LIVER FUNCTION – CLINICAL CHEMISTRY 2

Gross Anatomy of Liver TWO BLOOD SUPPLY SOURCES OF LIVER:

1. Hepatic Artery
2. Portal Vein

TWO MAJOR CELL TYPES IN LIVER:

1. Hepatocytes
2. Kupffer Cells

BIOCHEMICAL FUNCTIONS OF THE LIVER

FOUR MAJOR FUNCTIONS OF THE LIVER:

1. Excretion and Secretion

2. Synthesis
3. Detoxification
4. Storage

REMEMBER: What is the major heme waste product:

ANSWER: Bilirubin

MAJOR COMPOSITION OF BILIRUBIN (3)

1. Bile Acids or Salts *and other substances

2. Bile Pigments
3. Cholesterol 1
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THREE (3) THINGS THAT THE LIVER DOES WITH CARBOHYDRATES: LIVER FUNCTION ALTERATIONS DURING DISEASE

1. Utilizing Glucose for Cellular Energy Requirements THREE CLASSIFICATIONS OF JAUNDICE BASED ON SITE OF DISORDER:
2. Glucose Circulation for Peripheral Tissue Use
1. Prehepatic Jaundice
3. Glycogenesis
2. Hepatic Jaundice
THREE (3) NONSUGAR CARBON SUBSTANCES: 3. Post hepatic Jaundice

1. Pyruvate (3) HEPATIC JAUNDICE WITH ELEVATED UNCONJUGATED BILIRUBIN:

2. Lactate
1. Gilbert Syndrome
3. Amino Acids
2. Crigler-Najjar Syndrome
TWO (2) MECHANISMS OF DETOXIFICATION: a) Type 1
b) Type 2
1. Inactivation of Compound by Binding 3. Physiologic Jaundice of the Newborn
2. Chemical Modification of Compound for Excretion

CHEMICAL REACTIONS IN DRUG-METABOLIZING SYSTEM:

(2) HEPATIC JAUNDICE WITH ELEVATED CONJUGATED BILIRUBIN:
1. Oxidation
2. Reduction 1. Dubin-Johnson Syndrome
3. Hydrolysis
2. Rotor Syndrome
4. Hydroxylation
5. Carboxylation
6. Demethylation
(3) LIVER INJURY STAGES:

1. Alcoholic Fatty Liver

2. Alcoholic Hepatitis

3. Alcoholic Cirrhosis

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LIVER FUNCTION TESTS HEPATITIS V.S. BILIARY OBSTRUCTION

BILIRUBIN ASSAY

1. Evelyn-Malloy Method
2. Jendrassik-Grof Method

ENZYMES

TWO (2) MOST CLINICALLY USEFUL ENZYMES

1. Aminotransferase

2. Phosphatase
a) Alkaline Phosphatase
b) 5’ – Nucleotidase
c) Gamma-Glutamyltransferase
d) Lactate Dehydrogenase

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HEPATITIS B

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HEPATITIS B

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