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A Yellow-Bellied Lawyer?

A Case Study in Liver Physiology

Co Authors:

Megan M. Emge
Human Development and Family Studies
Texas Tech University

Zenobia N. Okwunwanne
Biological Sciences
Texas Tech University

Raphinos Uragu
Biological Sciences
Texas Tech University

Johnna L. Yowell
Texas Tech University

Breanna N. Harris
Biological Sciences
Texas Tech University


This interrupted case study tells the story of Michael, a Harvard law graduate with a stressful job and a seemingly heavy drinking problem. Students are provided with background information, medical history, and lab results in order to guide them towards determining what is wrong with Michael. This study highlights cirrhosis and the effects of alcohol abuse on the liver. Before beginning the case study, students should have a background in the physiological role of the liver and the breakdown of hemoglobin. Students are asked to use the information provided for them in the case study to gather more information about liver cells and their functions, alcohol, and alcoholic liver damage. Ultimately, using multiple blood tests, the Maddrey's discriminant function (DF) score, and results from a magnetic resonance elastography (MRE), they will diagnose Michael with alcoholic cirrhosis. This case was developed for use in a non-majors physiology course, but could easily be used for a majors class.

  • Describe how the liver operates under normal conditions vs. disease states.
  • Describe how chronic alcohol abuse can lead to liver disease.
  • Compare and contrast the three stages of alcoholic liver disease (with symptoms, liver tests specific for stage, lab results).
  • Explain how hemoglobin is metabolized and how jaundice can occur.
  • Interpret the results of various blood tests, including: AST, ALT, GGT, Bilirubin, and Prothrombin time.
  • Understand how to calculate blood alcohol concentration and Maddrey's DF score.
Keywords: liver; alcohol; cirrhosis; alcoholic liver disease; alcohol metabolism; jaundice; bilirubin; BAC; hemoglobin
Topical Area: N/A
Educational Level: Undergraduate lower division, Undergraduate upper division
Formats: PDF
Type/Method: Interrupted
Language: English
Subject Headings: Biochemistry   Biology (General)   Epidemiology   Medicine (General)   Nursing   Nutrition   Physiology   Toxicology  
Date Posted: 11/30/2016
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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