Liver Function

Question 1

Describe the liver

Answer 1

Often called the train station
* Consists of a right and left lobe
* Lobules – functional unit and consist of hepatocytes (liver cells)
* Blood moves through the liver via sinusoids
* Small ducts converge to form R and L hepatic duct
* Hepatic ducts exit liver via common hepatic duct

Question 2

Roles of the liver

Answer 2

1. metabolism
2. digestion
3. hormonal
4. detoxification

Question 3

Functions of the liver

Dont know if this needs to be known??

Answer 3

Question 4

Metabolic role of the liver

Answer 4

• CHO
• protein
• lipid
• vitamin storage
• mineral storage

Question 5

Role of the liver with CHO metabolism

Answer 5

• gluconeogenesis
• glycogen synthesis and breakdown

Question 6

Role of the liver with protein metabolism

Answer 6

• synthesis of serum proteins
• synthesis of blood clotting factors
• deamination/transamination to produce non-essential aa
• remove and detoxify ammonia through urea synthesis

Question 7

Role of the liver with lipid metabolism

Answer 7

• synthesis of cholesterol, phospholipids, TG’s
• breakdown of fatty acids for energy production

Question 8

What vitamins are stored in the liver?

Answer 8

• B vitamins
• Fat soluble vitamins

Question 9

What minerals are stored in the liver?

Answer 9

• Fe
• Cu
• Mg
• Zn

Question 10

Role of the liver in digestion

Answer 10

• Production of bile: fat and fat soluble vitamin absorption
• conjugation and excretion of bilirubin (breakdown product of RBCs) to prevent jaundice due to build up

Question 11

What is given to infants with bile atresion?

Answer 11

MCFAs because they dont need as much bile to absorb it

Question 12

Hormonal and deotoxification role of liver

Answer 12

• Conjugation and excretion of: aldosterone & alcohol dehydrogenase hormone
• Enzymes in the liver detoxify: alcohol, drugs, poisons

Question 13

Signs and Symptoms of Liver Disease

Answer 13

• Mild abdominal pain and generalized fatigue are the most common sign (improper storage of glycogen).
• Anorexia
• Muscle wasting (sarcopenia)
• Wt loss
• Jaundice: potential for malabsorption in these conditions (typically end stage)
• Hypoglycemia or hyperglycemia
• Anemia (moderate to severe)
• portal hypertension
• Esophageal varices
• Ascites
• Hypoalbuminemia
• Encephalopathy

Question 14

AST and ALT in liver disease

Answer 14

Elevation of AST and ALT is not reflective of liver damage
* ALT can be elevated due to muscle physiology

Question 15

What are esophageal varices

Answer 15

a swollen artery, vein or lymph vessel in the esophagus that can burst open and bleed creating a holeinto other tissue

Question 16

What is encephalopathy?

Answer 16

Inability to synthesis blood urea nitrogen and can die if ammonia gets high enough

Question 17

Liver function tests

Answer 17

• ALT (Alanine aminotransferase/transaminase) (very sensitive to hepatic damage)
• AST (aspartate transaminase/aminotransferase) or SGOT (serum glutamic-oxaloacetic transaminase)
• ALP (serum alkaline posphatase)
• Ammonia
• Albumin-may not be a good marker of visceral protein status in liver disease
• Bilirubin
• BUN
• Prothrombin time (PTT)

Question 18

ALT tests normal vs. liver disease

Answer 18

• Normal Male: 10-40 U/L
• normal Female: 7- 35U/L
• liver disease: ↑↑

Question 19

AST test normal vs. liver disease

Answer 19

• normal: 10-30 U/L
• liver disease: ↑

Question 20

ALP test normal vs. liver disease

Answer 20

• normal: 10-30 UL
• liver disease: ↑

Question 21

Ammonia test normal vs. liver disease

Answer 21

• normal: 15-45 ug N/dL
• liver disease: ↓

Question 22

albumin test normal vs. liver disease

Answer 22

• normal: 35-48 g/L
• liver disease: ↓

Question 23

Bilirubin test normal vs. liver disease

Answer 23

• normal: 0.3-1.2 mg/dL
• liver disease: ↑

Question 24

BUN test normal vs. liver disease

Answer 24

• normal: 6-20 mg/dL
• liver disease: ↓ or normal

Question 25

PTT test normal vs. liver disease

Answer 25

* noraml 10-13 sec * liver disease: prolonged