MLAB 2401 Clinical Chemistry

Chapter: Liver Unit Learning Objectives

At the end of this unit, the student should be able to:

1. State the location and size of the liver. 2. Describe blood circulation through the liver. 3. Describe the characteristics of the liver lobule. 4. List and describe in detail at least five (5) functions of the liver. 5. List two (2) ways in which the liver protects the body from foreign substances. 6. Describe how bilirubin is formed. 7. Describe the steps in bile pigment metabolism. 8. State the functions of bile. 9. Identify the enzyme responsible for the conjugation of bilirubin. 10. Differentiate between direct and indirect bilirubin. 11. Describe the pathway of urobilinogen elimination. 12. Explain how urine bilirubin is detected. 13. Define first pass metabolism. 14. Explain why liver function is evaluated through a panel of tests. 15. Define jaundice. 16. Describe three classifications of jaundice, citing examples/causes of each as well as urobilinogen and total, direct, and indirect levels of bilirubin seen in each. 17. Compare/contrast Gilbert's disease and Dubin-Johnson disease 18. State the method used to determine the presence/concentration of bilirubin. 19. Describe the precautions needed when drawing/handling specimens for bilirubin. 20. List and describe functions of the reagents used in the Jendrassik-Groff bilirubin method. 21. State how to calculate indirect bilirubin. 22. State the reference bilirubin values for adults, and newborns. 23. Define kernicterus. 24. Describe the purpose, procedure and reference values of urine urobilinogen. 25. Describe the liver's role in protein metabolism/catabolism. 26. Describe the characteristics/possible causes of Reye's syndrome. 27. Identify the type of virus, route of transmission, incubation periods, and testing options for viral hepatitis A, B, C, and D. 28. Briefly examine the progression in alcoholics from alcoholic fatty liver to alcoholic hepatitis to alcoholic cirrhosis. 29. Describe the following enzymes as they relate to liver function: a. Alkaline phosphatase b. AST (SGOT) c. ALT (SGPT) d. Lactate dehydrogenase e. GGT f. 5' Nucleotidase

4/9/2018