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A Yellow-Bellied Lawyer?

A Case Study in Liver Physiology


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.


liver; alcohol; cirrhosis; alcoholic liver disease; alcohol metabolism; jaundice; bilirubin; BAC; hemoglobin

Topical Areas


Educational Level

Undergraduate lower division, Undergraduate upper division



Type / Methods




Subject Headings

Biochemistry  |   Biology (General)  |   Epidemiology  |   Medicine (General)  |   Nursing  |   Nutrition  |   Physiology  |   Toxicology  |  

Date Posted


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