Chem ppt flashcards, Unit 4



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should NOT have severe chronic lung disease, inoperable ischemic heart disease, active infective liver or immunological disease, chronic infection like tuberculosis, pre-existing malignancy or lower urinary tract dysfunction




How is total body water (TBW) distributed?

Two- thirds of total body water(TBW) is distributed into intracellular fluid (ICF) compartment, and one third into the extracellular fluid (ECF) compartment. These compartments are separated by plasma membrane.

How is the ECF subdivided?

  • Interstitial fluid compartment (≈75% of ECF)

Intravascular fluid compartment (≈25% of ECF): these fluid compartments are separated by capillary endothelium

What is the average adult blood volume and plasma volune?

The average adult has ≈ 5.0 L blood volume (intravascular compartment) and a plasma volume of ≈ 3.0 L when the hematocrit is ≈40%.

What are some factors that influence water and electrolytes in the human body?

Factors that influence water and electrolyte requirements include activity of the individual, environment, and disease.

How much water do adult humans need to intake?

On average, an adult must take in ≈ 1.5 to 2.0 L of water daily to maintain fluid balance

What are some primary cationic electrolytes?

Na+, K+, Ca2+, and Mg2+


What are some primary anionic electrolytes?

Cl, HCO3, HPO42–, SO42–, organic ions, and negatively charged proteins

What are the major ions in the ECF?

Na+, Cl, and HCO3

What are the major ions in the ICF?

K+, Mg2+, organic phosphates, and protein

What causes active transport?

  • The unequal distribution of ions is due to active transport of Na+ from inside to outside the cell against an electrochemical gradient.

ATP which is present in most cell membranes is required for active transport.

What is an example of an active transport system in the human body?

Na + /K + -ATPase, an ubiquitous Na-H exchanger (often referred to as an antiporter), actively pumps H+ out of the ICF in exchange for Na+. This is critical for maintaining intracellular pH homeostasis.

Define active transport?

  • Can be defined as a process in which a molecule is carried from a region of lower concentration to a region of higher concentration against the concentration gradient.

Because of the resistance which occurs during this process, it needs energy. It is thus named as "active“ transport because of its one vital ingredient, which is the energy that is required for this process.

Define passive transport?

  • Can be defined as a process in which a molecule is carried from a higher concentration to a lower concentration along the concentration gradient and therefore, it faces no resistance.

Because of the lack of persistence, passive transport requires no energy for this purpose to take place and hence the name "passive“ transport.

What is the difference between an active and a passive transport?

  • The main difference between active transport and passive transport is the fact that active transport needs energy which is known as Adenosine Triphosphate (ATP).

  • Active transport requires energy whereas passive transport does not.

Active transport involves the carrying of a molecule or a solute against a concentration gradient; Passive transport involves the carrying of a molecule or a solute along the concentration gradient.

What role does sodium have in kidney function?

  • Kidney function

    • Proximal convoluted tubules

      • 70% to 80% of filtered sodium is actively reabsorbed

      • water and chloride passively reabsorbed

    • Descending loop of Henle

      • water but not electrolytes is passively absorbed

    • Ascending loop of Henle

      • chloride is actively reabsorbed with the sodium following

    • Distal convoluted tubules

secretion of aldosterone, renin and antidiuretic hormone

What role does sodium have in hyponatremia?

  • Defined as a decrease plasma sodium concentration (<130 to 135 mmol/L)

  • Hypo-osmotic hyponatremia: Hyponatremia characterized by low plasma sodium concentration, low calculated or measured osmolality.

  • Depletional hyponatremia: Hyponatremia due to excess loss of sodium

Dilutional hyponatremia: Hyponatremia due to increased ECF volume

What role does sodium have in hyperosmotic hyponatremia?

  • Hyponatremia that occurs in the presence of increased quantities of others solutes in the ECF as a result of an extracellular shift of water or on intracellular shift of Na+ to maintain osmotic balance between ECF and ICF compartments.

