011215 liver enzyme tests Flashcards
which liver enzyme is found in both cyto and mito?
AST
AST is synonymous with
SGOT
does AST or ALT have a broad tissue distribution?
AST/SGOT
is AST or ALT more specific for the liver?
ALT (found predominantly in liver)
in alcoholic hepatitis, what would you expect of the AST and ALT?
AST>ALT
in viral hepatitis, what would you expect of the AST and ALT?
ALT>AST
alk phos is elevated for
bone disease
pregancy
biliary obstruction
5’NT
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
if alk phos and GGT are elevated
points to biliary obstruction
GGT
broad tissue distribution
NOT elevated in bone disease
frequently elevated in diseases of liver, biliary tract, pancreas
GGT is nonspecific for
cholestatic and hepatocellular
but helpful for determining source of alk phos elevation
ALT over 500 points too
hep A hep B autoimmune hepatitis meds ischemia (shock liver)
alcoholic liver disease rarely has transminases above what level?
300
AST:ALT of greater than 2:1 suggests
alcoholic liver disease
when evaluating pt with liver dis, ask two questions:
hepatocellular or cholestatic? synthetic fxn (able to make proteins)? albumin and INR
if advanced liver disease, why can ALT and AST be minimally elevated?
b/c liver burns out
as disease progresses, does alk phos decrease?
no
at what level of total bilirubin will you detect jaundice?
3 in good light
in hospital light: 5-6
for liver synthetic fxn, what is usually looked at?
INR (b/c albumin can be low with kidney dis, etc)
the most important test result to look at for liver dis would be
INR
b/c when you burn the hepatocytes, the ALT and AST will go down
to determine how sick a pt is, what should you look at in terms of lab tests?
INR (predicts long term prognosis)
can you use the liver lab tests to point to specific disease?
no
they limit the differential. from there, you do specific tests
with acute hepatocellular injury, what do you expect to see?
elevated AST and ALT
BUT NORMAL INR
INR is elevated-what are you thinking?
something more chronic
