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MLT Hepatic 2

Hepatic from lecture

Liver is the major site of storage for iron, glycogen and lipids
liver plays an important role in getting rid of waste products such as bilirubin ammonia and urea
Indicators of metabolic function decreased albumin functions are due to decreased synthesis by the liver
ascites is due to decreased oncotic pressure
increased prothrombin time is increased clotting time
most clotting factors are produced by the liver
ammonia is very toxic to the brain
bilirubin is derived from the breakdown of hemoglobin
a majority of enzymes are intracellular
when tissue damage occurs enzymes are released into the plasma
the most sensitive tests for the liver are enzyme tests
hemoglobin in RBCs forms heme + iron + protein
heme is converted to unconjugated (indirect) bilirubin
unconjugated (indirect) bilirubin is ____ and will attach to ________ to be transported to the __________ insoluble albumin liver
unconjugated bilirubin can not be excreted in the _______ in this form urine
bilirubin is transported to the liver and combines with ______ by the enzyme to form glucuronic acid glucuronyl transerase conjugated (direct) bilirubin
conjugated (direct) bilirubin is water _________ soluble
the majority of conjugated bilirubin produced in the liver is transported into the bile ducts and intestinal tract
in the GI tract bacterial enzymes convert the conjugated bilirubin to uroilinogen
urobilinogen forms ______ which gives the feces its brown color urobilin
Total bilirubin reference range 1.0mg/dL or less
urine bilirubin reference range should be negative
signs and symptoms of jaundice serum bilirubin is greater than 3mg/dL
signs and symptoms of jaundice serum appearance is icteric
prehepatic jaundice is also known as hemolytic jaundice
hepatic jaundice involves the _______ conversion of unconjugated bilirubin to conjugated bilirubin by the liver decreased
posthepatic jaundice is also known as obstructive jaundice
in pre and post hepatic jaundice the function of the liver is not impaired
In prehepatic jaundice an increased destruction of _______ exceeds the ability of the liver to conjugate and excrete bilirubin. RBCs
Causes of prehepatic jaundice are hemolytic anemias transfusion reactions hemolytic disease of newborn
lab findings for prehepatic jaundice include ______ total bilirubin ______ indirect or unconjugated bilirubin ______urine bilirubin ______fecal urobilinogen ______retic count increased: total bilirubin increased: indirect or unconjugated bilirubin negative: urine bilirubin increased: fecal urobilinogen increased: retic count
Hemolytic Disease of the Newborn is usually due to the _____ incompatibility of the mother and child Rh
_____ levels of indirect bilirubin due to excessive breakdown of baby's RBCs increased
when baby's unconjugated bilirubin levels reach greater than ___________ bilirubin is either unbound or loosely bound to albumin 15-20mg/dL
loosely bound of unbound unconjugated bilirubin has a high affinity for brain and CNS tissue
bilirubin deposited in the brain tissue causes irreversible brain damage called kernicterus
monitor baby's _____ as well as ______ levels very closely albumin bilirubin
hepatic jaundice is the failure to conjugate bilirubin
hepatic jaundice has defective transport in or out of hepatocyte
hepatic jaundice lab values _______ depending on disease process vary
hepatic retention jaundice is the defective transport of _______ into _________ bilirubin hepatocyte
hepatic retention jaundice Physiologic jaundice of newborn baby's glucuronyl transferase system not fully developed, especially in premies
hepatic retention jaundice Chronic liver disease liver eventually loses its ability to conjugate
Lab findings for Hepatic Retention Jaundice ____indirect bilirubin urine bilirubin ______ increased negative
Created by: Mwortman