The most common type is seen in severe hyperglycemia.

What role does sodium have in isomotic hyponatremia?

A pseudohyponatremia caused by an electrolyte exclusion effect characterized by decrease in measured Na+ concentration but with normal plasma osmolality, glucose and urea levels.

What role does sodium have in hypernatremia?

  • Increase plasma sodium concentration (>150 mmol/L)

Hypovolemic hypernatremia: Hypernatremia characterized by decrease ECF caused by renal or extra-renal loss of hypo-osmotic fluid, leading to dehydration.

What role does sodium have in Hypovolemic hypernatremia?

  • Hypernatremia in the presence of excess total body water indicating a net gain of water and sodium, with sodium gain in excess of water.

Commonly seen in hospital patients receiving hypertonic saline or sodium bicarbonate.

What is Normovolemic hypernatremia?

Hypernatremia in the presence of normal ECF volume seen in diabetes insipidus.

What role does potassium have in Hypokalemia?

  • Decrease in extracellular potassium (<3.5 mmol/L) either due to redistribution of extracellular K+ into ICF, or true K+ deficits, caused by decreased intake or loss of potassium rich body fluids

  • characterized by muscle weakness, irritability and paralysis. Concentrations less than 3 mmol/L are often associated with marked neuromuscular symptoms.

At lower concentrations, tachycardia and cardiac conduction defects are apparent by ECG (flattened T waves) and has been known to lead to cardiac arrest.

What role does potassium have in Hyperkalemia?

  • Increased plasma K+ (>5.0 mmol/L) which may be caused by redistribution, increased intake, or increased retention

pre-analytical conditions such as hemolysis, thrombocytosis, and leukocytosis have been known to cause marked pseudohyperkalemia

Following are characteristics of what type of electrolyte disorder?

Decreased chloride levels

causes of hypokalemia will parallel causes of hyponatremia

respiratory acidosis, accompanied by increased HCO3-, is another common cause of decreased Cl with normal Na



Hypochloremia

Hyperchloremia is defined as?

Increased Chloride levels

Following are characteristics of what type of electrolyte disorder?

similar to increased Na+ concentrations, as seen in dehydration, prolonged diarrhea with loss of sodium bicarbonate, diabetes insipidus, and overtreatment with normal saline solutions



Hyperchloremia

Hyperchloremia is seen in respiratory alkalosis or respiratory acidosis?

Seen in respiratory alkalosis because of renal compensation for excreting HCO3-.

How much of the total carbon dioxide of plasma is made up of bicarbonate ions?

Bicarbonate ions makeup all but ≈2 mmol/L of the total carbon dioxide of plasma

What is the characteristic of acid-base imbalances?

Alterations in HCO3- and CO2 dissolved in plasma

What is the total carbon dioxide (CO2) content of plasma consist of?

Carbon dioxide dissolved in an aqueous solution (dCO2), CO3 loosely bound to amine groups in proteins (carbamino compon), HCO3-, and very small quantities of CO32- ions and carbonic acid acid (H2CO3).

What is the normal blood PH?

7.35 – 7.45

Alkalemia (alklaosis) is defined as?

an arterial blood pH > 7.45

True or False

Acids - are chemical substances that donate protons (H+ ions)



True

True or False

Bases - are chemical substances that accept protons



True

PH of a solution is defined as?

negative logarithm of hydrogen ion activity (pH = - log aH+)

What is the average pH of blood (7.40) corresponds to?

a hydrogen ion concentration of 40 nmol/L

What PK is defined as?

Is the pH at which an acid is half dissociated, existing as equal proportions of acid and conjugate base.

What is PK values for acids?

Acids have pK values <7.0

What is PK values for bases?

Bases have pK values > 7.0

What is the most important buffering system in the body?

