Clinical Biochemisty Of Liver Disease Flashcards
High ALT?
ALT»_space; ALP
Hepatocellular cause
ALT
Alanine aminotransferase
High ALP?
ALP»_space; ALT
Blockage
Cholestatic cause
Functions of the liver
Carb metabolism - gluconeogenesis, glycogen syn & breakdown
Fat met - FA syn, chol syn & exc, lipoprotein syn, ketogenesis, bile syn
Protein met - syn plasma proteins, urea syn
Hormone met
Storage - glycogen, vit A, vit B12, iron
Met & exc of drugs
Haem -> bilverdin
Haem oxygenase
Bilverdin –> uncondugated bilirubin
Biliverdin reductase
Total bilirubin
Conjugated & uncondugated
Direct bilirubin
Conjugated bilirubin
Indirect bilirubin
Uncondugated bilirubin
In what form is the majority of bilirubin in the blood?
Uncondugated
What makes urine dark in a jaundiced patient?
Bilirubin
Pre hepatic
Haemolysis
Hepatic
Hep
Cirrhosis
Tumours
Inborn errors
Post hep
Gallstones
Carcinoma
Half life of albumin
20 days (goes down in chronic)
BUT
also goes done in infection & inflammation- liver makes pro inflammatory molecules instead of albumin
Pro thrombin time
Good indicator of liver function
Tests that reflect liver function
Bilirubin
Albumin
PT time
Urea
Glucose
Test that reflect liver damage
ALK Phos
ALT
GGT
AST
A1-anti-trypsin deficiency
Genetic disorder
Causes defective production of A1AT
Leading to decreased A1AT activity in the blood and lungs,
and deposition of excessive abnormal A1AT protein in liver cells.
Finding out cause of acute hepatitis, request:
Serology
Alcohol, paracetamol
Liver autoantibodies (SMA, AMA)
(Ferritin)
When evaluating consequences of acute hepatitis, request:
PT time Glucose Direct & indirect bilirubin Platelets (Ammonia)
