SEM 1 - (CC) LIVER FUNCTION TEST 3

Question 1

It involves enzyme and ammonia tests.

Answer 1

TEST FOR DETOXIFICATION FUNCTION

Question 2

Any injury to the liver that results in cytolysis and necrosis causes the ______ of various enzymes.

Answer 2

liberation

Question 3

______ are often the only indication of cell injury in early or localized liver disease.

Answer 3

Enzyme tests

Question 4

The ______________ are mostly assessed when there is hepatocellular injury caused by toxins such as drugs and alcohol.

Answer 4

aminotransferases (ALT and AST)

Question 5

Both ALT and AST are increased in ______ and ________ with ___ having higher plasma levels.

Answer 5

drug and alcohol hepatoxicity ; AST

Question 6

It arises from the deamination of amino acids, which occursmainly through the action of digestive and bacterial enzymes (bacterial proteases, ureases, and amine oxidases) on proteins in the intestinal tract.

Answer 6

Ammonia

Question 7

It is only metabolized in the liver through the enzymes of the Krebs-Henseleit or urea cycle.

Answer 7

Ammonia

Question 8

The liver normally removes most of this NPN via the portal vein circulation and converts it to urea which is then eliminated by the kidneys (urine)

Answer 8

Ammonia

Question 9

_____ is the only organ responsible for ammonia detoxification via the urea cycle.

Answer 9

Liver

Question 10

also released from metabolic reactions that occur in skeletal muscles during exercise

Answer 10

Ammonia

Question 11

what are the disease associated with increased levels of Ammonia?

Answer 11

Cirrhosis, hepatitis, Reye’s syndrome, chronic renal disease, and acetaminophen poisoning

Question 12

ref. range for Ammonia

Answer 12

19-60 ug/dL (11-35 mmol/L)

Question 13

Diagnostic Significance of Ammonia(NH3)

• For the diagnosis of _______ (hepatic coma) and _______

Answer 13

hepatic failure and Reye’s Syndrome

Question 14

In severe liver disorder, NH3 accumulates and reaches the systemic circulation, which is then converted to ______ in the brain, thus compromising the Kreb’s cycle leading to ____due to lack of ATP for the brain.

Answer 14

glutamine ; coma `

Question 15

An elevated plasma NH3 is _______ and is often associated with _____

Answer 15

neurotoxic ; encelopathy

Question 16

An important mechanism by which ammonia can cause toxicity to the CNS is its ability to lower the concentration of ____________, a crucial neurotransmitter in the CNS, by reacting with
glutamic acid producing glutamine via reversal of the glutaminase-catalyzed reaction.

Answer 16

gamma-aminobutyric acid (GABA)

Question 17

Ammonia also increases central nervous system ___ environment

Answer 17

pH

Question 18

Plasma levels of ammonia, though an NPN, are not dependent on renal function but on _______, thus, NH3 is not useful in the study of kidney diseases.

Answer 18

liver function

Question 19

In panhepatic cirrhosis, there is 80% loss of hepatocytic function, thus plasma ammonia is _______

Answer 19

elevated

Question 20

(Measurement of Ammonia)

______ is a source of contamination which leads to false elevated concentrations.

Answer 20

Smoking

Question 21

(Measurement of Ammonia)

Prolonged standing of the specimen increases ammonia level due to enzymatic deamination of labile amides such as ______

Answer 21

glutamine

Question 22

(Measurement of Ammonia)

Preferred sample: ______

Answer 22

Arterial blood

Question 23

(Measurement of Ammonia)

Sample requirement:

Answer 23

Heparin or EDTA plasma (sample kept in ice water immediately)

Question 24

(Measurement of Ammonia)

Common method:

Answer 24

Glutamate Dehydrogenase

Question 25

(Measurement of Ammonia) Major interference:

Answer 25

Hemoglobin (avoid hemolyzed blood, false increased)

Question 26

(Measurement of Ammonia) Venous blood may be considered as an alternative to arterial blood, provided, tourniquet application should be less than ___ minute without repeated ______ prior to and during sample collection.

Answer 26

one ; fist clenching

Question 27

(Measurement of Ammonia) Specimens should be kept in ___ water until separation of cells from plasma occurs

Answer 27

ice

Question 28

Nitrogen ion in a protein-free filtrate (PFF) of the specimen is converted to ammonia using hot concentrated sulfuric acid in the presence of catalyst.

Answer 28

Digestion (Kjeldahl) Method

Question 29

Digestion (Kjeldahl) Method Catalyst:

Answer 29

Copper sulfate, mercury, and selenium

Question 30

Nesslerization Reaction symbol of Dimercuric potassiumiodid

Answer 30

K2Hg2I2:

Question 31

Nesslerization Reaction ___ end color: Nitrogen content in the sample is low to moderate ______ end color: Nitrogencontentis high

Answer 31

Yellow Orange brown

Question 32

itis currently the most commonly method formeasurement of ammonia. It involves the formation of Schiff base between ammonia and the alpha-keto producing glutamine which is primary amine at 340 group of alpha-ketoglutarate, then NH3 + a-ketoglutarate + NADPH Pathophysiology of Hepatic Cirrhosis nm in the presence of GLDH.

Answer 32

Glutamate Dehydrogenase (GLDH)

Question 33

(Pathophysiology of Hepatic Cirrhosis) __________ is the terminal phase of hepatic injuries that make the liver ineffective at completing all the vital fuctions.

Answer 33

liver cirrhosis

Question 34

(Pathophysiology of Hepatic Cirrhosis) It rarely causes signs and symptoms in its inception, but as liver function deteriorates, all the clinical manifestations are evident.

Answer 34

Hepatic Cirrhosis

Question 35

It is a clinical condition in which a scar tissue replaces a normal, healthy liver tissue.

Answer 35

Hepatic Cirrhosis