Bicarbonate/carbonic acid buffer system

What is the effectiveness of Bicarbonate/carbonic acid buffer system?

is based on the fact that the lungs are able to readily dispose of or retain CO2

----------are able to increase or decrease the rate of reclamation of bicarbonate from the ------------?

renal tubules- glomerular filtrate

What is the normal bicarbonate/dCO2 ratio?

20:1

What is the ratio (cHPO42-/cH2PO4-) In Phosphate buffer system At the plasma pH of 7.4?

4:1 (pK=6.8)

Name the buffer system which the total concentration of it is in both erythrocytes and plasma accounts for about 5% of the non-bicarbonate buffer value of plasma?

Phosphate buffer system

What is the form of organic phosphate in phosphate buffer system?

2,3-diphosphoglycerate (present in erythrocytes in a concentration of about 4.5 mmol/L),

In phosphate buffer system----------- accounts for about 16% of the non-bicarbonate buffer value off erythrocytes.

organic phosphate

What is the major part of the non-bicarbonate buffers of erythrocyte fluid?

hemoglobin

What is the most important buffer groups of protein in the physiological pH range?

imidazole groups of histidine (pK = 7.3)

What protein accounts for the greatest portion (>90%) of the non-bicarbonate buffer value of plasma?

albumin

What are four conditions associated with Abnormal Acid-Base Status and Abnormal Electrolyte Composition of the Blood?

Metabolic acidosis (primary bicarbonate deficit)

Metabolic alkalosis (primary bicarbonate excess)

Respiratory acidosis

Respiratory alkalosis



Following are characteristics of what type of acid base condition?

production of organic acids that exceeds the rate of elimination (e.g. production of a set the acetic acid and β- hydroxybutyric acid in diabetes ketoacidosis and of lactic acid in lactic acidosis)



Metabolic Acidosis

Following are characteristics of what type of acid base condition?

reduced excretion of acids (H+) ask occurs in renal failure and some renal tubular acidosis, resulting in the accumulation of acid that consumes bicarbonate



Metabolic Acidosis

Following are characteristics of what type of acid base condition?

excessive loss of bicarbonate due to increased renal excretion (decreased tubular reclamation) or excessive loss of duodenal fluid (as in diarrhea)



Metabolic Acidosis

In Metabolic Acidosis the ratio of cHCO3-/cCO2 is decreased or increased?

Decreased because of the primary decrease in bicarbonate.

What is the resulting drop in pH in Metabolic Acidosis?

The resulting drop in pH stimulates respiratory compensation via hyperventilation, which lowers PCO2 and thereby increases the pH

Anion gap is increased or decreased in Metabolic Acidosis?

Increased

What is the first indication of a metabolic acidosis?

the presence of an elevated anion gap

What test should be used for assessing the presence of an elevated anion gap?

should be assessed in the electrolyte profiles of all patients

What is Respiratory compensatory mechanism in metabolic acidosis?

The decrease in pH stimulates hyperventilation (Kussmaul respiration) which results in:

1. The elimination of carbonic acid as CO2

2. A decrease in PCO2 (hypocapnia)

3. A decrease in cdCO2



What is Kussmaul breathing?

Is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure

When Metabolic Alkalosis occurs?

1. Excess base is added to the system

2. Base eliminations decreased

3. Acid-rich fluids are lost


In the Metabolic Alkalosis the ratio of cHCO3-/cCO2 is increased or decreased?

increased because of the primary increase in bicarbonate

What is Respiratory compensatory mechanism in metabolic alkalosis?

The patient will hypoventilate to raise PCO2, thereby lowering the pH stored normal

What are some compensatory mechanisms in metabolic alkalosis?

It will include both respiratory and renal compensation. The increase in pH depresses the respiratory center, causing retention of carbon dioxide (hypercapnia), which in turn causes an increase in cH2CO3 and cdCO2.

The kidneys respond to the state of alkalosis by decreased Na+-H+ exchange, decreased formation of ammonia and decreased reclamation of bicarbonate



What is respiratory acidosis?

