Liver and Gastric Function Lecture Series-2 Flashcards

Vocabulary flashcards derived from lecture notes on Liver and Gastric function tests, including jaundice classification, enzymatic markers, and specialized diagnostic procedures.

Synthetic Liver Function

The liver's ability to produce plasma proteins like albumin and coagulation factors, as well as cholesterol, triacylglycerol, and lipoproteins.

Detoxification and Excretion

A major liver function involving the conversion of ammonia to urea, and the processing of bilirubin and drug metabolites.

Alanine aminotransferase (ALT)

A marker of liver injury and hepatocellular damage, with normal serum levels typically between $10-35\,IU/L$.

Alkaline phosphatase (ALP)

A marker of cholestasis; very high levels ($10-12$ times the upper limit) are indicative of extrahepatic obstruction like gallstones.

Gamma glutamyl transferase (GGT)

A marker of cholestasis used to detect alcohol abuse, as its levels parallel alcohol intake.

Bilirubin

A bile pigment estimated by the van den Bergh reaction; normal serum levels vary from $0.2$ to $0.8\,mg/dl$.

Unconjugated Bilirubin (Indirect Bilirubin)

A bilirubin-albumin complex (free bilirubin) that typically varies from $0.2-0.7\,mg/dl$ and gives an indirect positive van den Bergh reaction.

Conjugated Bilirubin (Direct Bilirubin)

Water-soluble bilirubin that varies from $0.1-0.4\,mg/dl$ in blood and can be excreted in urine during obstructive jaundice.

van den Bergh reaction

A test where diazotised sulfanilic acid reacts with bilirubin to form purple azobilirubin; it can be direct positive, indirect positive, or biphasic.

Hemolytic Jaundice

A type of jaundice where unconjugated bilirubin is increased and the van den Bergh test is indirect positive.

Obstructive Jaundice

A condition where conjugated bilirubin is elevated (choluric jaundice) and the van den Bergh test is direct positive.

Hepatocellular Jaundice

A condition where both conjugated and unconjugated bilirubins are increased, resulting in a biphasic van den Bergh reaction.

Acholuric Jaundice

A state common in prehepatic jaundice where unconjugated bilirubin is high in the blood but absent in the urine because it is not water-soluble.

Fouchet's Test

A diagnostic procedure used to detect the presence of bile pigments (bilirubin) in urine.

Hay’s Test

A test used to detect bile salts in urine, indicating obstruction in the biliary passages.

Ehrlich's Test

A test used to detect urobilinogen in urine, which is typically increased in hemolytic anemias and absent in obstructive jaundice.

Hypoalbuminemia

A decrease in serum albumin levels, common in chronic liver diseases due to albumin's fairly long half-life of $20$ days.

A/G Ratio Reversal

A condition in cirrhosis where albumin levels decrease and gamma globulins increase, reversing the normal ratio of albumin ($3.5-5\,g/dl$) to globulin ($2.5-3.5\,g/dl$).

AST/ALT Ratio > 2

A diagnostic ratio suggestive of alcoholic hepatitis, hepatitis with cirrhosis, or liver metastases.

Regan Iso-enzyme

A carcinoplacental iso-enzyme of $ALP$ found in about $15\%$ of cases involving carcinoma of the lung, liver, and gut.

Parietal Cells

Gastric cells responsible for the secretion of Hydrochloric acid ($HCl$) and Intrinsic factor.

Chief Cells

Gastric cells responsible for the secretion of pepsinogen.

Basal Acid Output (BAO)

The hydrochloric acid output of the stomach in the absence of all external stimuli.

Zollinger-Ellison Syndrome

A clinical condition characterized by severe hyperacidity where the $BAO/PAO$ ratio is greater than $0.6$.

Achlorhydria

The absence of $HCl$ in gastric juice while pepsin is still present; common in old age and carcinoma of the stomach.

Achylia Gastrica

A condition where both acids and enzymes are absent in gastric secretion, found in advanced carcinoma and gastritis.

Augmented Histamine Test

A stimulation test using $0.04\,mg/Kg$ of histamine to differentiate true achlorhydria and show maximum acid secretion capacity.

Serum Amylase

A pancreatic enzyme ($\alpha\,1-4\text{ glucosidase}$) involving two iso-enzymes (P and S); levels increase within $6-24$ hours in acute pancreatitis.

Macro Amylasemia

A condition where amylase complexes with $IgG$ and $IgA$, preventing urinary excretion and causing persistent serum elevation without symptoms.

Secretin Cholecystokinin Test

A pancreatic function test measuring duodenal aspirate for volume, Bicarbonate (should be >$15\,mmol/L$ at $30$ minutes), and Amylase.

Mucoviscidosis

Also known as fibrocystic disease of the pancreas, where sweat contains increased $Na^+$ and $Cl^-$ (normal $Cl^- < 60\,mmol/L$).

D Xylose Absorption Test

A malabsorption study where oral $D\text{ xylose}$ is given and its excretion in urine is measured; normally $25\%$ is excreted in $5$ hours.

Schilling Test

A diagnostic test using $^{60}Co$ labeled Vitamin $B_{12}$ to identify defective absorption.