Biochemical markers

Question 1

T/F

Enzymes leak from damaged liver cells; hence they reflect liver function

Answer 1

FALSE

Enzymes leak from damaged liver cells; hence they reflect liver INJURY

Question 2

Alanine amino transferase (ALT)

Answer 2

• Specific to enzymes in the liver (L for liver)

- Enzymes leak from damaged liver cells; hence they reflect liver INJURY

Question 3

Aspartate Aminotransferase (AST)

Answer 3

• Non specific: liver, heart, skeletal muscle, kidneys, pancreas (S non SPECIFIC)
• Reflect injury to these organs

Question 4

Alkaline Phosphatase (ALP)

Answer 4

• Enzyme found in biliary ducts

- Reflects injury in BILIARY duct

Question 5

Glamma-glutamultransferase (GGT)

Answer 5

• Mirrors ALP

- can be used to confirm if rise in ALP is from hepatic origin (microscopic bile ducts

Question 6

What does marked increase in ALT show?

Answer 6

• PARACETAMOL induced hepatitis (drug/toxin)
• ACUTE viral hepatitis
• Liver ischaemia

Question 7

What does modest increase in ALT show?

Answer 7

• chronic/alcoholic/autoimmune hepatitis

Question 8

What does mild increase in ALT show?

Answer 8

CIRRHOSIS
NAFLD
Hepatocellular carcinoma
HAEMOCHROMASOSIS/WILSONS

Question 9

Marked increase in ALP?

Answer 9

CHOLESTASIS

Question 10

Moderate increase in ALP?

Answer 10

Hepatitis, cirrhosis, carcinoma, abscess

Stuff that’s bad enough to affect microscopic bile ducts tooo

Question 11

Unconjugated bilirubin is formed from?

Answer 11

Extravascular haemolysis results in the breakdown of haem into bilirubin

Question 12

Unconjugated bilirubin is conjugated by the ___ so that it can be excreted in ____

Answer 12

liver, bile

Question 13

What is albumin’s half life?

Answer 13

20 days

Question 14

What does low protein AND low albumin indicate?

Answer 14

Advanced cirrhosis
Alcoholism
Protein malnutrition
chronic inflammation
renal/gut.skin loss 
THE LIVER ISNT FUNCTIONING PROPERLY

Question 15

What is albumin (testwise)?

Answer 15

functional liver test

Question 16

Reduced synthetic function of liver results in …

Answer 16

Hypoalbuminaemia

Question 17

What is prothrombin time

Answer 17

Liver function test

Less circulating procoagulant factors due to synthetic liver damage cause reduced clotting factors

Question 18

What is INR?

Answer 18

International normalized ratio aka prothrombin time

Question 19

Clotting factors have ___ half lives, 6-8 ____, so changes can occur _____

Answer 19

short, hours, rapidly

Question 20

Albumin has a half life of 20 ____ so changes occur _____

Answer 20

days, in weeks

Question 21

What is alpha 1 trypsin?

Answer 21

It is an enzyme inhibitor

protects tissues from enzymes of inflammatory cells

Question 22

Alpha 1 trypsin deficiency is a ____ condition and can result in…

Answer 22

genetic

emphysema in lungs, cirrhosis, globules of unsecreted proteins in liver cells

Question 23

Wilson’s disease is characterized by…

Answer 23

LOW CAERULOPLASMIN LEVELS IN BLOOD (COPPER CARRYING ENZYME)

Question 24

What do high levels of unconjugated bilirubin indicate?

Answer 24

• Increased RBC breakdown (haemolytic anaemia)

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