Any condition that decreases elimination of carbon dioxide through the lungs results in an increase in PCO2 (hypercapnia) and dCO2 (respiratory acidosis).

Does respiratory acidosis occur only through decreased elimination of CO2?

Yes

What is the most common cause of respiratory acidosis?

Chronic Obstructive Pulmonary Disease (COPD)

What may be another cause of respiratory acidosis?

Rebreathing , or breathing air high in CO2 content may also cause a high PCO2

What are some compensatory mechanisms in respiratory acidosis?

The increased PCO2 stimulates the respiratory center, resulting in an increase pulmonary rate and depth of respiration. Elimination of carbon dioxide through the lungs results in a decrease in cdCO2; thus the ratio of cHCO3-/cdCO2 and pH approach normal.The kidneys respond similarly to the way that they respond to metabolic acidosis and namely, with increased Na+-H+ exchange, increased ammonia formation and increased reclamation of bicarbonate.

What causes respiratory alkalosis?

A decrease in PCO2 (hypocapnia) and the resulting primary deficit in cdCO2 (respiratory alkalosis) are caused by an increased rate and/or depth of respiration.

Is the basic cause of respiratory alkalosis is excess elimination of acid via the respiratory about?

Yes

What does excessive elimination of carbon dioxide cause?

Excessive elimination of carbon dioxide reduces the PCO2 and causes an increase in the cHCO3-/cdCO2 ratio.

What is the first stage of compensatory mechanism of respiratory alkalosis?

In the first stage, erythrocyte and tissue buffers provide H+ ions that consume a small amount of HCO3-.

What is the second stage of compensatory mechanism of respiratory alkalosis?

The second stage becomes operational in prolonged respiratory alkalosis and the kidneys respond by decreasing Na +-H + exchange, decreasing formation of ammonia and decreasing reclamation of bicarbonate.

What is Diabetes Mellitus?

A group of metabolic disorders of carbohydrate metabolism in which glucose is underuse leading to hyperglycemia

What are some life-threatening episodes?

Life-threatening episodes: ketoacidosis, hyperosmolar coma

What are some complications due to DM?

Complications: diabetic retinopathy (blindness), diabetic nephropathy (renal failure), neuropathy (nerve damage), atherosclerosis

About how many cases are DM Type 1?

About 5% to 10%

What are some abrupt symptoms of DM Type 1?

Abrupt onset of symptoms such as polyuria, polydipsia, and rapid weight loss.

What is the cause of DM Type 1?

They have insulinopenia (a deficiency of insulin) caused by loss of pancreatic islet β-cells

What are patients with DM Type 1 dependent on?

Dependent on insulin to sustain life and prevent ketosis

Do most patients with DM Type 1 have antibodies?

Most patients have antibodies that identify an autoimmune process

When is the peak/main onset of DM Type 1?

Peak incidence occurs in childhood and adolescence (before the age of 18), but onset in the remainder may occur at any age

About how many cases are DM Type 2?

About 90% of cases

Do most patients with DM Type 2 show any symptoms?

Patients have minimal symptoms, and are not prone to ketosis

Are patients with DM Type 1 dependent on anything?

Patients are not dependent on insulin to sustain life and to prevent ketonuria

How are insulin levels in a DM Type 2 patient?

Insulin concentrations may be normal, decreased, or increased.

D most individuals with DM Type 2 have impaired insulin action?

Yes

How is DM Type 2 characterized?

This form of diabetes is characterized by receptor deficiency.

What is DM Type 2 commonly associated with?

Commonly associated with obesity; can be improved by weight loss

What are some treatments for DM type 2?

Individuals with the disease may require dietary manipulation, oral hypoglycemic agents, or insulin to control hyperglycemia.

When is the peak/main onset of DM Type 2?

Peak incidence after 40 years of age, but it may occur in younger people

What are some underlying causes of hyperglycemia?

