Exam 3 Liver Disorders & Lab Analysis

With which Disorder is the following associated with:
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Cirrhosis
What is the main cause of a Fatty Liver?
Alcoholism
What may a Fatty Liver progress to?
Alcoholic Hepatitis
Permanent Cirrhosis
How would you describe Hepatitis?
Inflammation of the liver
What Disorder are the following associated with?
Bacteria, parasites, radiation, alcohol, drugs, chemicals, toxins, Jaundice
Hepatitis
Describe the chemical tests for Hepatitis in association with bilirubin, albumin, AST, and ALT
Increased Direct & Indirect Bilirubin
Positive Urine Bilirubin
Increased ALT & AST
Decreased Albumin
What are the 2 leading causes of Cirrhosis?
Alcohol Abuse
Chronic HCV
Cirrhosis causes what type of abilities of the liver to be reduced?
Synthesizing
What will be increased and decreased in Cirrhosis?
Decreased Albumin
Decreased Clotting Factors
Increased GGT
Increased PT
True or False:
Cirrhosis causes a decrease in albumin and clotting factors which leads to an increase in PT and bleeding disorders
True
What type of electrophoresis pattern is associated with Cirrhosis?
Beta-Gamma Bridging
What is the 12th leading cause of death in the United States of America?
Cirrhosis
What can be attributable to HBV & HCV?
Tumors
What is the marker for tumors due to liver disorders?
AFP
What disorder is usually following a viral or URT infection?
Reye’s Syndrome
Which disorder is associated with aspirin use?
Reye’s Syndrome
Reye’s Syndrome is associated with increased levels of what 3 substances?
Ammonia
ALT
AST
What are most Drug-Induced Disorders of the Liver associated with?
Ethanol
What over-the-counter drug is often associated with Drug-Induced Disorders of the Liver?
Acetaminophen
Which disorder are the following attributed to:
Inherited iron storage disease
Sideroblastic anemia results
Pigmentation to skin
Hemochromatosis
What type of stain helps visualize iron deposits?
Prussian Blue
What method is the following consistent with?
Serum + Diazo Reagent –> Azobilirubin
Conjugated Bilirubin
What method is the following consistent with?
Serum + Accelerator + Diazo Reagent –>
Azobilirubin
Total Bilirubin (Conjugated + Unconjugated)
What methods is the following consistent with?
Azobilirubin + Alk Tartrate –> Blue color at 600 nm
Total Bilirubin (Conjugated + Unconjugated)
& Conjugated Bilirubin
Serum + Diazo Reagent –> ?
Azobilirubin
Serum + Accelerator + Diazo Reagent –> ?
Azobilirubin
Azobilirubin + Alk Tartrate –> ?
Blue color at 600 nm
Malloy & Evelyn method uses what?
Methanol Accelerator
Jendrassik-Grof method uses what?
Caffeine Accelerator
What is Delta Bilirubin?
Conjugated bilirubin bound to albumin
What is Delta Bilirubin seen in?
Severe Liver Obstruction
What does Delta Bilirubin react as in testing?
Conjugated Bilirubin
Who should a Direct Spectrophotometry be used on?
Newborn Serum that does not contain carotinoids
Direct Spectrophotometry – Absorbance at _______ is proportional to concentration
450 nm
Direct Spectrophotometry – After the child is 1 month of age what method do you use?
Jendrassik-Grof Method
What method measures light reflected from the skin?
Transcutaneous Method
Who should the Transcutaneous Method be used on?
Newborn Serum that does not contain carotinoids
Where is urobilinogen detected at?
Urine
Feces
What reagent do you use with urobilinogen to get a colored compound?
Ehrlich’s Reagent
Low levels of what is seen in malnutrition or starvation?
Albumin
A prolonged PT indicates severe what?
diffuse liver disease
Is a prolonged PT a good prognosis or a bad prognosis?
bad prognosis
You will see increased levels of what in Reye’s Syndrome, Cirrhosis, Drug Toxicity, and Hepatoma?
Ammonia
What can you use Ammonia to assess?
Detoxification and Excretion Function of the Liver
Encephalopathy =
Hepatic Coma
Enzymes are considered indicators of ____ _____ rather than cell function?
cell damage
What type of disorder are the following associated with:
ALP: N
GGT: N
AST/ALT: N
Albumin: N
Total Bilirubin: Increased
Direct Bilirubin: N
Urine Bilirubin: Negative
Urine Urobilinogen: Increased
Prehepatic
What type of disorder are the following associated with:
ALP: Increased
GGT: Increased
AST/ALT: VERY Increased
Albumin: N
Total Bilirubin: Increased
Direct Bilirubin: Increased
Urine Bilirubin: Positive
Urine Urobilinogen: N/Increased
Hepatic
What type of disorder are the following associated with:
ALP: N/Increased
GGT: VERY Increased
AST/ALT: Increased
Albumin: Decreased
Total Bilirubin: Increased
Direct Bilirubin: N/Increased
Urine Bilirubin: Various
Urine Urobilinogen: Various
Alcoholic Hepatitis
What type of disorder are the following associated with:
ALP: VERY Increased
GGT: Very Increased
AST/ALT: Increased
Albumin: N
Total Bilirubin: Increased
Direct Bilirubin: Increased
Urine Bilirubin: Positive
Urine Urobilinogen: Decreased
Obstruction
Match the findings with the condition:
Inherited iron storage disease causing sideroblastic anemia
Hemochromatosis
Match the findings with the condition:
Leading cause of cirrhosis; elevated GGT, beta-gamma bridging
Alcoholism
Match the findings with the condition:
Highest levels of AST and ALT seen
Viral hepatitis
Match the findings with the condition:
Liver disease following the flu; elevated ammonia
Reye’s syndrome
Match the findings with the condition:
Alpha fetoprotein used as a marker
Hepatoma
Match the findings with the condition:
Gallstones cause the appearance of pale stools
Obstructive jaundice
Match the bilirubin results with the most likely condition:
Posthepatic jaundice
Increased direct bilirubin, positive urine bilirubin,
negative urine urobilinogen, pale stools
Match the bilirubin results with the most likely condition:
Obstruction
Increased direct bilirubin, positive urine bilirubin,
negative urine urobilinogen, pale stools
Match the bilirubin results with the most likely condition:
Hemolytic anemia
Increased indirect bilirubin; increased urine urobilinogen
Match the bilirubin results with the most likely condition:
Viral hepatitis
Increased direct & Increased Indirect Bilirubin; positive urine bilirubin and urobilinogen
Match the bilirubin results with the most likely condition:
Gallstones
Increased direct bilirubin, positive urine bilirubin,
negative urine urobilinogen, pale stools
Match the bilirubin results with the most likely condition:
Prehepatic jaundice
Incrased indirect bilirubin; increased urine urobilinogen
What over-the-counter drug is highly toxic to the liver?
acetaminophen
What protein is decreased in liver disease, but also decreased in malnutrition and starvation?
Albumin
Name the coagulation test that, when prolonged, may be an indicator of diffuse liver disease.
PT
What liver enzyme is commonly elevated in bile duct obstructions?
ALP & GGT
What is the purpose of the caffeine accelerator in the J-G method for total bilirubin?
Converts indirect bilirubin to water soluble form
How should specimens for bilirubin analysis be stored?
Protect from light
How will hemolysis affect test results?
Falsely decreases
What methodology is commonly used to test for bilirubin in the serum of newborns?
Direct spectro
What is Delta bilirubin?
Direct bilirubin bound to albumin
In what condition will delta bilirubin be elevated?
Severe obstruction
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