Liver Function Test 1

Yves Laure Pimentel · 70問 · 2年前

通報

問題一覧

Liver Is the ____ metabolic organ in the body

CHIEF

Is the CHIEF metabolic organ in the body

Liver

Liver Two types of cells:

hepatocytes and kupfer cells (phagocytic)

. has the capacity to REGENERATE by cell division and hypertrophy of the remaining tissue in case of tissue injury

Liver

to abolish the liver tissue function, more than ____ of the liver must be destroyed

80%

Liver Synthetic

TP, ALB., PT

Liver Conjugation

BILIRUBIN

Liver Excretory and Secretory

BILIRUBIN

Liver Detoxification

AMMONIA

Liver Storage

VIT. A,D,E,K, GLYCOGEN, WATER SOLUBLE VITAMINS (VIT.B COMPLEX)

USE TO CHECK LIVER PROBLEM MARKER OF HEPATO CELLULAR NECROSIS/ HEPATIC NECROSIS

AST, ALT

– most USEFUL indices for assessing liver severity

Albumin and Vit.k Dependent Coag Factors

= False increase for protein

Hemolysis

Plasma levels of total protein is 0.2-0.4 g/dL _______than serum due to fibrinogen

HIGHER

Plasma levels of total protein is _______ HIGHER than serum due to fibrinogen

0.2-0.4 g/dL

Total Protein Determination IT is Used rather than Plasma

Serum

USED TO MEASURE AND QUANTITATE PROTEIN

ELECTROPHORESIS

STANDARD reference method

Kjeldahl Method

Measurement of NITROGEN content

Kjeldahl Method

Kjeldahl Method Measurement of ________content

NITROGEN

Kjeldahl Method 1 gram of nitrogen =

6.54 g PROTEINS

Kjeldahl Method Reagent: ? (digesting agent)- WHICH SEPARATES CARBON NUTRIENT

H2SO4- Sulfuric acid

Curpic Ions + Di peptide +Na+ K+ Tartrate (Rochelle salt) + Potassium Iodide + NaOH = Violet color –_____ nm ? Protein Conc.

545

WHAT METHOD? Curpic Ions + Di peptide +Na+ K+ Tartrate (Rochelle salt) + Potassium Iodide + NaOH = Violet color –545 nm Protein Conc.

Biuret Method

has the HIGHEST analytical sensitivity

Folin-Ciocalteu (Lowry) Method

Folin-Ciocalteu (Lowry) Method (3)

Tyrosine, Tryptophan, and histidine

Tyrosine, Tryptophan, and histidine Method

Folin-Ciocalteu (Lowry) Method

Folin-Ciocalteu (Lowry) Method Reagents

phosphotungstic-molybdic acid or phenol reagent & biuret reagent.

WHAT METHOD USES .Reagents: phosphotungstic-molybdic acid or phenol reagent & biuret reagent.

Folin-Ciocalteu (Lowry) Method

Ultraviolet Absorption - tryptophan, tyrosine and phenylalanine absorbs at ____ nm

280

- tryptophan, tyrosine and phenylalanine absorbs at 280 nm

Ultraviolet Absorption

Ultraviolet Absorption-

tryptophan, tyrosine and phenylalanine absorbs at 280 nm

– for monoclonal spike

Electrophoresis

Electrophoresis MOST IMPORTANT FINDING

MONOCLONAL GAMMOPATHY

globulin flat curve IN WHAT REGION

A1 – globulin flat curve DSE

PULMONARY EMPHYSEMA AND LIVER CIRRHOSIS

– globulin band spike AT

A2 – globulin band spike DSE

NEPHROTIC SYNDROME

small spikes in B region DSE

IDA

alpha-1 & alpha-2 –

acute

– acute

alpha-1 & alpha-2

alpha-1, alpha-2, & gamma -

chronic

- chronic

alpha-1, alpha-2, & gamma

Polyclonal ↑ (all fractions) in gamma with beta-gamma bridging

Beta-gamma bridging

Beta-gamma bridging DSE

HEPATIC CIRRHOSIS

Gamma spike DSE

MULTIPLE MYELOMA/ MONOCLONAL GAMMOPATHY

Polyclonal - Diffuse ↑ in gamma

Gamma spike

Hemolyzed specimen-

↑ beta or unusual band between alpha-2 & beta

Serum + sodium sulfate

Salt Fractionation:

