Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

T IoD biochemistry > Biochemical investigation of liver disease > Flashcards

Biochemical investigation of liver disease Flashcards

1
Q

what are the major functions of the liver?

A
  • carb metabolism
  • fat, protein,hormone metabolism
  • drugs and foreign compounds
  • storage
  • bilirubin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is damaged in hepatitis?

A

hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the characteristics of cirrhosis?

A
  • increased fibrosis
  • liver shrinkage
  • decreased hepatocellular function
  • obstruction of bile flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

where is ALT present?

A

Hepatocytes

Mildly in skeletal muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where is AST present?

A

Hepatocytes, cardiac/skeletal muscle and erythrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is more liver specific out of ALT and AST?

A

ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what can cause a rise in alkaline phosphatase?

A

Cholestasis, 3rd trimester of pregnancy,meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the albumin half life, why is this important?

A

20 days

in liver damage it won’t drop as quickly as you expect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a useful marker for hepatocellular carcinoma?

A

alpha fetoprotein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is alpha fetoprotein useful for?

A

A marker of hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is low low levels of caeruloplasmin associated with?

A

Wilsons disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is high levels of ferritin associated with?

A

iron overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

where does bilirubin become conjugated?

A

in liver by joining with albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what happens to conjugated bilirubin?

A

bilirubin –> urobilinogen –> excretion or enterohepatic circulation/ kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what can physiological process can cause a change in alkaline phosphatase?

A

Growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what markers are important in inflammatory patterns?

A

ALT mainly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what markers are important in cholestatic patterns?

A

ALP mainly

GGT and bilirubin also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when do albumin concentrations tend to be decreased?

A

chronic liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the first things to exclude when there is a raised ALT?

A

Alcohol intake,diabetes, increased triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If the ALT is raised but less than double the upper limit what is the recommendation?

A

repeat in 1-3 months unless they appear very ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the first line tests for a raised ALT?

A
  • AST to work out ratio
  • FBC
  • Auto antibodies
  • ferritin
  • hep B surface antigen
  • Hep C antibody
  • liver USS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the second line tests for a raised ALT?

A
  • anti tissue transglutaminase antibodies
  • alpha 1 antitrypsin
  • caeruloplasmin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A raised ALT with a raised GGT is suggestive of?

A

alcohol intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A raised ALT showing thrombocytopenia on blood test is suggestive of?

A

hypersplenism

portal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

A raised ALT investigated showing a raised AMA is suggestive of/

A

PBC (AMA m2 is specific)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

A raised ALT investigated showing a raised ASM/ANA is suggestive of?

A

AIH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is ALT with raised ferritin suggestive of?

A

Iron overload

28
Q

what populations are more likely to have haemochromotosis?

A

Scottish men

Post menopausal women

29
Q

Where in the cells is AST found?

A

20% cytosol

80% mitochondria

30
Q

what is half life of AST?

A

12-22 hours

31
Q

what is a AST:ALT ratio <1 suggestive of?

A

Majority of liver diseases will have this finding

32
Q

what is a AST:ALT ratio >2 suggestive of?

A

An extrahepatic source

33
Q

A raised AST:ALT ratio above 2 is suggestive of an extrahepatic source what are examples of this?

A 
Alcohol hepatitis
ischaemia/ toxins
acute wilsons
lymphoma
cirrhosis
34
Q

what is a AST:ALT ratio >4 suggestive of?

A

fulminant wilsons disease

35
Q

A raised ALT with raised anti tissue transglutaminase antibodies suggests?

A

Coeliacs

36
Q

what is the most common finding on biopsy for non explained raised transaminases?

A

Non alcoholic steatohepatitis followed by non alcoholic fatty liver

37
Q

what is more prevelant: non alcoholic fatty liver disease or alcoholic liver disease?

A

non alcoholic fatty liver disease

38
Q

what is the most common cause of abnormal LFT’s?

