Liver Function Test Flashcards by Crisanto Tallo

Plasma level of total protein

0.2 to 0.4 g/dl slightly higher than serum due to fibrinogen

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the two test that provide the most useful indices for assessing severity of liver disease

(Synthetic Liver Function ) Serum Albumin and Vit. K dependent coagulation factor

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how many mg of bilirubin is produce daily in the healthy adult

200-300mg of bilirubin

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How many g of albumin daily is produce by the normal liver

12 g

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The anatomic unit or functional unit of the liver

Hepatic Lobule

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A test for hepatocellular fxn and potency of bile duct

Bromsulfathalein Dye Excretion Test

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Ammonia reference value as serum

19-60 ug/dl or 11-35 mmol/L

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name 7 enzymes that are secreted in the Liver

ALP , Aminotransferase , 5’ nucleotidase , GGT , OCT , LAP and LD

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Enzyme secreted in the liver that is specific for Alcoholic Hepatitis

GGT

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Reference value for Total Protein

6.5-8.3 g/dl

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Give 1 Clinical significance or disease associated with Gamma Spike

Multiple myeloma

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Give 1 Clinical significance or disease associated with alpha 1 globulin flat curve

Juvenile cirrhosis ( AAT deficiency )

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Give 1 Clinical significance or disease associated with Beta gamma bridging

Hepatic Cirrhosis

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Give 1 Clinical significance or disease associated with alpha 2 globulin band spike

nephrotic syndrome

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Is an alternative test to chemical analysis of serum Total Protein

Refractometry

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A Method/ Test in Total Protein that is based on the principle that Cupric ion complex the groups involved in the PEPTIDE BOND forming a violet colored chelates which is proportional to the number of peptide bonds present and reflects TOTAL protein level at 545 nm

Biuret Method

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Method in Total Protein that has the HIGHEST ANALYTICAL SENSITIVITY

Folin Ciocalteu

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Other name of Folin Ciocalteu

Lowry Method

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A Method/ Test in Total Protein that is based on the principle OXIDATION OF PHENOLIC CPDS. such as tyrosine , tryptophan and histidine

Folin-Ciocalteu

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According to Kjeldahl 1 g of Nitrogen is equivalent to how many grams of Protein?

6.54 g of Protein

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A Method/ Test in Total Protein that is based on the principle that the absorbance of protein at 210nm is due to the absorbance of the peptide bond specific wavelength (280 nm)

UV absorption Method

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It is the reference method for Total Protein but not routinely use

Kjeldahl Method

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Reference value for Albumin

53-65% or 3.5-5.0 g/dl

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Reference value for y-Globulin

12-22% or 0.8-1.6 g/dl

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Spikes of a1 , a2 and B globulin bands indicates

Inflammation

Globulin is Soluble to ______ and _____.

Weak Salt soln. and Hydrocarbon solvents

Albumin is Soluble to _____ and ______.

Water and Concentrated salt soln

Albumin is Insoluble to _______, _______ and ______

Saturated salt soln Highly conc. salt soln Hydrocarbon solvent

Globulin is insoluble to ____, ____ and ______.

Water , Conc and Saturated salt soln.

Is the hereditary absence of albumin ; inability to synthesize albumin

analbuminemia

Most commonly used dye in for Protein

BCG

Most specific dye for Protein

BCP

True or False the presence of penicillin may cause falsely INCREASE RESULT of serum albumin

False it may cause falsely low serum Albumin

It differentiates intrahepatic disorder from extrahepatic obstructive liver disease

Prothrombin time ( Vit. K response Test)

Preferred specimen for Ammonia Determination

Arterial Blood if Venous blood is use tourniquet should be use minimally, and first clenching and relaxing avoided during collection

Formula for Deta Bilirubin

TotalBilirubin - Indirect Bilirubin + Direct Bilirubin

Conversion factor for Bilirubin

17.1

Other name for Hepatic Lobule

Acini

Reference value for Indirect bilirubin

0.2-0.8 mg/dl

Reference value for Direct Bilirubin

0-0.2mg/dl

Reference value for Total Bilirubin

0.2-1.0 mg/dl

Is the presence of two albumin bands instead of a single bnd in electrophoresis

Bisalbuminemia

Reference value for a1-globulin

2.5-5% ( 0.1 - 0.3 mg/dl )

Reference value for a2-globulin

7 - 13% ( 0.6 - 1.0 mg/dl )

