Test for pancreatic and intestinal functions are very important for clinical evaluation gastro intestinal disorders . So it will e useful for medical and allied professional students and practitioners.
Liver function tests (LFT’s) are groups of laboratory blood assays designed to give information about the state of patients liver
They include
Liver enzymes (SGOT, SGPT, ALP, GGT etc.,)
Bilirubin(Direct and indirect)
Albumin
Prothrombin time / INR
Jaundice is a symptom of underlying diseases in our body mainly in the liver. Do you know about the cause, diagnosis methods, preventive measures of jaundice? Know about it through this presentation.
billirubin production billirubin transport and metabolism, different laboratory methods of billirubin estimation ,normal and abnormal levels of billirubin, different classification and types of jaundice and liver diseses, liver functioning, enterohepatic circulation, billirubin production and degradation, benefits and diseases of abnormal level of billirubin
The liver is the largest organ in the body
It is located below the diaphragm in the right upper quadrant of the abdominal cavity and extended approximately from the right 5th rib to the lower border of the rib cage.
Test for pancreatic and intestinal functions are very important for clinical evaluation gastro intestinal disorders . So it will e useful for medical and allied professional students and practitioners.
Liver function tests (LFT’s) are groups of laboratory blood assays designed to give information about the state of patients liver
They include
Liver enzymes (SGOT, SGPT, ALP, GGT etc.,)
Bilirubin(Direct and indirect)
Albumin
Prothrombin time / INR
Jaundice is a symptom of underlying diseases in our body mainly in the liver. Do you know about the cause, diagnosis methods, preventive measures of jaundice? Know about it through this presentation.
billirubin production billirubin transport and metabolism, different laboratory methods of billirubin estimation ,normal and abnormal levels of billirubin, different classification and types of jaundice and liver diseses, liver functioning, enterohepatic circulation, billirubin production and degradation, benefits and diseases of abnormal level of billirubin
The liver is the largest organ in the body
It is located below the diaphragm in the right upper quadrant of the abdominal cavity and extended approximately from the right 5th rib to the lower border of the rib cage.
Daily bilirubin production - 250-300mg%
85% heme moiety of aged RBC
5% RBC precursors destroyed in bone marrow ( ineffective
erythropoiesis),Catabolism of some heme proteins – myoglobin,
cytochrome, peroxidase
Medical considerations in dental treatment of patients with liver disease. Main types of liver disease, clinical manifestations, lab tests, treatment considerations.
Liver function tests for Pharm.D (Medicinal biochemistry & Clinical pharmacy)Soujanya Pharm.D
Introduction, Major functions of liver, Tests to assess liver function, Classification of liver function tests, Interpretation of results (Medicinal biochemistry & Clinical pharmacy)
this is a series of notes on clinical pathology, useful for undergraduate and post graduate pathology students. Notes have been prepared from standard textbooks and are in a format easy to reproduce in exams.
Introduction to protein , Structure of Amino acid, Asymmetric carbon, Nomenclature of amino acid, Classification of amino acid, Properties & functions of amino acids, Definition of protein, Peptide bond
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
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APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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3. CONTD
Vital organ of the digestive system
Weight of human liver: 1.44 – 1.66 kg
Lies to the right of stomach and & overlies
the gall bladder (in right hypochondrium &
most of the epigastrium)
Divided into 2 lobes (right and left) if
viewed from parietal surface. If viewed on
visceral surface, it is divided into 4 lobes
with the addition of caudate & quadrate
lobes.
4. CONTD
Two major types of cells:
Parenchymal cells (hepatocytes): 80%
of liver volume.
Non-parenchymal cells: constitute
40% of total number of liver cells but
only 6.5% of its volume.
[Sinusoidal hepatic endothelial cells,
kupffer cells & hepatic stellate cells are
some of the non-parenchymal cells]
5. CONTD
Is connected to 2 large blood vessels:
hepatic artery & portal vein.
Hepatic artery carries blood from
aorta.
Portal vein carries blood containing
digested nutrients from the entire
gastrointestinal tract and also the spleen
& pancreas.
6. FUNCTIONS OF LIVER
The various functions of liver are
carried out by the liver cells or
hepatocytes. It is thought to be
responsible for up to 500 separate
functions, usually in combination with
other systems and organs.
7.
8. 1. METABOLIC FUNCTION
Liver actively participates in
carbohydrate, protein , lipid, mineral &
vitamin metabolism.
Carbohydrate Metabolism: Glycolysis,
TCA cycle, Glycogen metabolism,
Gluconeogenesis, HMP shunt
9. CONTD
Lipid Metabolism: Cholesterol
metabolism, PL synthesis,
Lipogenesis , Synthesis of TAG,
Lipolysis, FA oxidation, LP
metabolism , Ketogenesis
Protein Metabolism: Plasma protein
synthesis, Transamination,
Deamination, Urea cycle, Uric acid
synthesis
10. 2. EXCRETORY FUNCTION
Bile pigments, bile salts, drugs,
steroids (cholesterol), heavy metals
etc are excreted in bile into
intestine.