A

non alcoholic fatty liver disease

39
Q

what are the stages of non alcohol fatty liver disease?

A

Healthy liver –> non alcohol fatty liver –> cirrhotic/ non alcohol steatohepatitis –> HCC

40
Q

what is step 1 in the development of non alcoholic fatty liver disease?

A

Non alcoholic fatty liver –> cirrhotic liver/ non alcoholic steatohepatitis

41
Q

what is step 2 in the development of non alcoholic fatty liver disease?

A

Cirrhotic liver/ non alcoholic steatohepatitis –> hepatocellular carcinoma

42
Q

What are the major risk factors in non alcoholic fatty liver disease for fatty liver –> cirrhotic liver (step one)?

A
  • obesity
  • arterial hypertension
  • diabetes
  • dyslipidaemia
  • PNPLA3/TM6SF2
  • polymorphisms
43
Q

What are the major risk factors in non alcoholic fatty liver disease for cirrhotic liver (step one) –> hepatocellular carcinoma (HCC)?

A 
obesity
diabetes
advanced fibrosis
PNPLAS3/TM6SF2
Age
44
Q

how does body weight change in NAFLD and alcoholic liver disease?

A

NAFLD- increase

alcoholic- varies

45
Q

how does fasting plasma glucose change in NAFLD and alcoholic liver disease?

A

NAFLD- increased

alcoholic- normal

46
Q

what is the reported daily alcoholic intake in alcoholic liver disease?

A

> 20g in women and over 30g in men

47
Q

how does AST change in NAFLD compared with alcholic liver disease?

A

Normal in NAFLD

alcoholic liver disease- increase

48
Q

what is the AST:ALT ratio in non alcoholic fatty liver disease?

A

<0.8 Unless advanced

49
Q

what is the AST:ALT ratio in alcoholic liver disease?

A

> 1.5

50
Q

what is the management for NAFLD with an ALT <50?

A

Lifestyle advice to achieve weight loss
Reduce alcohol
Reassess

51
Q

what is the management for NAFLD with an ALT of 50-150?

A

Lifestyle advice, weight loss, alcohol reduction, stop hepatotoxic drugs

52
Q

what is gilberts disease?

A

A defect in the regulatory part of gene coding for bilirubin UPD-glucuronyl transferase leading to raised bilirubin

53
Q

what is crigler najjar?

A

Ascence in bilirubin UDP glucuronyl transferase

54
Q

what over the counter things can raise GGT?

A

Phenytoin

st johns wart.

55
Q

If there is a raised ALP how can you check the origin of the problem?

A

check GGT levels if normal bone in origin

if not normal; vit d/ pregnanc

56
Q

what can cause ALP levels to be high in the population?

A
  • black women
  • old age
  • hyperthyroidism
  • pregnancy
57
Q

what tests can be done to check for fibrosis?

A

P3NP

ELF

58
Q

what tests can be done to check for alcohol?

A

CDT

Ethanol metabolites

59
Q

what tests can be done for tumour markers?

A
  • CA199
    CEA
    AFPT
    CA125
60
Q

What is P3NP often used for?

A

to monitor methotrexate treatment long term as it can cause liver fibrosis

61
Q

what is the ELF test?

A

Meases three biomarkers

  1. hyaluronic acid
  2. P3NP
  3. tissue inhibitor of metalloproteinase 1

uses this to calculate a fibrosis score

62
Q

what is a non invasive assesment for pancreatic exocrine insufficiency?

A

faecal elastase

63
Q

what causes a raised CEA?

A

colorectal cancer

64
Q

what causes a raised AFPT?

A

Hepatocellular carcinoma

65
Q

what causes a raised CA125?

A

ovarian cancer

- conditions that cause peritoneal inflammation

66
Q

what is hepatic elastography used to assess?

A

chronic liver disease

67
Q

what are some causes of iron overload?

A

haemochromotosis

alcohol

T IoD biochemistry (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions