011215 liver enzyme tests

Question 1

which liver enzyme is found in both cyto and mito?

Answer 1

AST

Question 2

AST is synonymous with

Answer 2

SGOT

Question 3

does AST or ALT have a broad tissue distribution?

Answer 3

AST/SGOT

Question 4

is AST or ALT more specific for the liver?

Answer 4

ALT (found predominantly in liver)

Question 5

in alcoholic hepatitis, what would you expect of the AST and ALT?

Answer 5

AST>ALT

Question 6

in viral hepatitis, what would you expect of the AST and ALT?

Answer 6

ALT>AST

Question 7

alk phos is elevated for

Answer 7

bone disease
pregancy
biliary obstruction

Question 8

5’NT

Answer 8

broad tissue distribtuion
in liver, enzyme is associated with canalicular and sinusoidal plasma membranes

NOT elevated in bone disease or pregnancy
not used clinically as often as GGT

Question 9

if alk phos and GGT are elevated

Answer 9

points to biliary obstruction

Question 10

GGT

Answer 10

broad tissue distribution
NOT elevated in bone disease
frequently elevated in diseases of liver, biliary tract, pancreas

Question 11

GGT is nonspecific for

Answer 11

cholestatic and hepatocellular

but helpful for determining source of alk phos elevation

Question 12

ALT over 500 points too

Answer 12

hep A
hep B
autoimmune hepatitis
meds
ischemia (shock liver)

Question 13

alcoholic liver disease rarely has transminases above what level?

Answer 13

300

Question 14

AST:ALT of greater than 2:1 suggests

Answer 14

alcoholic liver disease

Question 15

when evaluating pt with liver dis, ask two questions:

Answer 15

hepatocellular or cholestatic?
synthetic fxn (able to make proteins)? albumin and INR

Question 16

if advanced liver disease, why can ALT and AST be minimally elevated?

Answer 16

b/c liver burns out

Question 17

as disease progresses, does alk phos decrease?

Answer 17

no

Question 18

at what level of total bilirubin will you detect jaundice?

Answer 18

3 in good light

in hospital light: 5-6

Question 19

for liver synthetic fxn, what is usually looked at?

Answer 19

INR (b/c albumin can be low with kidney dis, etc)

Question 20

the most important test result to look at for liver dis would be

Answer 20

INR

b/c when you burn the hepatocytes, the ALT and AST will go down

Question 21

to determine how sick a pt is, what should you look at in terms of lab tests?

Answer 21

INR (predicts long term prognosis)

Question 22

can you use the liver lab tests to point to specific disease?

Answer 22

no

they limit the differential. from there, you do specific tests

Question 23

with acute hepatocellular injury, what do you expect to see?

Answer 23

elevated AST and ALT

BUT NORMAL INR

Question 24

INR is elevated-what are you thinking?

Answer 24

something more chronic