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GIT Dr. Shaf3y
P a g e | 1
G.I.T.
27
122013
artificial lung ventilator
artificial heart heart lung machine
artificial liver
artificial liver
artificial liver
2
Liver
Liver 2
Which is impossibleartificial liver
Liver artificial liver
Liver
Liver
Liver
liver << carbohydrates metabolism
Liver carbohydrates
GIT Dr. Shaf3y
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glycogen Liver glucose Normal level
glycogen
Which meansLiver Normal
glycogenesis
glycogen
glycogenolysis
gluconeogenesis
glucose amino acids
glucose << Normal
Liver metabolism of protein
Liver Proteins
globulins
immune globulins
Liver albumin
alpha one globulin
beta globulins
transferrin
trans cobalamine 2
proteins immune globulins
Immune globulins
Reticuloendothelial system
Immune system
Immune globulins antibodies
GIT Dr. Shaf3y
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Liver
exclusive proteins
albumins << exclusively Liver
Liver
Liver
liver break down
Proteins Ammonia
ammonia Liver
Urea
urea
Kidney urea
urine
Liver proteins
proteins
proteins ammonia
ammonia Liver Urea
Kidney urea
liver Metabolism of Fat
liver Metabolism of fat
cholesterol
cholesterol
Diet Liver
Diet intestine
blood stream
cholesterol Diet Non estratified cholesterol
Non estratified cholesterol
GIT Dr. Shaf3y
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Diet
non estratified
wall blood vessel atherosclerosis
Diet
blood vessel
atherosclerosis
cholesterol Liver
cholesterol Liver
Liver
Liver
Liver Estratrified cholesterol
blood vessel
atherosclerosis
diet Liver
diet
Liver
Liver cholesterol
Liver cholesterol
non estratified cholesterol Diet Liver
Low density
non Estratified
diet
High density
liver blood vessel
GIT Dr. Shaf3y
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Liver
low density lipoprotein Liver
Liver level
cholesterol level Normal
cholesterol << totally Normal
Non estratified bad good
bad non Estratified
Liver cell failure
atherosclerosis
thrombosis
coagulation factors
atherosclerosis
thrombosis
coagulation factors
clotting factor thrombus
vitamins
liver vitamins
Vitamin Kliver activation
Liver activation vitamin D
liver folic acid B12
Liver << Suicidal
activation vitamin K
activation vitamin D
storage folic acid and B12
GIT Dr. Shaf3y
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Minerals
Liver minerals
storage iron
metabolism
liver functions Metabolism
DetoxicationDetoxification
Detoxification
toxins liver
toxins drugs drugs Liver toxins ammonia Liver ammonia urea
Kidney
Detoxification
function Liver
Coagulationcoagulation factors
1972
2,, 7,, 9,, 10
Liver anti coagulant
Protein C and protein S
coagulation factors
anti coagulant protein C and protein S
bile
Liver bile
Liver 600 bile
300 gall bladder 300intestine<< directly
bile fat absorption
Immunological
GIT Dr. Shaf3y
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G.I.T. Portal vein
G.I.T. Portal vein
directly
sepsis
HCL HCL
intestine
absorption
Portal blood Liver
Liver Von Kupffer cell
Von Kupffer cell
macrophages
Portal blood
Liver
phagocytosis
Liver
Liver
Macrophages activated Liver Von Kupffer cell
activate Other immune system
cytokines activate T. Lymphocytes B. Lymphocytes
portal vein
Liver
macrophages Von Kupffer
Cytokines activate immune system
GIT Dr. Shaf3y
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functions Liver
Endocrinal
liver erythropoietin
20 %erythropoietin
Liver activate << vitamin D
growth hormoneLiver
Liver somatomediens Insulin like growth factor
growth hormone direct
Liver somatomedines C
Liver
growth hormone
function
anatomy of the liver
Liver function
Liver Function liver function
Liver functions
testing function of the liver
testing
testfunction of the liver
enzymes
GIT Dr. Shaf3y
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Enzymes
function of the liver
enzymes damage of the liver
function of liver
enzymes enzymes
ASTSGOT
Serum Glutamic Oxaloacetic transaminases
AST
Liver heart Kidney lung RBCs Muscles intestine placenta
Organs damage
diagnostic Liver disease
enzymeliver damage
Liver damage
liver improve
as a prognostic marker
as a prognostic marker
AST SGOT
ALT SGPT Serum Glutamic Pyruvic transminases
ALT SGPT
Liver G.I.T.
