Brainscape's Knowledge GenomeTM

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


See full index

Pathology (Guide) > Chemical Pathology - LFTs > Flashcards

Chemical Pathology - LFTs Flashcards

1
Q

What are markers of liver cell damage?

A
  • ALT
  • AST
  • ALP
  • GGT
  • Bilirubin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are markers of synthetic function?

A
  • Clotting (INR)
  • Albumin
  • Glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the best marker of liver function in acute liver injury?

A

Prothrombin time

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

What are some causes of transaminitis (Transaminases in the 1000s)?

A
  • Acute viral hepatitis
  • Toxins (e.g. paracetamol)
  • Ischaemic hit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where are AST and ALT found?

A

Liver, cardiac and skeletal muscle, and the kidney + brain

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

What are some causes of a raised AST and ALT?

A

Hepatic (e.g. hepatitis, transaminitis)

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

What conditions are indicative of a raised ALT > raised AST?

A
  • Chronic liver disease (e.g. NASH)
  • Chronic hepatitis C
  • Hepatic obstruction
  • Advanced fibrosis/cirrhosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some causes of an AST:ALT ratio of 2:1?

A

Alcoholic liver disease

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

What are some causes of an AST:ALT ratio of 1:1?

A

Viral hepatitis

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

Where is GGT found?

A
  • Hepatocytes
  • Biliary cells
  • Kidney
  • Pancreas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of picture is seen with a raised GGT and ALP?

A

Cholestatic/obstructive
- Gallstones
- Head of pancreas tumour

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

What are some causes of a raised GGT?

A
  • Chronic alcohol use
  • Bile duct disease
  • Metastases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is ALP found?

A

High concentrations in liver, bone (osteoblastic activity), intestine + placenta

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

What are some physiological and pathological causes of an isolated rise in ALP?

A

Physiological:
- Pregnancy
- Childhood (growth spurt)

Physiological:
>5x upper normal limit
- Paget’s disease
- Osteomalacia
- Liver (cholestasis, cirrhosis)
<5x upper normal limit
- Primary tumours, infiltrative liver disease
- Hepatitis
- Renal osteodystrophy

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

Why is ALP normal in multple melanoma?

A

Plasma cells suppress osteoblasts (ALP produced by osteoblasts)

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

What is albumin indicative of?

A

Liver synthetic function

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

What are some causes of a low albumin levels?

A
  • Chronic liver disease
  • Malnutrition
  • Protein-losing enteropathy
  • Nephrotic syndrome
  • Sepsis
18
Q

What are some causes of low urea?

A
  • Severe liveer disease
  • Malnutrition
  • Pregnancy
19
Q

Where is urea synthesised?

A

The liver

20
Q

What are some causes of a raised urea (>10x the upper normal limit)?

A
  • Upper GI bleed
  • Dehydration/AKI
21
Q

What are some causes of prehepatic jaundice?

A
  • Haemolytic anaemia
  • Ineffective erythropoeisis
22
Q

What are some bilirubin findings of prehepatic jaundice

A
  • No conjugated bilirubin
  • No urine bilirubin
  • Normal/increased urobilinogen
  • Normal/increased unconjugated bilirubin
  • Splenomegaly
23
Q

What are some causes of hepatic jaundice?

A
  • Hepatocellular dysfunction
  • Impaired conjugation (Gilbert’s syndrome)
  • Impaired bilirubin uptake
24
Q

What are som bilirubin findings of hepatic jaundice?

A
  • Increased conjugated bilirubin
  • Increased unconjugated bilirubin
  • Increased urobilinogen
  • Urine bilirubin present
  • Dark urine
  • Increased AST/ALT
  • Splenomegaly
25
Q

What are some causes of post-hepatic jaundice?

A

Obstruction
- Stones
- Pancreatic cancer

26
Q

What are some urine and stool findings of post-hepatic jaundice?

A
  • Incerased conjugated bilirubin
  • Absent/decreased urobilinogen
  • Urin bilirubin present
  • Dark urine (increased urobilinogen)
  • Pale stool (decreased stercobilinogen)
  • Increased ALP
27
Q

How much albumin is synthesised daily in the average adult?

A

200mg/kg

28
Q

What does albumin do?

A

Binds many hormones, calcium + other metabolites

29
Q

What can contribute to a reduced albumin?

A
  • Acute illness/systemic inflammation
  • Malnutrition
30
Q

What is a poor prognostic factor in critically ill patients?

A

Hypoalbuminaemia

31
Q

Which clotting factors are synthesised in the liver?

A
  • Factors V, VII, IX, X, XII, XIII
  • Fibrinogen
  • Prothrombin
32
Q

What is the INR?

A

International normalised ratio
- Prothrombin time standardised for age and population
- Expressed as ratio of normal

33
Q

What are some other causes of deranged clotthing (aside from hepatocellular dysfunction)?

A
  • Iatrogenic (therapeutic warfarinisation)
  • Hereditary thrombophilia
  • Acquired consumption (DIC)
34
Q

What is jaundice?

A

Elevated serum bilirubin manifesting as yellowing of the skin or sclera (icterus)

35
Q

What is bilirubin?

A

A breakdown produce of heme (majority produced by breakdown of haemoglobin)

36
Q

What is the process of bilirubin, urobilinogen and stercobilinogen production?

A
  • Normal bilirubin metabolism: conjugation in hepatocytes + secretion into bile ducts then GI tract
  • Conjugated bilirubin metabolised in GI tract into urobilinogen
  • Urobilinogen partially reabsorbed and excreted in kidneys (as urobilin) + the rest is converted into stercobilin
37
Q

What is basic pathophysiology of pre-hepatic jaundice?

A

Raised bilirubin production

38
Q

What is the basic pathophysiology of hepatic jaundice?

A

Decreased ability to conjugate bilirubin

39
Q

What is the basic pathophysiology of post-hepatic jaundice?

A

Decreased ability to excrete conjugated bilirubin

40
Q

Why is there no urine bilirubin in prehepatic jaundice?

A
  • Unconjugated bilirubin (from heme breakdown in spleen), is tightly bound to albumin
  • Too larger to pass through glomerulus
  • Expect: raaised LDH, reduced haptoglobin
41
Q

What are some causes of hepatomegaly with a smooth margin?

A
  • Viral hepatitis
  • Biliary tract obstruction
  • Hepatic congestion secondary to HF/Budd-Chiari
42
Q

What are some causes of hepatomegaly with a craggy border?

A
  • Hepatic metastatic disease
  • Polycystic disease
  • Cirrhosis (will shrink)

Pathology (Guide) (84 decks)

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