56. Serum markers of liver and pancreas pathology Flashcards
• What two gastrointestinal enzymes are markers of injury to hepatocytes?
The aminotransferases, which are alanine aminotransferase and aspartate aminotransferase
• A patient has viral hepatitis. What do you expect the ratio of aspartate aminotransferase to alanine aminotransferase to be?
Low (in viral hepatitis, AST < ALT)
• A patient has alcoholic hepatitis. What do you expect the ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) to be?
High (in alcoholic hepatitis, AST > ALT)
• A 40-year-old man is intoxicated and not making any sense. Elevated serum γ-glutamyl transpeptidase may indicate which diagnosis?
Chronic alcoholism, along with possible Wernicke encephalopathy
• A patient has elevated alkaline phosphatase. To differentiate between bone disease and liver pathology, what marker do you use?
γ-glutamyl transpeptidase (like ALP, GGT is elevated in liver and biliary disease, but unlike ALP, it is not elevated in bone disease)
• Alkaline phosphatase, in addition to being a marker of liver disease, is also a marker of ____ disease.
Bone
• Which two gastrointestinal enzymes are used as markers for acute pancreatitis? Which one is more specific?
Amylase and lipase; lipase is more specific
• A patient has epigastric abdominal pain radiating to the back, fever, and nausea. What two enzymes will likely be elevated on lab studies?
Amylase and lipase will likely be elevated (the patient has acute pancreatitis)
• Which serum protein is decreased in Wilson disease?
Ceruloplasmin
• A patient has bronze rings in the irises, liver cirrhosis, muscle rigidity, and dystonia. What serum protein is most useful to check?
Ceruloplasmin is decreased, because this patient likely has Wilson disease (the bronze rings are Kayser-Fleischer rings)
• A boy who has never received any vaccines comes to the ED with an elevated amylase level (lipase is normal). Name a likely diagnosis.
Mumps