[Secretory function of liver
includes secretion of bile into the
intestine]
11.
12. 3. SYNTHETIC FUNCTION
Synthesis of plasma proteins (except
immunoglobulin), LPs, clotting factors as
well as protein C, protein S & antithrombin
In 1st
trimester fetus, the main site of RBC
production
Produces and secretes bile (some of the bile
directly drains in to the duodenum & some
is stored in the gall bladder.
13. CONTD
Major site of thrombopoietin
production ( a glycoprotein
hormone regulating platelet
production by bone marrow)
Produces IGF-1 (PP protein
hormone having role in children
growth & continues to have
anabolic effects in adults)
14. 4.
DETOXIFICATION/BIOTRANSFORMA
TION FUNCTION
Detoxification means the chemical
alteration of xenobiotics for their easy
disposal from body.
Xenobiotics are harmful chemical agents
entering the body either from exogenous
sources through inhalation/ingestion/skin
contact or may be endogenously
produced within the body during
metabolic activity.
15. CONTD
Purpose of detoxification: To make
water insoluble toxic substances
into water soluble nontoxic form to
facilitate their excretion via
urinary/fecal route
Liver is the main organ for
xenobiotics metabolism.
16.
17. 5. STORAGE FUNCTION
The liver stores a multitude of
substances, including glucose (in the
form of glycogen), vitamin A (1–2 years'
supply), vitamin D (1–4 months'
supply), vitamin B12 (1–3 years'
supply), vitamin K, iron & folic acid.
18. 6. OTHER FUNCTIONS
The liver is responsible for
immunological effects—
the mononuclear phagocyte
system (MPS) of the liver contains many
immunologically active cells, acting as a
'sieve' for antigens carried to it via
the portal system.
The liver produces albumin, the
major osmolar component of blood
serum.
19. CONTD
The liver synthesizes angiotensinogen,
a hormone that is responsible for
raising the blood pressure when
activated by renin.
The liver also functions as a blood
reservoir, being an expandable organ.
22. INTRODUCTION
The catabolic end product of heme.
80% of this is derived from Hb & 20%
from other heme containing substances
(Myoglobin, Cytochromes, Peroxidase &
Catalase).
35 mg bilirubin from 1 gm of Hb
Total bilirubin production: 250 - 300
mg/D
23. FOUR STEPS OF BILIRUBIN
METABOLISM
1. Production of bilirubin : Events in
reticuloendothelial cells
2. Transport of bilirubin in blood bound
with albumin
3. Hepatic metabolism of bilirubin: Events
in hepatocytes
4. Intestinal metabolism of bilirubin:
Events in intestinal lumen
29. ENTERO-HEPATIC CIRCULATION
OF UROBILINOGEN
Some of urobilinogen (10 – 20%)
from intestine is reabsorbed to
portal blood , of which 90% reaches
the liver and reexcreted to bile.
Remaining 10% goes to kidney &
excreted with urine.
30.
31.
32.
33. DIFFERENCE BETWEEN
CONJUGATED & UNCONJUGATED
BILIRUBIN
Conjugated
Bilirubin
Unconjugated
Bilirubin
Water soluble Water insoluble
Alcohol insoluble Alcohol soluble
Normal conc. Up to
0.25 mg%
Normal conc. Up to
0.75 mg%
Present in bile Absent in bile
Normally absent in
urine but appears in
high plasma conc.
Always absent in
urine
34. NORMAL BILIRUBIN
CONCENTRATION IN BLOOD
Total Bilirubin: 0.1 – 1.0 mg%
Direct (Conjugated) bilirubin: 0.25 mg%
Indirect (Unconjugated) bilirubin: 0.75 mg
%
If serum bilirubin is >1 mg% , it is
hyperbilirubinemia.
36. WHAT ARE “LIVER FUNCTION
TESTS”
Groups of tests that give information
about the state of a person’s liver.
Few are truly associated with function
Albumin: protein synthetic function
Most are related to cell injury
Patterns of tests pointing to specific
cell injury
37. INDICATIONS OF LFTS
Differential diagnosis of jaundice
Liver disease: Diagnosis,
Assessment of severity & prognosis
Monitoring of treatment
Detection of complications
38. A. TESTS THAT MEASURE
BIOSYNTHETIC FUNCTIONS OF
LIVER
1. Serum Total Protein Conc. : 6 – 8 gm/dl
2. Serum Albumin Conc. : 3.5 – 5.3 gm/dl
3. Serum Albumin to Globulin Ratio: 2 : 1
4. Prothrombin Time: 12 – 14 seconds
(These all are normal levels )
39. CONTD
Synthesis of albumin is exclusively
in liver but synthesis of Globulin
occurs in liver & plasma cell
So, in hepatic dysfunction, serum
conc. of total protein & albumin
decreases markedly, but serum
globulin conc. is little affected
leading to alteration ( decrease /
reversal) of albumin to globulin
ratio.
