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Clinical Pathology > Chemistry 2 (Hepatic) > Flashcards

Chemistry 2 (Hepatic) Flashcards

1
Q

AST is present in

A

Cardiac>liver>sk. musc>kidney>brain>lung>panc

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2
Q

which is more specific for liver (AST or ALT)

A

ALT (in liver and kindey)

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3
Q

which is 80% mitochondrial and 20% cytoplasmic

A

AST

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4
Q

which has marked diurnal variation

A

ALT

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5
Q

Fast LDH isoenzymes are, and are seen in

A

LD1>2

heart, RBC, kidney

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6
Q

In adults, ___ tends to be slightly higher than ___

A

ALT>AST

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7
Q

Slow LDH isoenzymes are, and are found in

A

LD4&5

liver and skeletal muscle

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8
Q

LDH isoenzymes that is “dire finding”

A

LD6

hepatic vascular insufficiency

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9
Q

order of normal [LDH] by isotype

A

2>1>3>4>5

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10
Q

what is “flipped LD ratio” and when is it seen

A

LD1>LD2

acute MI, hemolysis, renal infarct

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11
Q

[LDH] order in normal CSF

A

1>2>3>4>5

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12
Q

where is acid phosphatase found

A

prostate
RBCs
bone

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13
Q

What separates RBC acid phosphatase from others

A

susceptible to inhibition by 2% formaldehyde

resistant to inhibition by tartrate (TRAP of hairy cell)

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14
Q

Sources of Alkaline phosphatase

A

bone, bile ducts, intestine, placenta

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15
Q

Alk phos decreased in

A

hypophosphatemia

malnutrition

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16
Q

alk phos isoenzyme that is inactivated by hear or urea

A

bone (100%)

biliary (50%)

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17
Q

most sensitive marker of hepatic metastases

A

biliary alk phos

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18
Q

bone alk phos produced by osto___

A

osteoblasts (during bone formation)

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19
Q

Regan isoenzyme

A

seen in 5% of pts with CA

identical to placental alk phos

20
Q

blood groups that are particularly susceptible to false increase in alk phos when not fasting

A

Lewis+ B or O secretors

21
Q

mild alk phos increase

A

pregnancy
CHF
hyperthryroidsm
NSAIDs

22
Q

most sentitive marker to biliary injury

A

GGT

23
Q

Toxins that increase GGT

A

warfarin, barbiturates, Dilantin, valproate, methotrexate, EtOH

24
Q

5’-nucleotidase found in, and increased in

A

biliary epithelium

cholestasis

25
Q

transport requirements for ammonia

A

fresh sample, chilled during transport, no hemolysis

26
Q

which bilirubin type appears in urine

A

conjugated only

27
Q

Unconjugated hyperbilirubinemia seen n

A

Crigler-Najjar
Gilbert
Hemolysis
cirrhosis

28
Q

Conjugated hyperbilirubinemia seen in

A 
Dubin-Johnson
hepatitis
estrogen
obstruction
Rotor
29
Q

what is delta-bilirubin

A

conjugated bilirubin attached to albumin

can’t be excreted so lasts a long time

30
Q

T1/2 of Factor 7

A

12 hr

31
Q

Vit K deficiency can be caused by

A

impaired bile secretion (bile salts needed for K+ absorption

32
Q

Immunoglobulins in autoimmune hepatitis

A

polyclonal IgG

33
Q

Immunoglobulins in primary biliary cirrhosis

A

polyclonal IgM

34
Q

A/G ratio in liver disease

A

<1.0

35
Q

physiologic and breast milk jaundice are both___

A

unconjugated

36
Q

2 inherited unconjugated bilirubinemias

A

Crigler-Najjar

Gilbert

37
Q

2 inherited conjugated bilirubinemias

A

Dubin-Johnson

Rotor

38
Q

Physiologic jaundice seen at ____ days of life, rises at ____

A

2-3days

5-6mg/dL

39
Q

Concerning signs in neonatal jaundice

appears within ___, rising beyond ____, persisting beyond___, total >____, single day increase>___, conjugated >___

A 
appear within 24hr
rising beyond 1 wk
persisting beyond 10d
total > 12mg/dL
single day increase >5mg/dL
conjugated >2 mg/dL
40
Q

exchange transfusion when bili

A

> 20mg/dL

41
Q

phototherapy not useful for ___

A

conjugated hyperbili

42
Q

Jaundice in 1st 24hr ddx

A

HDFN, hemorrhage, sepsis, TORCH

43
Q

Jaundice after 1st week ddx

A

breast milk jaundice, extrahepatic biliary atresia, CF, Alagille

44
Q

AST/ALT ratio in toxic/ischemic/Etoh vs Viral

A

toxic >2

viral <1

45
Q

best indicator of prognosis in acute hepatic injury

A

PT longer than 4s

Clinical Pathology (59 decks)

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