Evaluation of Liver Status and Hepatitis Panel Flashcards

Vocabulary practice flashcards covering liver function tests, bilirubin metabolism disorders, serum enzymes, synthetic functions, Starling's forces, and Hepatitis B viral marker interpretation.

DeRitis Ratio

The ratio of AST to ALT ($\text{AST}/\text{ALT}$) used to differentiate between alcoholic hepatitis ($\text{AST} > \text{ALT}$) and non-alcoholic parenchymal liver disease ($\text{AST} < \text{ALT}$).

Gilbert Syndrome

A pre-hepatic condition characterized by elevated unconjugated bilirubin ($B_1$) due to a transport deficit in the sinusoidal membrane of the hepatocyte and UDP glucuronyl transferase enzyme deficiency ($UDPGT1A1$ mutation).

Crigler-Najjar Syndrome

A pre-hepatic disorder characterized by elevated unconjugated bilirubin ($B_1$) caused by UDP glucuronyl transferase enzyme deficiency ($UDPGT1A1$ mutation).

Dubin-Johnson Syndrome

A post-hepatic condition characterized by elevated conjugated bilirubin ($B_2$) caused by a defective secretory protein (multidrug-resistant protein MRP2) leading to blockade of bilirubin excretion into the canaliculi.

Rotor Syndrome

A post-hepatic disorder presenting with normal unconjugated bilirubin ($B_1$) and elevated conjugated bilirubin ($B_2$) along with elevated total bilirubin.

Bilirubin Summary Table

A panel showing bilirubin profiles across liver conditions: Pre-hepatic conditions present with $\uparrow B_1$, Normal $B_2$, $\uparrow \text{TB}$; Post-hepatic conditions present with Normal $B_1$, $\uparrow B_2$, $\uparrow \text{TB}$; Hepatic conditions present with $\uparrow B_1$, $\uparrow B_2$, $\uparrow \text{TB}$.

Albumin

The most abundant and largest serum protein synthesized by the liver; it binds bilirubin and drugs, serves as a storage molecule in the intravascular space, and provides intravascular oncotic pressure alongside $Na^+$.

Hepatic Encephalopathy

A neurological condition caused by liver impairment and depletion of $\alpha$-ketoglutarate due to excessive ammonia accumulation; early symptoms include sleep disturbance and pruritus, progressing to asterixis, lethargy, stupor, obtundation, and coma.

Asterixis

A prominent motor manifestation of hepatic encephalopathy characterized by a flapping tremor of the hands.

Lecithin Cholesterol Acyltransferase (LCAT)

An enzyme present in higher concentrations in women that removes cholesterol from peripheral tissues to create denser high-density lipoprotein (HDL), mediating reverse cholesterol transport.

$\alpha_1$-Antitrypsin

The most abundant $\alpha_1$-globulin and major plasma protease inhibitor (an acute phase reactant) that inhibits trypsin and elastin; a significant deficiency leads to emphysema.

Ceruloplasmin

The major copper-containing protein in serum and enzyme with the highest concentration in circulation; it promotes copper secretion into plasma and the biliary tract and converts ferrous to ferric iron.

Aspartate Aminotransferase (AST/SGOT)

A parenchymal liver enzyme found in both the cytosol and mitochondria of hepatocytes (and cardiac myocytes) that catalyzes the transamination between aspartate and $\alpha$-ketoglutarate to produce oxaloacetate and glutamate.

Alanine Aminotransferase (ALT/SGPT)

A parenchymal liver enzyme found exclusively in the cytosol of hepatocytes that catalyzes the transamination between alanine and $\alpha$-ketoglutarate to produce pyruvate and glutamate.

Alkaline Phosphatase (ALP)

A canalicular enzyme found on the canalicular side of hepatocytes (as well as bone and placenta) that hydrolyzes phosphomonoesters at pH 9–10; elevated in biliary duct obstruction and bone diseases.

$\gamma$-Glutamyl Transferase ($\gamma$-GT)

A canalicular liver enzyme involved in protein synthesis, glutathione regulation, and transport of amino acids across cell membranes; used to confirm biliary obstruction.

5'-Nucleotidase

A canalicular enzyme marker used specifically to confirm biliary injury.

Amylase

A non-specific pancreatic marker also secreted by salivary glands that increases during inflammation of either the salivary glands or the pancreas.

Lipase

A pancreatic marker specific to the pancreas that breaks down triacylglycerol into fatty acids and diacylglycerol, increasing during pancreatic inflammation.

HBsAg

Hepatitis B Surface Antigen; a marker for acute or recent HBV infection, which indicates a chronic carrier state if persistently positive for $>6\text{ months}$.

Anti-HBs

Antibody to Hepatitis B Surface Antigen; indicates recovery from HBV infection, immunity, past infection, or successful vaccination.

Anti-HBc Total

Total antibody against Hepatitis B Core Antigen; indicates past or current HBV infection and remains present during window period, chronic infection, and recovery.

HBeAg

Hepatitis B Envelope Antigen; indicates a high viral replicative state and high infectivity.

Anti-HBe

Antibody to Hepatitis B Envelope Antigen; indicates a low viral replicative state and low infectivity.

Window Period (Hepatitis B)

The phase in HBV infection where HBsAg and Anti-HBs are both negative, while Anti-HBc (total or IgM) is positive.

Dane's Particle

The complete infectious virion of the Hepatitis B Virus (a DNA virus belonging to the Hepadnaviridae family).

Hepatitis D Virus (HDV)

A defective RNA delta virus that requires HBsAg for replication, causing coinfection (at the same time) or superinfection (in prior HBV infection).

Starling's Forces

Hydrostatic pressure (which pushes water out of a compartment, e.g., blood pressure) and oncotic pressure (which pulls water into a compartment, e.g., maintained by albumin and $Na^+$).