Liver G.I.T.
<< More specific for the liver
Liver disease
SGOT SGPT
GIT Dr. Shaf3y
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SGPT
Liver
follow up SGOT
SGPT
SGPT SGOT
Liver
Liver
follow up
SGOTSGPT
Alkaline phophatasealkaline phosphatase Liver bone
alkaline phophatase Liver bone
Liver bone
symptoms
SGOT SGPT Liver
bone
alkaline phosphatase SGOT SGPT
Liver
SGOT SGPT bone
alkaline phosphatase Liver SGPT
GIT Dr. Shaf3y
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alkaline phosphatase
liver disease
Liver disease
Liver disease
Normal level << alkaline phosphatase
313k A unit
Normal level of alkaline phosphatase
313
level
1330
cirrhosis Hepatitis
cirrhosis Hepatitis
30
Obstructive jaundice hepatocellular carcinoma
unit alkaline phosphatase
KA Unit
unit
313unit
international unit
international unit
30130
130300
Cirrhosis Hepatitis
300
obstructive jaundice hepatocellular carcinoma
GIT Dr. Shaf3y
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alkaline phosphatase
Liver disease
Liver disease
alkaline phosphatase
bone disease
bone disease alkaline phosphatase
bone disease osteomyelitis, fracture, osteosarcoma, metastasis, Paget disease of the bone, hyper parathyroidism
disease bone
alkaline phosphatase
enzyme 5 Nucleotidase
target
5 Nucleotidase
alkaline phosphatase
Liver bone
5 Nucleotidase
liver disease
bone disease
alkaline phophatase
liver bone
SGOT SGPT
bone Liver
5 Nucleotidase
Gamma G.T.Gamma glutamyle transferase
GIT Dr. Shaf3y
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Gamma Glutamyle Transferase
Gamma Glutamyle Transferase
ESR of the liver
ESR of the liver
ESR infection inflammation
ESR infection inflammation
Gamma G.T. liver disease
Gamma Glutamyle Transferase
liver disease
liver disease Gamma G.T.
Follow upFollow up<< go home
SGOT
Gamma G.T.
enzyme Hepatotoxic drugs
Hepatotoxic drugs
Gamma G.T.
hepato-toxic drug Alcohol
Alcohol gamma G.T.
Gamma G.T.
follow up absence from alcoholism
GIT Dr. Shaf3y
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Gamma G.T.
Gamma G.T.
Hepatotoxic drug
alcoholism
rejection
rejection
rejection
Gamma G.T.
obstructive jaundice
obstructive jaundice
Gamma G.T.
enzymes
Liver disease
enzymes at least 3
SGOT normal 40
SGOT 55
Liver disease
Liver enzymes 3
fatty liver
Normal 67 75 diabetic
GIT Dr. Shaf3y
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Obese
15
4055
15
hepatitis marker Liver biopsy
fatty liver
enzymes
enzymes Liver damage
enzymes Liver
enzymes Liver exhausted
fulminant hepatic failure extensive damage Liver
enzymes
SGOT 3,000
900
400
Liver
Liver
enzymes
bilirubin
bilirubin enzymes << liver
bilirubin enzymes <<Liver
1
GIT Dr. Shaf3y
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investigations
how to interpret data
data
enzymes investigations Liver
Bilirubin
Heme and globin
haem
Iron Protoporphyrin
Protoporphyrin bileverdine bileverdine indirect bilirubin
Indirect bilirubin Liver
direct bilirubin
direct bilirubin bile
Intestine stercobilinogen
stercobilinogen
Liver
Entero-hepatic circulation
urine
urobilinogen
jaundice
Hemolytic Obstructive Hepatocellular
GIT Dr. Shaf3y
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Hemolytic
Hemolytic
hemoglobin
heme
bileverdine
indirect bilirubin
Indirect bilirubin
indirect bilirubin
direct bilirubin liver
indirect
direct liver
direct bile intestine
stercobilinogen
stercobilinogen
stool dark
urobilinogen
urine dark on standing
Dark on standing
Urine << dark on standing
whatever
Normal color
GIT Dr. Shaf3y
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urobilin Oxidation
dark on standing
stercobilinogen dark stool
urobilinogen urine << dark on standing
Obstructive jaundice
obstruction
Hemoglobin Normal
heme Normal
bileverdine Normal
indirect bilirubin Normal
direct bilirubin Normal
Obstruction
direct bilirubin
direct bilirubin << is water soluble
dark urine
dark urine
Obstructive jaundice
direct bilirubin
direct bilirubin