Genetic defects of β-cell function, genetic defects in insulin action, exocrine pancreas disease, and endocrinopathies (Cushing syndrome, acromegaly, glucogonoma)

What is the functional anatomic unit of the liver?

The lobule

What are Kupffer cells?

Macrophages that live in the liver

What do Kupffer cells contain, and what function do they serve?

Lysosomes which break down phagocytized bacteria.

What is the main site for clearance of antigen-antibody complexes from the blood?

Lysosomes in Kupffer cells.

What are the major functioning cells in the liver? What are they responsible for?

Hepatocytes, which are responsible for most of its metabolic and synthetic functions

What is the site of oxidative phosphorylation and energy production?

Mitochondria

What is the site of protein synthesis?

Rough ER

What does the smooth ER contain?

Microsomes involved in drug and toxn metabolism and cholesterol and bile acid synthesis.

What enzyme is contained in lysozomes? What does it act as?

Hydrolytic enzymes which act as scavengers.

What are two substances secreted by the Golgi apparatus?

Bile acids and albumin.

How is hepatic excretory function measured in the liver?

Measurement of plasma concentrations of endogenously produced compounds such as bilirubin, and less commonly used bile acids.

What are drug metabolic tests used for in assessing hepatic excretory function?

Used as markers of function in liver transplants and in advanced liver disease.

What plasma proteins are used in assessing hepatic protein synthesis function?

Plasma proteins such as albumin, transthyretin, immunoglobulins, ceruloplasmin, α1-antitrypsin, and α-fetoprotein and coagulation proteins.

Besides proteins, what other organic compound is used in assessing hepatic synthetic function?

Urea

When checking ammonia metabolism in hepatic metabolic function what ailments are being checked for?

Reye syndrome and hepatic encephalopathy

What are xenobiotics?

Foreign substances that are cleared and metabolized by the liver such as bromsulfonphthalein (BSP), indocyanine green (ICG), aminopyrine, caffeine, lidocaine and stain rose bengal.

What are some clinical manifestations of liver disease?

Jaundice, portal hypertension, Bleeding esophageal varices, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome.

What is another name for jaundice?

Icterus

What is jaundice characterized by?

A yellow appearance of the skin, mucous membranes and sclera caused by bilirubin deposits.

How does portal hypertension occur?

When there is obstruction to portal flow anywhere along its course

How are the causes of obstruction leading to portal hypertension classified?

Pre-sinusoidal, sinusoidal, and post sinusoidal.

Which classification is the most common cause of portal hypertension?

Pre-sinusoidal

Which classification is also known as Budd-Chiari syndrome?

Post sinusoidal

Which coagulation factors are synthesized in the liver and measured by PT (prothrombin time)?

Factor I (Fibrinogen)

Factor II (Prothrombin)

Factor V (Proaccelerin)

Factor VII (Proconvertin)

Factor X (Stuart Factor)


What may also cause an increase in PT in cholestasis?

Vitamin K deficiency

What does a disorder of fibrinogen lead to in both acute and chronic liver disease?

Prolonged PTT

What does Disseminated Intravascular Coagulation (DIC) with?

Hepatic necrosis

What may contribute to ineffective intravascular coagulation?

Thrombocytopenia

What are enzymes released from diseased liver tissue?

Aspartate aminotransferase (AST, SGOT)

Alanine aminotransferase (ALT, SGPT)

Alkaline phosphatase (ALP)

γ- glutamyltransferase (GGT)



Lactate dehydrogenase (LDH)

What are the cytosolic enzymes?

AST, ALT, and LD

What are Mitochondrial and cytosolic isoenzymes in hepatocytes?

AST, ALT

What are the canalicular membranes of hepatocytes?

ALP and GGT

AST activity is what times that of ALT?

Two times

Are hepatocyte activities of LD higher or lower than that of AST and ALT relative to plasma?

