DSA 2: Approach to Hepatobiliary Patient (Elevated Liver Enzymes)

Question 1

PT/INR, Albumin, Cholesterol, and Ammonia are examples of?

Answer 1

True liver function tests

Question 2

Hepatocellular injury causes what levels to be elevates?

Cholestatic injury causes what to be elevated?

Answer 2

1) AST/ALT

2) Alkaline phosphatase and bilirubin

Question 3

Elevation of alkaline phosphatase and bilirubin leads to?

Answer 3

Jaundice and pruritus

Question 4

What liver test provides indication of hepatic uptake, metabolic (conjugation) and excretory functions?

Answer 4

Bilirubin

Question 5

Between AST/ALT which is a more specific measure of liver injury?

Why?

Answer 5

1) ALT

2) Because AST is also found in striated muscle and other organs

Question 6

What correlates with serum alkaline phosphatase activity and is elevated with liver damage?

Answer 6

γ-Glutamyl transpeptidase (GGT)

Question 7

What is the single best acute measure of hepatic synthetic function?

Answer 7

Coagulation factors

Question 8

Clotting factors II, VII, IX, X function only in the presence of?

Answer 8

Vitamin K

Question 9

PT prolongation from fat malabsorption is distinguished from hepatic disease by?

Answer 9

Rapid and complete response to vitamin K replacement

Question 10

In pts with chronic liver disease what correlates with severity of liver dysfunction?

Answer 10

Degree of hypoalbuminemia

Question 11

What does not correlate well with hepatic function or the presence or degree of acute encephalopathy?

Answer 11

The elevation of blood ammonia