Biochemical markers Flashcards
T/F
Enzymes leak from damaged liver cells; hence they reflect liver function
FALSE
Enzymes leak from damaged liver cells; hence they reflect liver INJURY
Alanine amino transferase (ALT)
- Specific to enzymes in the liver (L for liver)
- Enzymes leak from damaged liver cells; hence they reflect liver INJURY
Aspartate Aminotransferase (AST)
- Non specific: liver, heart, skeletal muscle, kidneys, pancreas (S non SPECIFIC)
- Reflect injury to these organs
Alkaline Phosphatase (ALP)
- Enzyme found in biliary ducts
- Reflects injury in BILIARY duct
Glamma-glutamultransferase (GGT)
- Mirrors ALP
- can be used to confirm if rise in ALP is from hepatic origin (microscopic bile ducts
What does marked increase in ALT show?
- PARACETAMOL induced hepatitis (drug/toxin)
- ACUTE viral hepatitis
- Liver ischaemia
What does modest increase in ALT show?
- chronic/alcoholic/autoimmune hepatitis
What does mild increase in ALT show?
CIRRHOSIS
NAFLD
Hepatocellular carcinoma
HAEMOCHROMASOSIS/WILSONS
Marked increase in ALP?
CHOLESTASIS
Moderate increase in ALP?
Hepatitis, cirrhosis, carcinoma, abscess
Stuff that’s bad enough to affect microscopic bile ducts tooo
Unconjugated bilirubin is formed from?
Extravascular haemolysis results in the breakdown of haem into bilirubin
Unconjugated bilirubin is conjugated by the ___ so that it can be excreted in ____
liver, bile
What is albumin’s half life?
20 days
What does low protein AND low albumin indicate?
Advanced cirrhosis Alcoholism Protein malnutrition chronic inflammation renal/gut.skin loss THE LIVER ISNT FUNCTIONING PROPERLY
What is albumin (testwise)?
functional liver test
Reduced synthetic function of liver results in …
Hypoalbuminaemia
What is prothrombin time
Liver function test
Less circulating procoagulant factors due to synthetic liver damage cause reduced clotting factors
What is INR?
International normalized ratio aka prothrombin time
Clotting factors have ___ half lives, 6-8 ____, so changes can occur _____
short, hours, rapidly
Albumin has a half life of 20 ____ so changes occur _____
days, in weeks
What is alpha 1 trypsin?
It is an enzyme inhibitor
protects tissues from enzymes of inflammatory cells
Alpha 1 trypsin deficiency is a ____ condition and can result in…
genetic
emphysema in lungs, cirrhosis, globules of unsecreted proteins in liver cells
Wilson’s disease is characterized by…
LOW CAERULOPLASMIN LEVELS IN BLOOD (COPPER CARRYING ENZYME)
What do high levels of unconjugated bilirubin indicate?
- Increased RBC breakdown (haemolytic anaemia)
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