Lower

Are plasma activities of LD higher or lower than those of ALT and AST?

Higher

What is the simplest mechanism of enzyme release from diseased liver tissue?

Cell injury

What enzyme does alcohol appear to induce to expression of on the surface of hapatocytes?

Mitochondrial AST

The release of what two enzymes appears to be associated with increased synthesis, membrane fragmentation by bile acids, and solubilization of membrane-bound enzymes of bile acids?

GGT and ALP

What is the half-life of ALT?

48 hours

What is the half-life of AST?

16-18 hours

What does the much longer half-life of ALT lead to?

Higher activites of ALT than AST in most forms of hepatocellular injury

What is the half-life of liver isoenzyme of ALP?

1 to 10 days

What is the reported half-life of GGT?

4.1 days

What are disorders of bilirubin metabolism?

Unconjugated hyperbilirubinemia, and conjugated hyperbilirubinemia

What is increased in unconjugated hyperbilirubinemia?

Production of unconjugated bilirubin from heme

What is decreased in unconjugated hyperbilirubinemia?

decreased delivery of unconjugated bilirubin in plasma to hepatocyte

decrease uptake of unconjugated bilirubin across hepatocyte membrane

decreased storage of unconjugated bilirubin

decreased conjugation



What is decreased in conjugated hyperbilirubinemia?

decrease secretion of conjugated bilirubin into canaliculi

decreased drainage



What is conjugated hyperbilirubinemia also known as?

Cholestasis

What five viruses have been identified in hepatic viral infection?

A, B, C, D, and E.

What is the most common cause of acute viral hepatitis?

Hepatitis A (HAV)

What is Hepatitis A associated with?

Waterborne and foodborne contamination

Does Hepatitis A have a chronic form?

No

How is Hepatitis B virus transmitted?

Parenteral, sexual, or from mother to child after delivery (vertical transmission).

How is Hepatitis B prevented ?

It can be prevented by passive (hepatitis B immune globulin [HBIG]) or active (hepatitis B recombinant vaccine) immunization

What is the most common cause of chronic hepatitis?

Hepatitis C virus

What is the major risk factor for acquiring Hepatitis C virus?

Hepatitis C major risk factor include injection from drug use as well as transfusion before testing the blood supply

What is used to detect the presence of Hepatitis C virus?

HCV RNA is used to detect the presence of Hepatitis C virus.

The known causes of transmission of Hepatitis D, and E viruses are?

Fecal-Oral and Household.

What is acute hepatitis?


Acute injury directed against hepatocytes which may either be directly or indirectly.

Give an example of a drug that causes direct injury to hepatocytes.

Acetaminophen

What is indirect injury to hepatocytes?


Indirect injury is immunologically mediated injury that occurs with hepatitis viruses and most drugs including ethanol.

A person with Wilson’s Disease will show an increase of ALT/AST Upper reference limit by how much?

3-10 URL

What is the Bilirubin level for someone with viral, alcoholic, drug induced, autoimmune hepatitis, and Wilson’s Disease?

5-10 mg/dL

What is acute alcoholic hepatitis characteristically associated with?

Leukocytosis and increased concentrations of acute phase response proteins.

What drug has a toxic metabolite that can cause Toxic hepatitis?

Acetaminophen

What is another term for Ischemic Hepatitis?

Hypoperfusion

What is increased during Ischemic Hepatitis?

Cytosolic enzymes

What is Cholestatic Hepatitis?

It is the obstruction of bile secretion and dysfunction of bile canaliculi in the Golgi apparatus of the liver cells.

What is chronic hepatitis?

It’s the continuous inflammatory damage to hepatocytes lasting more than six months, accompanied by hepatocytes lead generation and scarring.

What are the two major components of chronic hepatitis?

Fibrosis and necroinflammatory activity.

What is ALT activity strongly correlated with and NOT strongly correlated with?

