LIVER FUNCTION TESTS III
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it helps to monitor the decline of serum bilirubin following surgical removal of gallstones a. uncojugated bilirubin b. conjugated bilirubin c. delta bilirubin d. jaundice
Delta Bilirubin • tightly bound to ALBUMIN • has a LONGER HALF LIFE than other bilirubin • it is formed due to PROLONGED ELEVATION OF CONJUGATED BILIRUBIN IN BILIARY OBSTRUCTION • it helps to monitor the decline of serum bilirubin following surgical removal of gallstones • reference value: <0.2 mg/dL
which of the classification of jaundice is caused by Failure of bile to flow to the intestine/ impaired bilirubin excretion a. pre hepatic jaundice b. post hepatic jaundice c. hepatocellular combined jaundice
• pre hepatic - caused : too much destruction of RBCs • Post hepatic - caused : Failure of bile to flow to the intestine/ impaired bilirubin excretion • hepatocellular combined jaundice - caused : hepatocyte injury caused by VIRUSES, ALCOHOL AND PARASITES
Which of the derangement of bilirubin metabolism is bilirubin transport deficit a. Gilbert’s bilirubin b. Crigler - Najjar syndrome c. dubin johnson syndrome d. lucey driscoli syndrome
gilbert’s syndrome - Bilirubin TRANSPORT bilirubin • characterized by IMPAIRED CELLULAR UPTAKE BILIRUBIN • LAB RESULT : elevated B1
Which of the derangement of bilirubin metabolism is blockage of the excretion of bilirubin into the canaliculi a. Gilbert’s bilirubin b. Crigler - Najjar syndrome c. dubin johnson syndrome d. lucey driscoli syndrome
Dubin Johnson syndrome and Rotor syndrome • Bilirubin EXCRETION deficit • blockage of the excretion of bilirubin into the canaliculi, caused by hepatocyte membrane defect ; hereditary disorders • intense dark pigmentation in the liver due to accumulation of lipofuchsin pigment • lab result : elevated TOTAL BILIRUBIN AND B2
familial form of unconjugated hyperbilirubinemia a. Gilbert’s bilirubin b. Crigler - Najjar syndrome c. dubin johnson syndrome d. lucey driscoli syndrome
Lucey driscoli syndrome • familial form of unconjugated hyperbilirubinemia caused by a circulating inhibitor of bilirubin conjugation • elevated b1
measurement of _________ is sensitive and specific marker for hepatic and post hepatic jaundice because it is not elevated with hemolytic anemia a. B1 b. B2 c. delta bilirubin d. total protein
measurement of B2/ CONJUGATED BILIRUBIN is sensitive and specific marker for hepatic and post hepatic jaundice because it is not elevated with hemolytic anemia
bilirubin standard solution is made from __________ a. B1 b. B2 c. delta bilirubin d. total protein
bilirubin standard solution is made from B1 / UNCONJUGATED BILIRUBIN
VISIBLE ICTERSIA OCCURS WHEN BILIRUBIN IS ___ A. >3MG/DL B. <3MG/DL C. >25 MG/DL D.>2-3 MG/DL
VISIBLE ICTERSIA OCCURS WHEN BILIRUBIN Is > 25mg/dL jaundice bilirubin levels exceed 2-3 mg/dL
coupling accelerator for evelyn and malloy method a. albumin b, caffeine sodium benzoate c. methanol d. sodium acetate
evelyn and malloy method coupling accelator : METHANOL final reaction : pink to PURPLE azobilirubin
coupling accelerator for jendrassik and grof a. albumin b, caffeine sodium benzoate c. methanol d. sodium acetate
Jendrassik and Grof coupling accelerator : Caffeine Sodium Benzoate Buffer : sodium acetate ascorbic acid : terminates the initial reaction and destroy the excess diazo reagent final reaction : pink to BLUE azobilirubin
most commonly used bilirubin assay a. evelyn and malloy method b. jendrassik and Grof
Jendrassik and Grof most commonly used popular technique for the discreet analyzers more sensitive than evelyn and malloy
which of the following does not belong in increased b1 a. biliary obstruction b. gilbert’s syndrome c. lucey Driscoll syndrome d. G6pd
increased B1 1. Gilbert's Syndrome 2. Crigler najjar syndrome 3. hemolytic anemia 4. hepatocellular disease 5. lucey driscoll syndorme 6 G6pd answer: biliary obstruction ( increasd in B2)
which of the following does not belong in increased b2 a. biliary obstruction b. gilbert’s syndrome c. biliary atresia d. dubin johnson syndrome
increased B2 ( BBDaPA) • Biliary obstruction • biliary atresia • dubin - johnson syndrome • pancreatic cancer • alcohol and viral hepatitis
coloreless end product of bilirubin metabolism that is oxidized by intestinal bacteria to the brown pigment urobilin a. total protein b, albumin c, bilirubin d, urobilinogen
urobilinogen - COLORLESS END PRODUCT of bilirubin metabolism that is oxidized by intestinal bacteria to the brown pigment urobilin
what is the method in Urobilinogen a. ehrlich method b. mac donald method c. rosenthal white method d. nota
Bromsulfonthalein (BSP) dye excretion test • rosenthal white (double collection method) • mac donald method (single collection method) urobilinogen methods: EHRLICH’S METHOD (p- dimethyl aminobenzaldehyde reagent)
it is used to assess the extent of liver damage and differentiate HEPATOCELLULAR FROM OBSTRUCTIVE DISEASE a. Enzyme tests b. ammonia c. total protein b. bilirubin
enzyme test • it is used to assess the extent of liver damage and differentiate HEPATOCELLULAR (functional) FROM OBSTRUCTIVE DISEASE (mechanical) • only indication of cell injury in early or localized liver disease
which of the ff enzymes is secreted in the liver a. ggt b. lap c. alp d. aota
enzymes secrteted in the liver GGT OCT ALP LDH LAP AMINOTRANSFERASES (AST, ALT) 5- NUCLEOTIDASE nag GOAL ko ay makabili nang LANd