40. CONTD
The clotting factors involved with
the PT are F I, II, V, VII & X
(produced by liver). For synthesis
of F II, VII, IX & X , vitamin K is
needed.
Prolonged PT indicates the
deficiency of concerned clotting
factors due to hepatic dysfunction
or vitamin K deficiency.
41. PT IS MORE SENSITIVE: WHY?
Half life of Albumin: 20 days
Half life of Prothrombin: hours to
days
So, PT is more sensitive rather
than serum albumin/total protein
& is an early marker of impaired
synthetic function of liver.
42. B. TESTS BASED EXCRETORY
FUNCTIONS OF LIVER
1. Serum Bilirubin Conc. :
0.1 – 1 mg/dl (total bilirubin)
44. CONTD
These enzymes are present within
hepatocytes. Damage to hepatocytes
or increased permeability of
hepatocytes due to inflammation
causes release of these enzymes into
the blood & ultimately leading to
their raised serum conc.
45. D. TESTS FOR CHOLESTASIS/
BILLIARY TRACT OBSTRUCTION
1. Serum alkaline phosphatase (ALP): 30 –
120 IU/L
2. Serum gamma glutamyl transferase
3. Serum 5’ nucleotidase
These levels are raised in cholestasis.
46. CONTD
ALP is the most important
indicator of cholestasis. Normally
it is present in canalicular &
sinusoidal membranes of
hepatocytes. Following cholestasis,
stagnated bile acid induces ALP
synthesis by hepatocytes & billiary
tract epi. cells leading to increased
plasma ALP
47. E. TESTS FOR METABOLIC
FUNCTIONS OF LIVER
Galactose tolerance test
Serum glucose level
Serum LDH
48. F. OTHER LFTS
Immunology: Blood tests may be
done to
detect:
a. Viruses and antibodies to
viruses: Various viral infections
can cause hepatitis
(inflammation of the liver) - for
example, hepatitis A
virus, hepatitis B virus, etc.
49. CONTD
b. Auto-antibodies: These are
antibodies which attack a part of our
own body and occur in autoimmune
disorders.
The most common autoimmune
disorders of the liver are primary
billiary cirrhosis, autoimmune
hepatitis, primary sclerosing
cholangitis, etc
50. CONTD
Other types of protein in the blood
can point to specific liver diseases
- for example:
Ceruloplasmin is reduced
in Wilson's disease.
Lack of α1-antitrypsin is an
uncommon cause of cirrhosis.
A high level of ferritin is a
marker of haemochromatosis.
51. CONTD
Other tests such as liver biopsy,
ultrasound scan, other types of
scan, etc may be needed to clarify
the cause of a liver disorder,
and/or to monitor its progress.
52.
53. LIMITATIONS OF LFTS
Poor sensitivity & specificity:
About 75 – 80% of liver needs to be
out of function for any of the LFT
to be positive
Seldom leads to diagnosis: Due to
enormous functional reserve
capacity & marvelous regenerating
power , only small portion of liver
is enough to perform all the
functions
54.
55.
56. TYPES OF JAUNDICE
Category Definition
Pre-
hepatic/Hemolytic
The pathology is
occurring prior to
the liver
Hepatic/Hepatocellul
ar
The pathology is
located within the
liver
Post-
hepatic/Cholestatic /
Obstructive
The pathology is
located after the
conjugation of
bilirubin in the liver
60. BIOCHEMICAL FINDINGS (CONTD)
Parameter Normal Hemolytic
jaundice
Hepatocell
ular
jaundice
Obstructiv
e jaundice
Serum ALP 30-120
IU/L
Normal ↑↑ ↑↑↑
Serum ALT 10-40 U/L Normal ↑↑↑ ↑
61. CARDINAL FEATURES OF DIFF
TYPES OF JAUNDICE
Hemolytic
Jaundice
Hepatocellular
Jaundice
Obstructive
Jaundice
Unconjugated
hyperbilirubinemi
a
Supporting
findings of
hemolysis
Darkurine
(due to
bilirubinuria)
Very high
serumALT with
small rise of ALP
Darkurine
(due to
bilirubinuria)
pale stool
( due to absence
of
stercobilinogen)
Absence of
urobilinogen in
urine
Very high
62.
63. CONTD
Breakdown of red blood cells
(which release bilirubin into the
blood) and immaturity of the
newborn's liver (which cannot
effectively metabolize bilirubin
and prepare it for excretion into
urine)
Normal neonatal jaundice appears
between the 2nd and 5th days of
life and clears with time