The Liver and Bilirubin Metabolism

Flashcards about Liver and Bilirubin Metabolism

What is the hepatic artery?

The liver is supplied with oxygenated blood from the heart via this artery.

What is the portal system?

This venous blood supply system brings blood from the gastrointestinal tract to the liver.

What are sinusoids?

These are capillary-like vessels within the liver where the portal vein terminates.

What are Kupffer cells?

These cells line the sinusoids of the liver and remove antigenic material, bacteria, old RBCs, toxins, and cellular debris from the portal blood.

What is the Space of Disse?

This is the interstitial space between the hepatic plate and the cell membrane of the sinusoid, where lymph originates.

What is a hepatocyte?

The liver cell that carries out most of the liver functions.

What is the bile canaliculi?

This canal receives bile formed in the hepatocyte.

What are metabolism, excretion, detoxification, storage, and immunologic?

List five major functions of the liver.

What is esterification with glucuronic acid?

This process involves converting lipid-soluble materials into water-soluble compounds, as seen with bilirubin.

What is ammonia?

This toxic substance, derived from bacterial action on amino acids in the large intestine, is converted to urea by hepatocytes.

What are Fibrinogen, Prothrombin, Factors 5, 7, 9, and 10?

Name proteins synthesized by the liver that are essential for coagulation.

What is the breakdown of hemoglobin?

What is the origin of Bilirubin?

What is 120 days?

What is the approximate lifespan of RBCs before they are engulfed by the reticuloendothelial cells (RTE)?

What is that is split off?

What happens to the globin molecule during the breakdown of hemoglobin?

What is microsomal heme oxygenase?

This enzyme breaks open the porphyrin ring of the heme molecule

What is plasma transferrin?

Ferric iron lost from the heme molecule is picked up by this plasma protein for transport.

What is biliverdin?

This green-colored product results from the breakdown of the heme molecule.

What is biliverdin reductase?

This enzyme reduces biliverdin to bilirubin.

What is unconjugated (or indirect) bilirubin?

Unbound bilirubin is known as

What is uridyldiphosphate glucuronyl transferase (UDPG)?

This enzyme transfers a glucuronic acid molecule to bilirubin, converting it to conjugated bilirubin

What is bilirubin diglucuronide (BDG)?

Conjugated bilirubin is also known as

What is urobilinogen?

What is the reduced product of bilirubin, formed by the action of bacterial enzymes in the intestine?

What is kidney?

A portion of urobilinogen, that is not removed by the liver, enters the systemic circulation and is removed by what organ?

What is urobilin (stercobilin)?

It is the partially oxidized form of urobilinogen, excreted in the feces, and gives feces its brown color.

What is delta bilirubin?

This bilirubin fraction is tightly bound to albumin and is not filtered by the kidneys.

What is caffeine-sodium benzoate?

It accelerates the coupling of bilirubin with the diazo reagent in the Jendrassik-Grof method.

What is diazotized sulfanilic acid?

It functions by splitting both bilirubin and bilirubin diglucuronide in the middle to form two dipyrroles.

What is 0.1-1.0 mg/dL?

This is the normal reference value for total bilirubin

What is Ictotest?

This test is four times more sensitive than the reagent strip and can detect as low as 0.05 mg/dL bilirubin.

What is 3.0-5.0 mg/dL?

Jaundice is not noticeable until bilirubin levels reach

What is prehepatic, hepatic, posthepatic?

List the three classifcations of jaundice

What are elevated unconjugated (indirect) bilirubin, increased fecal urobilinogen and an increased urine urobilinogen.

What are key lab results when a patient has Pre-Hepatic Unconjugated Hyperbilirubinemia?

What is Gilbert’s Syndrome?

This mild condition results from a genetic defect in the transport of bilirubin from the sinusoidal blood into the hepatocyte.

What is Crigler-Najjar syndrome?

A severe disease that results from a genetic deficiency in the microsomal enzyme UDPG- transferase.

What is Conjugated Hyperbilirubinemia?

Patient results will show an increase in direct bilirubin, decreased fecal urobilinogen and urine urobilinogen and increased urine bilirubin.

What is Dubin Johnson?

A chronic and benign impairment of conjugated bilirubin biliary excretion.

What is Rotor’s Syndrome?

This syndrome shows an increased total bilirubin and direct bilirubin. It is believed to be an inherited reduction in the activity of an intracellular binding protein, ligandin.

What is chronic alcoholism?

The most common cause of chronic cirrhosis in the United States is

What are Hyperbilirubinemia with bilirubinuria, Elevated AST/ALT activity, Acute phase reactant responses: iron/ferritin elevations and Reduced synthetic function: prolonged prothrombin time, low albumin and cholesterol

There are several laboratory indicators of Hepatocellular Injury including:

What is predominately cholestatic?

If bilirubin and ALP activity are elevated proportionally higher than AST and ALT activities, the pattern is called

What is UDPG-transferase (uridyldiphosphate glucuronyl transferase)?

At birth, this enzyme system is usually not fully developed. It is responsible for converting bilirubin into the diglucuronide form.

What is 20 mg/dL?

The critical concentration of serum bilirubin for possible brain damage in newborns is around