Liver Function

Hepatocytes, contain mitochondria in liver

-cells of the RES system
-macrophage old RBCs
-filter bateria and other small foreign proteins out of the blood

the portal triad consists of...

functional unit of liver

Basic functions of the liver include (8)

Hgb is broken down into unconjugated bilirubin by the...

bilirubin-albumin complex

indirect bilirunin is made into direct bilirunin by the

albumin that travels through the bloodstream

bilirubin diglucuronide

Bilirubin diglucuronide is broken down by what process

bilirubin diglucuronide converted to

urobilinogen excretion

bilirubin in body turning blood and skin a yellowish color

unconjugated bilirubin passes the BBB and enters through the brain tissue

yellow, shiny serum

a type of conjugated bilirubin that is bound to albumin covalently and liver is unable to seperate

Bilirubin
-normal serum level
-negative in urin
Urobilinogen
-urine trace amounts
-stool is normal

Why is unconjugated bilirubin not excreted through the kidney?

this jaundice is the cause of something before the liver

jaundice as a result of liver disorder

jaundice as a result of something past the liver, usually an obstruction

Serum Bilirubin
--indirect- increased
--direct- normal
Urobilinogen
--urine-increased
--stool- increased

pre- hepatic jaundice is usually a result of

In hepatic jaundice, the type of bilirubin you see is...

Bilirubin
-serum
--indirect- increased
--direct- increased
--urine- positive
Urobilinogen
--urine-slightly increased
--stool- variable

hepatic jaundice is a result of

Bilirubin
-Serum
--indirect-increased
--Direct- increased
--urine- positive
Urobilinogen
--Stool- decreased to normal
--urine- decreased to normal

Post hepatic jaundice is a result of

Name the four types of bilirubin

-Soluble in water and alcohol
-low affinity for brain tissue
-positive presence in urine

-soluble in alcohol, insoluble in water
-high affinity for brain tissue
-negative presence in urine

-bilirubin+ diazo rgt--> azo bilirubin
-conjugated gives an immediate reaction
-unconjugated must have albumin bond broken with methanol

Na acetate buffer+Caffeine-Na benzoate accelerator(omit in direct tube) +diazo for direct meausrement then use ascorbic acid to stop reaction and alkaline tartate to change pH and read in spectrophotometer

-conjugated and unconjugated use a mordant to bind bilirubin
-measured at two wavelengths
-Delta bilirubin is calculated by subtracting conjugated and unconjugated from total

-Serum + Total bili reagent ; incubate for 5-10 min.; read in spectophotometer
-DMSO solubilizes the indirect form of bilirubin)

- used mainly on newborns
- Serum color is read at two wavelengths (one for hgb, one for bilirubin)
-subtract hbg abs. from bili abs.

HPLC chromatography seperates what

0.1-1.1 or 0.2-1.2 mg/dL

0.0-0.3 mg/dL

0.1-1.1 mg/dL

>3.0 mg/dL in after 5 days
>18.0 mg/dL in >5days

0.0-0.2 mg/dL

Urine bilirubin test formula

0.1-1.1 mg/dL

>3.0 mg/dL in after 5 days
>18.0 mg/dL in >5days

0.0-0.2 mg/dL

Urine bilirubin test formula

What does Erhlich's reagant consist of

name the 5 liver enzymes

greatly increased in obstructive jaundice

Greatly increased in cirrhosis

Greatly increased in hepatitis

Toxic hepatitis can be caused by

-autosomal recessive genetic disorder that prevent's the body from getting rid of extra copper
-decreased levels of ceruloplasmin
-copper builds up in liver, brain, eyes, other organs
-Kayser-Fleischer rings

Two hereditary defects in unconjugated forms are?

Two hereditary defects in conjugated forms are?

-benign autosomal recessive disorder
-defect in the ability of hepatocytes to transport conjugated bilirubin into the bile
- no increase in liver enzymes
-has a factor VIII deficiency

-Most common hereditary cause of increased bilirubin
-reduced activity of enzyme glucuronyltransferase
-Main symptom is jaundice caused by mild levels of unconjugated bilirubin in the bloodstream
-does not require treatment
-does not result in kernicterus

-inherited form of non-hemolytic jaundice
- intense jaundice appears in the first days of life and thereafter
- Type 1 is characterized by a serum bilirubin usually >345 umol/L (mainly unconjugated)
-leads to brain damage in infants- kernicterus

-benign autosomal recessive disorder
-similar to dubin- johnson
-liver cells are not pigmented
-main symptom is a non- itching jaundice

-rare condition in newborn infants in which the common bile duct between the liver and small intestine is blocked or absent
-characterized by obliteration of discontinuity of the extra- hepatic bilary system
-results in obstruction to bile flow

The bilirubin in a urinalysis of a patient w/ no hepatic problem ?

All enzymes are increased, especially LD

ALP and AST are most highly increased, Total bilirubin will be increased too

-imparied cellular uptake
-defective conjugation (lack of UDP-glucuronyl
-abnormal secretion of bilirubin from hepatocytes

ALP>AST is a marker for

-inherited condition
-lack of transport molecule into bile canal causing defective excretion by liver cells
-produces an obstructive liver disease that reduces biliary excretion of conjugated bilirubin
-causes toxicity of kidney

tumors in the liver are usually related to...

Which liver enzyme is more liver specific

if bile duct is obstructed or bile canals inflamed, then hepatocytes become inflammed too. enzyme results are..

if true hepatic disease, then enzyme results are...

in obstruction, enzyme results are

If obstruction or inflimmation of bile ducts, enzyme results are

increase in AST and ALT suggests

Most intense increase in ALP is seen in