bile salts
GIT Dr. Shaf3y
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bile salts bradycardia puritis frothy urine
frothy urine
obstructive jaundice
hemoglobin
heme
bileverdine
indirect bilirubin
direct bilirubin
direct bilirubin
direct bilirubin
bile salts
bradycardia puritis
direct bilirubin
dark urine frothy
stercobilinogen
stool clay
urobilinogen
urine << dark
Darkdirect bilirubin
Hepatocellular
hepatocellular jaundice
hemoglobin << Normal
heme << normal
bileverdine << normal
indirect bilirubin <<Normal
Liver disease
GIT Dr. Shaf3y
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Indirect bilirubin
Indirect
indirect Liver
direct bilirubin
Liver cells
Indirect bilirubin hepatocyte
direct bilirubin
Liver disease
direct
Liver disease Hepatocellular jaundice Liver indirect
Indirect
Liver direct
Liver direct
direct
hepatocellular
indirect direct
stercobilinogen
direct bilirubin
Urobilinogen
variant
stercobilinogen
stercobilinogen
urobilinogen
GIT Dr. Shaf3y
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hepatocellular
disease Liver
indirect bilirubin direct bilirubin
stool stercobilinogen
Urobilinogen
direct bilirubin intestine
stercobilinogen
stercobilinogen
Liver urobilinogen
Liver disease
stercobilinogen
Liver
Liver
stercobilinogen
Urobilinogen Urine
normal
Liver urine
Liver disease
stercobilinogen
GIT Dr. Shaf3y
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Liver
entero-hepatic circulation
Liver
urobilinogen << variable
Liver
direct bilirubin
direct bilirubin Urine
GIT Dr. Shaf3y
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Mother of bilirubin
father of the enzymes
mother of proteins
protein
coagulation profile Liver cell failure
Coagulation profile
Liver
coagulations factors
1972
27910
PT PTT
Factors << 1972
27910
pathways extrinsic intrinsic
PT PTT
pathways
GIT Dr. Shaf3y
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PT
PT
prothrombin time extrinsic pathway
extrinsic pathway factor << 3 + 7
factor 7Liver
6
liver
Liver cell failure
PT PTT
PT
PT
liver
factor 7prothrombin time
half life 6 hours
Half life 6 hours
coagulation
proteins
Protein
albumin
Protein total protein
Albumin Globulin
GIT Dr. Shaf3y
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Normal levels
6
868
Normal levels
Normal ratio albumin globulin
4 / 2
4 /2
ratio
albumin
half life 21
albumin half life 21
Which meansHepatitis albumin
Normal
albumin
at least << 3 weeks
at least<< 3 weeks
albumin acute liver disease
chronic liver disease
liver enzymes
hepatitis
cirrhosis
enzymes
GIT Dr. Shaf3y
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Hepatitis cirrhosis
albumin
albumin <<chronic << cirrhosis
albumin <<Normal << acute << hepatitis
albumin
acute chronic
albumin
chronic
globulins
globulins
globulins
alpha globulins alpha alpha one alpha two
beta globulins gamma globulins
alpha one globulins
alpha one antitrypsin
COPD
congenital emphysema
alpha one antitrypsin
alpha one antitrypsin deficiency
alpha two globulin beta globulin
alpha two beta
Liver bile
bile
alpha two beta
GIT Dr. Shaf3y
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obstructive jaundice
obstructive jaundice
This is for theoretical interest not for clinical application
already obstructive jaundice
alkaline phosphatase
theoretical
gamma globulins
antibodies
gamma globulins
antibodies
gamma globulins acute chronic liver disease
acute Hepatitis B or C
antibodies
Hepatitis markers
acute liver disease
immune globulins
chronic
liver
Portal vein Liver
Liver
GIT Dr. Shaf3y
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bacteremia
bacteremia activate Immune system
immune globulins
chronic liver disease Liver cirrhosis
Liver
Liver
liver
bacteremia
Immune globulins
Immune globulins antibodies
acute and chronic liver disease
acute chronic liver disease
gamma globulins
acute chronic liver disease
gamma globulins
acute chronic liver disease
Immune globulins
liver disease
