Poorly developed blood brain barrier allowing B1 to cause damage to central nervous system B1 > 20 mg/dL
Kernicterus
69
Treatment for Neonatal Jaundice
Phototherapy
70
SUMMARY OF LIVER DISORDERS : AST/ALT 10-110 x ULN
Acute Viral Hepatitis
71
SUMMARY OF LIVER DISORDERS : AST/ALT: Slight persistent elevation Total Protein: Decreased
Chronic Hepatitis
72
SUMMARY OF LIVER DISORDERS : GGT 2-3 x ULN Lipid: Elevated
Alcoholic Liver Disease
73
SUMMARY OF LIVER DISORDERS : Albumin, Cholesterol: Decreased PT: Prolonged
Cirrhosis
74
SUMMARY OF LIVER DISORDERS : Total bilirubin and B1: Elevated
Primary Biliary Cirrhosis
75
SUMMARY OF LIVER DISORDERS : GGT up to 20 x ULN ALP: elevated
Hepatic Tumors
76
SUMMARY OF LIVER DISORDERS : GGT and ALP markedly Elevated
Cholestasis
77
recovery from viral infection and aspirin ingestion in children, neurologic abnormalities, accumulation of ammonia in CNS
Reye's Syndrome

CLINICAL CHEMISTRY (29 decks)

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