Serum + sodium sulfate

Salt Fractionation: Globulin =

PRECIPITATE

Salt Fractionation: = PRECIPITATE

Globulin

Salt Fractionation Albumin =

SUPERNATANT

Salt Fractionation = SUPERNATANT

Albumin

Turbidimetric & Nephelometric -

Sulfosalicylic and or Trichloroacetic acid -

- Sulfosalicylic and or Trichloroacetic acid -

Turbidimetric & Nephelometric

- measurement of refractive index due to solutes in serum

Refractometry

LIGHT BLOCKED

Turbidimetric

LIGHT SCATTERED

Nephelometric

LIGHT BEND IS? TO HIGH CONCENTRATION

DIRECTLY

REFRACTIVE INDEX FORMULA

REFRACTIVE INDEX =SPEED OF LIGHT IN AIR/ SPEED OF LIGHT IN WATER SOLUTION OR SOLVENT

WHAT IS THE MOST COMMON PROTEIN AFFECTED

ALBUMIN

HYPOPROTEINEMIA/ HYPERPROTENEIMIA BRUTONS AGAMMAGLOBUNEMIA

HYPOPROTEINEMIA

HYPOPROTEINEMIA/ HYPERPROTENEIMIA HYPOGAMMAGLOBUNEMIA

HYPOPROTEINEMIA

Inherited Immunodeficiency IS NOT INVOLVED IN?

ALBUMIN

Intrahepatic vs Extrahepatic

Prothrombin Time (Vitamin K Response Test)

= Loss SYNTHETIC ability of the liver.

Long PT

THIS IS USED TO ACTIVATE CLOT

VITAMIN K

VITAMIN K COAGULATION FACTORS

2,7,9,10

VITAMIN K COAGULATION FACTORS

VITAMIN K COAGULATION FACTORS WHAT BLOOD COMPONENT IS USED?

FRESH FROZEN PLASMA

MARKERS IN POST HEPATIC

ALP/GGT

CONJUGATION AND EXCRETION FUNCTION OF THE LIVER

BILIRUBIN

% urobilinogen –oxidation -> Urobilin/stercobilin

80%

80% urobilinogen –oxidation ->

Urobilin/stercobilin

80% urobilinogen –oxidation -> Urobilin/stercobilin color

orange

recirculates in blood

20% Urobiliongen:

20% Urobiliongen: color

colorless

Urobiliongen: ● Recycled and reexcreted to the

LIVER

Urobiliongen: Filtered to the ___________and excreted in the urine

KIDNEY

Bilirubin production: ____________ mg/day

200-300 mg/day

Bilirubin 1/ Bilirubin 2 Water soluble/polar

Bilirubin 2

Bilirubin 1/ Bilirubin 2 Cholebilirubin

Bilirubin 2

Bilirubin 1/ Bilirubin 2 Direct reacting

Bilirubin 2

Bilirubin 1/ Bilirubin 2 Post hepatic/obstructive and regurgitate bilirubin

Bilirubin 2

Bilirubin 1/ Bilirubin 2 Low affinity for brain tissue

Bilirubin 2

Bilirubin 1/ Bilirubin 2 Water insoluble/nonpolar

Bilirubin 1

Bilirubin 1/ Bilirubin 2 Hemobilirubin

Bilirubin 1

Bilirubin 1/ Bilirubin 2 Indirect reacting

Bilirubin 1

Bilirubin 1/ Bilirubin 2 Prehepatic bilirubin

Bilirubin 1

Bilirubin 1/ Bilirubin 2 High affinity for brain tissue

Bilirubin 1

Bilirubin transport or uptake deficit. Elevated b1

Gilbert’s syndrome

Gilbert’s syndrome - Bilirubin transport or uptake deficit. Elevated ?

- Conjugation deficit, most severe

Crigler-Najjar Syndrome

Crigler-Najjar Syndrome -

Conjugation deficit

Crigler-Najjar Syndrome type 1

deficiency of UDGPT

Crigler-Najjar Syndrome type 2

Partial Deficiency

Crigler-Najjar Syndrome Partial Deficiency what type ?

type 2

Crigler-Najjar Syndrome UDGPT what type ?

Type 1

100

most common bilirubin no morbidity and mortality

other names parasitology

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