Liver disease
immune globulin E
alcoholic liver disease
Immune globulin G
chronic hepatitis
GIT Dr. Shaf3y
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Immune globulin M
Primary biliary cirrhosis
Ammonia
liver cell failure
Ammonia
ammonia liver Urea
Liver
ammonia
ammonia toxins
ammonia toxins
test detoxication test
toxins
Liver
toxins
Liver toxins
Liver
<<test << Bromosulphthalein (BSP) test test
obsolete
serum ammonia
clearance test
clearance test
Local anaethesia anti arrhythmia anti epileptic
GIT Dr. Shaf3y
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Liver
Saysay
Liver
clearance test
worse patient
time
GIT Dr. Shaf3y
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scientific
Liver
Liver
clearance test
priority
Investigations
blood glucose
blood glucose
Liver glucose
Liver glycogen
glycogen
Hypoglycemia
Hypoglycemia
liver
cholesterol
total cholesterol << normal
Non esterifiedcholesterol Liver theoretical interest
GIT Dr. Shaf3y
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functions
alpha feto protein
alpha feto proteins
Hepato-cellular carcinoma
cancer
alpha feto protein intra uterine
Intra uterine alpha feto protein
alpha feto protein
Intra uterine
alpha feto protein
albumin
albumin
albumin
alpha feto protein
albumin of the fetus
alpha feto protein
albumin
alpha feto protein
disease
Disease<< hepato-cellular carcinoma cirrhosis G.I.T. malignancy Spina bifida
Twins pregnancy
alpha feto protein
hepato-cellular carcinoma
alpha feto protein Hepatitis
GIT Dr. Shaf3y
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cirrhosis G.I.T. malignancy
Open neural crest defect spina bifida meningeocele
female twins pregnancy
alpha feto protein
alpha feto protein
teratoma
dermoid cyst
alpha feto protein
follow up cirrhosis
cirrhosis hepato-cellular carcinoma
follow up alpha feto protein
alpha feto protein 6
For any detection
Screening
benign Malignant mass
Ultra sound
mass
mass benign malignant
alpha feto protein
Malignant
alpha feto protein
alpha feto protein
cancer
mass benign Malignant
alpha feto protein
malignant
alpha feto protein << Normal <<
GIT Dr. Shaf3y
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tumor Fibrolamellar carcinoma
alpha feto protein
alpha feto protein mass
hepato-cellular carcinoma
Normal mass benign Malignant
biopsy
Marker
Des gamma carboxy prothrombin
marker
Des gamma carboxy prothrombinfibrolamellar carcinoma marker
investigations
size Liver shrunken hepatomegaly
Ascitessplenomegaly
portal vein dilated Portal hypertension
bile duct << dilated obstructive jaundice
MassLiver
CT MRI
More accurate
ERCP PTC
biliary obstruction
GIT Dr. Shaf3y
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Biopsy from the liverbiopsy from the liver indication
hepatomegaly << for unknown reasons
elevated liver enzymes <<for unknown reasons
mass benign malignant
glycogen storage diseases biopsy liver
contraindications biopsy Liver
Bleeding tendency
prothrombin time <<Normal 4
Liver biopsy
platelet count
biopsy
Markedly shrunken liverMarkedly shurken liver
Organs
biopsy Massive ascites
Massive ascites
intestine gas
intestine floating
abdominal wall
contraindications biopsy
Uncooperative patientHepatic encephalopathy irritable
biopsy
sedation
hepatic encephalopathy
P
sedation Irritable pre hepatic coma
GIT Dr. Shaf3y
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local anaethesia biopsy
general liver biopsy
biopsy obstructive jaundice
bleeding tendency
biopsy biliary obstruction
biliary Liver dilated
biopsy puncture
peritonitis biliary peritonitis
bleeding tendency
Liver cell failure cirrhosis
laparotomy
liver
Liver cirrhosis
Weeping liverLiver
Liver
Liver cirrhosis
Liver cirrhosis
cirrhosis
Liver
Lymphatic obstruction Liver liver cirrhotic
Is weeping on itself
Liver function
GIT Dr. Shaf3y
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G.I.T.
45
152013
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