ALT activities are strongly correlated with necroinflammatory activity, but not with fibrosis.

What are the most common causes of Chronic hepatitis?

Chronic HBV, chronic HCV, and non-alcoholic steatohepatitis (NASH).

How is idiopathic hepatitis diagnosed?

Through liver biopsy and the absence of markers.

α1- Antitrypsin deficiency is diagnosed by?

α1- AT Phenotype.

How many genotypes of Chronic Hepatitis C are there?

24

What is the test performed after 24 weeks after completion of treatment for Hepatitis C?

Sensitive HCV RNA.

How are the results after completion of treatment for Hepatitis C interpreted?

Results can be treated as nonresponder, treatment responder, relapser, and sustained virologic response (SRV)

What are the diseases associated with fat and inflammation of the liver not associated with alcoholism?

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH)

NAFLD and NASH are associated with what diseases?

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH)

What is Autoimmune Hepatitis?

Autoimmune Hepatitis is a rapidly progressing form of chronic hepatitis associated with the presence of autoimmune markers and substantial hypergammaglobulinemia.

What are the most important antibodies for the diagnosis of Autoimmune Hepatitis?

Antinuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-liver-kidney microsomal antigen type I (LKM1)

What is the Antigen target for Anti-LKM1

Cytochrome P450 IID6

What are the Antigen targets for ASMA

Actin, Tubulin, Vimentin, Desmin, Skelitin

What are the most common drugs involved with drug induced chronic hepatitis?


Nitrofurantoin, Methyldopa, and HMG-CoA (3-hydroxy-3-methyl-glutaryl-CoA) reductase inhibitors.

What have been linked to chronic hepatitis?

Herbal Medications

What is Liver Disease?

When the liver or hepatocyte function abnormality cause inflammation, fibrosis, scarring.

What is genetic Liver Diseases that presenting as Chronic Hepatitis?

  1. Hemochromatosis

  2. Alpha I – Antitrypsin (AAT) deficiency

Wilson Disease

What is Hemochromatosis?

A rare genetic disorder, due to abnormalities in genes that regulates iron metabolism.

What is Alpha I-antirypsin?

Is a major protein serine protease inhibitor (serpin) in plasma, and is decreased homozygous deficiency and cirrhosis and increased by acute inflammation.

What is Wilson disease?

An autosomal recessive disorder associated with excessive quantities of copper in the tissue particularly the liver and central nervous system.

What is Alcoholic Liver Disease?

Risk factors for developing alcoholic liver disease include duration and magnitude of alcohol abuse, sex, presence of co-infection with HBV or HCV, and nutritional state.

What is Cirrhosis?

Defined anatomically as diffuse fibrosis with nodular regeneration, represents the end-stage of scar formation and regeneration in chronic liver injury.

What is Cholestatic Liver Disease

Stoppage or suppression of the flow of bile is associated with the retention of bile within the excretory system, which may be due to gallstones in the bile ducts (choledocholelithiasis), narrowing (strictures) and tumors.

What is Primary biliary Cirrhosis (PBC)?

Also known as nonsuppurative destructive cholangitis, is an uncommon autoimmune disorder targeting intrahepatic bile ducts primarily in middle age women (6:1 female to male ratio).

What is primary sclerosing Cholangitis (PSC)?

A chronic inflammatory disease of the biliary tree, most commonly affecting extrahepatic bile ducts, characterized by the presence of anti-neutrophil cytoplasmic antibodies (ANCA)

What is Gallstones?

Are solid formations in the gallbladder that are composed of cholesterol and bile salts.

What is Hepatic Tumors?

      • the most important primary liver tumor is hepatocellular carcinoma (HCC).

      • the major risk factor for development of HCC is infection with HBV or HCV.

the most widely used tumor marker is AFP.

What is Hepatocellular Carcinoma (HCC)?

A cancer arising from hepatocytes, complication of HBV and HCV also cause HCC.



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