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MP224- Normal Function of Renal and Hepatic Systems > 14- Measuring Hepatic Function > Flashcards

14- Measuring Hepatic Function Flashcards

1
Q

What leak into blood when liver cells are damaged

A

Liver enzymes

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2
Q

What substances are measured in Liver function tests

A

Bilirubin
Alanine Aminotransferase
Aspartate Aminotransferase
Gamma-glutamyl transferase
Alkaline phosphate
Protein
Albumin
Globulins

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3
Q

What liver enzymes provide indication of degree of inflammation

A

ALT and AST

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4
Q

What enzymes suggest the presence of obstructive biliary disease

A

ALP and GGT

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5
Q

What is hepatitis

A

A term used to describe inflammation of the liver.
It can occur as the result of a viral infection or because the liver is exposed to toxic substances such as alcohol

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6
Q

What is chloestasis

A

A condition where bile cannot flow from the liver to the duodenum

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7
Q

What is cirrhosis

A

Scarring of the liver as a result of continuous long term liver damage

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8
Q

How is unconjugated bilirubin moved to the liver

A

by albumin

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9
Q

How is bilirubin chemicals measured to the serum sample

A

Diazo dyes are added to the sample and light absorbance is measured.

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10
Q

What ios the healthy level of bilirubin in serum

A

under 20micromol

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11
Q

What level of serum bilirubin level will cause the patient to become jaundiced

A

above 35micromol/L

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12
Q

What indicates biliary obstruction

A

If the conjugated bilirubin is in a higher ratio to unconjugated

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13
Q

What does it mean if the conjugated to unconjugated bilirubin ratio is equal

A

Hepatocellular damage

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14
Q

What is ascites

A

Fluid builds up in the abdomen which causes abdominal distension >1500ml of water

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15
Q

What are the symptoms of ascites

A

Discomfort
Nausea
Appetite suppression
Increasing dyspnoea

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16
Q

What is unconjugated bilirubin

A

Bound to albumin and water-insoluble so does not appear in urine

17
Q

What is conjugated bilirubin

A

Diglucuronide, water-soluble appears in urine

18
Q

What is haemolytic or pre-hepatic jaundice and what are the causes

A

Haemolysis of red blood cells resulting in the formation of bilirubin at a rate faster than the liver can excrete

Unconjugated>conjugated 80micromol/L

Causes- drugs, infection and enzyme deficiency

19
Q

What is the causes of hepatocellular jaundice

A

Due to damage of hepatocytes

Causes- infection, drugs and alcohol

Intracellular enzymes leached into circulation

Damaged hepatocytes are unable to conjugate and transport bilirubin into bile.

300micromol/L conjugated and unconjugated

20
Q

What is cholestasis jaundice and what are the causes

A

Intra-hepatic- failure of bile flow or excretion within the liver
Extra-hepatic- obstruction of biliary tree outside the liver eg gallstones or malignancy

Bilirubin up to 500micromol/L

21
Q

Where is Alanine amino transferase found

A

Found in high concentrations in the liver and lower concentrations in the heart and muscles

22
Q

What do high ALT levels indicate

A

Acute liver damage, chronic liver disease and jaundice

23
Q

What does low ALT levels indicate

A

Vitamin B6 deficiency

24
Q

Where is aspartate aminotransferase found

A

Present in liver heart kidneys skeletal muscles and RBCs

25
Q

What does increased AST levels indicate

A

Raised in shock
Also raised in pregnancy and after exercise

26
Q

Where is Gamma-glutamyl transferase found

A

High concentrations in the liver, kidneys, prostrate and pancreas

27
Q

What is GGT levels rasied by

A

Alcohol consumption

28
Q

What does raised GGT levels indicate

A

Liver and biliary tract diseases and also pancreatic cancers

29
Q

Where is alkaline phosphatase found and produced

A

Produced in liver, bile ducts, bone and duct
Widely distributed in the body

30
Q

What does increased ALP levels indicate

A

Raised in diseases of the liver and biliary tract wit highest levels found in obstructive jaundice
ALP is also raised in cirrhosis and liver cancers.

Only slightly raised in acute hepatitis

31
Q

What does increased levels of ALP in the bone indicate

A

Pagets bone tumours

32
Q

What happens to albumin levels in chronic liver disease

A

They are lowered

33
Q

What does reduced albumin levels indicate

A

Malnutrition
chronic renal failure
nephrotic syndrome
severe burns

Over hydration

34
Q

What conditions with RBCs can be indicated by increased bilirubin levels

A

Haemolytic anaemia

MP224- Normal Function of Renal and Hepatic Systems (20 decks)

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