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41 Cards in this Set
- Front
- Back
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lobules of liver
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2
functional unit of liver, house blood supply, portal vein, hepatic artery, lymph vessels and bile ducts |
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parenchymal cells
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aka hepatocytes.
contain mitochondria, powerhouse of cells and for cell metabolism |
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sinusoid capillaries
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where blood and lymph flow through
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kupffer cells
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reticuloendothelial cells
macrophages of RBCs |
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portal triad
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6
house portal vein, hepatic artery, and bile duct |
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Carbohydrate metabolism
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glycogenesis, glycogenolysis, and glycogen storage
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Protein metabolism
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convert ammonia to urea
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cholesterol metabolism
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synthesizes cholesterol, convert cholesterol to HDL, and convert triglycerides to fatty acids
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conjugation, detoxification, and excretion
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converts foreign substances to metabolites for excretion
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vitamin storage
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Vitamins A,D,E,K
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Formation of bile
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stored in gall bladder
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Enzymes
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Stores enzymes, used for metabolism, AFT and ALT
can measure these for liver damage |
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bilirubin metabolism
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Hgb breakdown
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Bilirubin diglucuronide
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conjugated or direct bilirubin
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Kernicterus
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when excess bilirubin in blood gets to brain, seen in babies
unconjugated >15mg/dl |
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Bilirubin + Albumin
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Unconjugated or indirect bilirubin
to big to be excreted by kidney |
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Delta bilirubin
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bilirubin + Albumin covalently bound
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Seen in pt. with normal resutls
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N- bilirubin in serum (unconjugated)
neg- Bilirubin in urine trace- urobilinogen in urine N- urobilinogen in feces |
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Pre hepatic jaundice
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caused by hemolysis
excess unconjugated bilirubin Bilirubin Serum -Indirect=Increased -Direct=N Urine -Neg Urobilinogen -stool= Incr. -urine=Incr. |
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Hepatic jaundice
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conjugation failure, lack of UDP-gt,transport failure, or cell damage
Bilirubin Serum -Indirect=Increased -Direct=Incr Urine -Pos Urobilinogen -stool= variable -urine=Incr. |
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Liver Enzymes increased with Hepatic jaundice
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^^^ AST, ALT, and LD in serum
ALT>AST |
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Post hepatic jaundice
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from obstruction of bile duct or gallstones
Bilirubin Serum -Indirect=Increased -Direct=Increased Urine -Pos Urobilinogen (if complete blockage, Neg) -stool= Decr. to Neg -urine= Decr to Neg |
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Evelyn Malloy Assay
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Bilirubin + Diazo Reagent > Azobilirubin
for Conjugated bilirubin= immediate rxn for Unconj.= add methanol to break bond to albumin |
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Jendrasik-Grof Assay
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Serum+Na acetate (buffer) + Caffeine-Na benzoate (accelerator) + Diazo > Ascorbic acid (stop rxn) + alkaline tartrate (changes ph)
measure Alkaline tartrate in spectrophotometer |
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Total Bilirubin range
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0.1-1.1
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Direct bilirubin range
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0-0.3
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Indirect bilirubin range
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0.1-1.1 adults
Neonates -< 5 days = 18 -5 days = >3 |
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Delta Bilirubin
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0-0.2
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Erhlich's test for urine urobilinogen
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use P-dimethylaminobenzaldehyde
Erhlich's reagent + Na acetate > red color interference= porphobilinogen |
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Ammonia
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formed in GI tract and liver from amino acid breakdown
9-33umol/l |
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Ammonia increased in
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Hepatic coma
terminal stage of cirrhosis Reyes Syndrome |
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enzyme ^ with obstructive jaundice
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Alkaline phosphatase
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enzyme increased with cirrhosis
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GGT
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enzyme increased with hepatitis, also in heart, liver, muscle and RBCs
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AST
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enzyme increased with hepatitis, also in heart, kidney, skeletal muscle, and RBCs, but more liver specific
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ALT
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Wilson's Disease
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body cant rid of Copper due to decreased ceruloplasmin
build up on liver, eyes, and brain eyes show Kayser-Fleishcer rings |
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Dubin Johnson syndrome
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defect in hepatocytes being able to transport conjugated bilirubin to bile, leads to ^ conj. bilirubin
seen with factor VIII def. |
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Gilbert Syndrome
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most common hereditary cause of ^ bilirubin (unconj)
decreased activity of glucuronyltransferase and impaired cellular uptake no treatment but no kernicterus |
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Crigler-Najjar syndrome
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non-hemolytic jaundice caused by defect in UDP-gt
intense jaundice when born and persistent leads to kernicterus |
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Rotor Syndrome
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liver cells are not pigmented and causes non-itching jaundice
^ in conj. bilirubin |
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Biliary Artresia
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Rare, in newborns
common bile duct blocked or absent |
