DILI: Hepatic Lab Values

Question 1

LFTs

Answer 1

AST, ALT, GGT, ALP

Question 2

What happens to LFTs in long-term liver disease?

Answer 2

The values normalize

Question 3

Normal values for AST

Answer 3

5-40 U/L

Question 4

Normal values for ALT

Answer 4

5-40 U/L

Question 5

Normal values for ALP

Answer 5

30-140 U/L

Question 6

Where is AST also found (besides the liver)?

Answer 6

Cardiac muscle, skeletal muscle, kidneys, brain

Question 7

Where is ALP found (besides the liver)?

Answer 7

Placenta, intestine, kidney

Question 8

Specifically, where is ALP found?

Answer 8

Bile canaliculi in the liver

Question 9

ALP levels are elevated in what situations?

Answer 9

Pregnancy, bone and liver metastases

Question 10

Synthetic function labs

Answer 10

PT/INR, albumin

Question 11

When do you look at the LFTs?

Answer 11

Acute situations to find out the type of liver injury the patient has

Question 12

When do you look at the synthetic function labs?

Answer 12

If the patient has cirrhosis; look at these to prognosticate patients with liver disease

Question 13

Jaundice definition

Answer 13

Physical manifestation of hyperbilirubinemia

Question 14

Normal value of bilitrubin

Answer 14

1

Question 15

Features of unconjugated bili

Answer 15

found predominantly in the serum and lipophilic

Question 16

Features of conjugated bili

Answer 16

glucuronidated in hepatocytes and transported into the biliary canaliculi

Question 17

Unconjugated bili in jaundice

Answer 17

increased bili production, impaired bili transport into hepatocytes preventing conjugation, defective conjugation within the hepatocyte

Question 18

Conjugated bili in jaundice

Answer 18

impaired transport from hepatocyte to biliary duct, extrahepatic obstruction resulting in buildup of bili in hepatocytes causing backward leakage into the blood