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GI - 2 > Elevated Liver Enzymes and Jaundice > Flashcards

Elevated Liver Enzymes and Jaundice Flashcards

1
Q

Are “Liver Function Tests” markers for liver function?

A

NO - liver damage markers

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2
Q

AST

A

Aspartate Aminotransferase

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3
Q

ALT

A

Alanine Aminotransferase

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4
Q

Hepatocellular

A

Primary injury to hepatocytes

– Increased AST/ALT

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5
Q

Between AST and ALT - which is more specific to liver injury?

A

ALT

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6
Q

Cholestasis

A

Primary injury to bile ducts

– Increased Alkaline Phosphatase/Bilirubin

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7
Q

Signs of Cholestasis

A

Jaundice and Pruritus

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8
Q

What are the 4 Liver Enzyme Tests?

A
  1. Bilirubin
  2. AST and ALT
  3. Alkaline Phosphatase
  4. GGT
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9
Q

This liver enzyme test is an indication of hepatic uptake, metabolic and excretory functions

A

Bilirubin - indirect vs direct

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10
Q

This liver enzyme test is sensitive indicator of liver cell injury (ex. necrosis)

A

AST and ALT = ELEVATION

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11
Q

Normally, ALT is more specific to livery cell injury. What will cause a 2:1 increase of AST:ALT?

A

Ethanol induced livery injury

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12
Q

This liver enzyme test is a sensitive indicator of cholestasis, biliary obstruction and liver infiltration

A

Alkaline Phosphatase

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13
Q

When are elevations of Alkaline Phosphatase possibly normal?

A

Childhood
Pregnancy
Bone diseases

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14
Q

If Alkaline Phosphatase is elevated, what should you check?

A

GGT (gamma-Glutamyl Transpeptidase)

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15
Q

If GGT is normal =

A

Bone involvement

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16
Q

If GGT is elevated =

A

Liver issues

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17
Q

What are the 3 Liver FUNCTION tests?

A
  1. Coagulation factors
  2. Albumin
  3. Ammonia
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18
Q

What are the 3 Liver FUNCTION tests?

A
  1. Coagulation factors
  2. Albumin
  3. Ammonia
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19
Q

What is the best measure of hepatic synthetic function?

A

Coagulation factors

20
Q

All clotting factors except for ____ are synthesized in the liver

A

Factor VIII

21
Q

A _____ in clotting factors is helpful in diagnostic/prognostics of liver disease

A

DECREASE

22
Q

Which clotting factors need vitamin K to function?

A

2, 7, 9, 10

23
Q

INR (international normalized ration) is commonly used for which liver function test?

A

Coagulation factors

24
Q

A DECREASE in Albumin is due to?

A

DECREASED liver synthesis

25
Q

Decreased Albumin means that there will be excessive loss of it in?

A

Urine/stool

26
Q

Why is Albumin NOT sensitive to acute liver issues?

A

The serum half life is too long!! (2-3 weeks)

27
Q

What type of liver disease (acute or chronic) is Albumin more sensitive to?

A

Chronic

28
Q

In patients with chronic liver disease, the degree of HYPOALBUMINEMIA correlates with?

A

Severity of livery dysfunction

29
Q

An INCREASE in Ammonia is due to?

A

Defective hepatic detoxification pathways

30
Q

Increased Ammonia does not correlate well with?

A

Hepatic function or in presence of encephalopathy

31
Q

Jaundice will be seen when the bilirubin is greater than?

A

2

32
Q

What skin segments will most likely be visibly yellow with jaundice?

A

Sclera
Oral mucosa
Palms

33
Q

Hyperbilirubinemia presents as?

A

Jaundice

34
Q

Treatment of Jaundice?

A

Treat the cause

35
Q

Prehepatic jaundice

A

Blood issues

- sickle cell, thalassemia, transfusion reactions

36
Q

Hepatic jaundice

A

Liver issues

- hepatitis, cirrhosis, cancer, drugs

37
Q

Posthepatic jaundice

A

Downstream of the liver

- gallstones, tumors blocking flow of bile

38
Q

Bilirubin can be either?

A

Indirect (unconjugated)

Direct (conjugated)

39
Q

What can cause Unconjugated (indirect) hyperbilirubinemia?

A

Increased bilirubin production or impaired uptake

40
Q

What issues will be associated with Unconjugated hyperbilirubinemia?

A

Hemolysis

Gilbert Syndrome

41
Q

What can cause Conjugated (direct) hyperbilirubinemia?

A

Impaired excretion or hepatocellular dysfunction

42
Q

What issue will be associated with Conjugated hyperbilirubinemia?

A

Meds

43
Q

Gilbert Syndrome

A

Unconjugated Hyperbilirubinemia

- Asymptomatic hereditary jaundice

44
Q

With Gilbert Syndrome, what will increase the bilirubin?

A

FASTING

45
Q

FASTING that increases the indirect bilirubin is seen with?

A

Gilbert Syndrome

GI - 2 (61 decks)

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