A globulin that increases as a non-specific response to inflammation

a1-globulin

Rgt use in Kjeldahl Method

Sulfuric Acid , Tungstic Acid

Rgt use in Biuret Method

Alkaline Copper Sulfate Rochele Salt ( NaK Tartrate) NaOH , KI2

Biuret Method Detects Protein Concentration ___ mg/dl

10 or 15 mg/dl

Folin Ciocalteau Main Rgt

Phosphotungstic molybdic acid or phenol rgt

Rgt use in Salt Fractionation

Sodium Sulfate

Reference value for A/G ratio

1-3.0 : 1

Final Reaction of Evelyn Malloy Method

Pink to purple azobilirubin

Final Reaction of Jendrassik Method

Pink to Blue Azobilirubin

Buffer use in Jendrassik Method

Sodium Acetate

Jendrassik Grof Method is not affected by Hgb up to ____ mg/dl and pH changes

750 mg/dl

Also known as Conjugation Deficit

Crigler - Naljar Syndrome

Also known as Bilirubin Excretion Deficit

Dublin Johnson Syndrome and Rotor Syndrome

Are often the only indication of cell injury in early or localized Liver Disease

Enzyme Test

Visible Icterisia occurs when bilirubin is ___mg/dl

25mg/L

Also known as Bilirubin Transport Deficit

Gilbert's Syndrome

In Prothrombin Time Vit. K is administered INTRAMUSCULARLY , ___mg daily for _ to _ days

10mg for 1-3 days

In adults it is the most common cause of Hyperbilirubinemia

Cholelithiasis

Total Bilirubin is measured in how minutes after adding methanol or caffein soln

15mins

Coomassie brilliant blue dye is for dectection of proteins to as little as ___

1ug

Ninhydrin which develops a ___ color by reacting with primary amines is widely used for detection of peptides and amino acid after ____ chromatography

Violet , Paper

Use for amino acid analyses

Ion Exchange Column

Reference value for Delta bilirubin

Is a familial form of unconjugated hyperbilirubinemia caused by a circulating INHIBITOR OF BILIRUBIN CONJUGATION

Lucey-Driscoll Syndrome

Jaundice is clinically evident when bilirubin level exceeds ____

2mg/dl

Delta Bilirubin is not calculated on neonatal patients on how many days

Specific marker of Pre Hepatic and Post Hepatic Jaundice because it is not affected by hemolysis

Measurement of B2 bilirubin

NM use in the Biuret Reaction

545 nm

Evelyn Malloy Method Diazo A Rgt.

0.1% Sulfanilic Acid + HCl

Evelyn Malloy Method Diazo B Rgt.

0.5% Sodium Nitrite

A critically important neurotransmitter in the CNS that is lowered by Ammonia Toxicity

Gamma Amino Butyric Acid ( GABA )

Common Method use in Ammonia

Nesslerization Reaction , Berthelot , Glutamate Dehydrogenase

In Nesslerization Reaction if N2 is low or moderate what is the end color

Yellow End Color

Nesslerization Reaction if N2/ammonia is high the color

Orange Brown Color

Rgt use in Berthelot Reaction

Phenol , Hypochlorite , Na nitroprusside , Indolephenol blue

5 Common Conditions associated with increase Ammonia

Cirrhosis , Hepatitis , Reye Syndrome , Chronic Renal Disease and Acetaminophen poisoning

Reference value for Uribilinogen in Stool

75-275 ehrlich unit / 100g of feces

Reference value for Uribilinogen in Urine

0.1-1.0 ehrlich units / 2hrs or 0.54 ehrlichs/day

Give 2 BSP Administration Method

Rosenthal White and Mac Donald Method

Dose use in Mac Donald Method

5mg/kg body weight of the px

Specimen collection in Rosenthal White Method

after 5mins and after 30mins

Specimen collection in Mac Donald Method

After 45 mins

Dose use of Rosenthal White Method

2mg/kg body weight of the px

Normal value for Macdonald Method

+/- 5% dye retention

Normal Value for Rosenthal white method

After 5mins = 50 % dye retention | After 30mins = 0% dye retention

Evelyn Mally Diazo Blank Rgt.

1.5% HCl

5 Enzyme Markers of Hepatic Parenchymal Diseases

Amino Transferase , LDH , ICD , OCT , SDH

4 Enzyme Markers of Obstructive Hepatic Disorder with Biliary Tree Involvement

5' - NT , ALP , GGT , LAP