Endocrine Systems

Question 1

Which liver function test is more specific than AST (aspartate aminotransferase) for liver disease?

Answer 1

ALT (alanine aminotransferase)

Question 2

If AST (Aspartate aminotransferase) is high but ALT (alanine aminotransferase) is normal what does this suggest?

Answer 2

An extra hepatic cause e.g. muscle is making AST high.

If this is the case CPK (creatine phosphokinase) should be measured. This enzyme is found in the heart, brain and skeletal muscle.

Question 3

If ALT > AST what does this indicate?

Answer 3

Liver disease - Viral Hepatitis

Question 4

If AST > ALT what does this indicate?

Answer 4

Alcoholic liver disease

Question 5

If a person has high ALP (alkaline phosphatase) but normal GGT (Gamma-glutamyl transferase) what does this indicate?

Answer 5

An extra hepatic cause e.g. bone - increased osteoblastic activity

Question 6

If a person has a sudden increase in ALP and GGT what could this be a sign of?

Answer 6

Hepatocellular carcinoma

Question 7

If a person has jaundice, anaemia, high unconjugated bilirubin but everything else is okay, what does this indicate?

Answer 7

Hamolytic Jaundice

Question 8

If a person has jaundice, high unconjugated and conjugated bilirubin, very high AST and ALT, but normal ALP and GGT, what does this indicate?

Answer 8

Hepatocellular Jaundice

Question 9

If a person has jaundice, high unconjugated bilirubin, very high conjugated bilirubin, slightly elevated AST and ALT and very high ALP and GGT, what does this indicate?

Answer 9

Obstructive Jaundice

Question 10

A patient has epigastric pain radiating to the back, fever and high amylase + lipase, what does this indicate?

Answer 10

Pancreatitis

Question 11

A patient has a fever, RUQ pain, jaundice, dark urine, very high ALT and AST (400-4000 IU) with ALT>AST, they have slightly raised ALP. What does this indicate?

Answer 11

Viral hepatitis

Question 12

A patient has a fever, RUQ pain, jaundice, dark urine, very high ALT and AST (>10,000 IU) with ALT>AST, they have slightly raised ALP. What does this indicate?

Answer 12

Acetaminophen (paracetamol) toxicity

This results in extremely high ALT and AST (compared to very high in viral hepatitis)

Question 13

A patient has a fever, RUQ pain, jaundice, dark urine, high ALT and AST (<400 IU) with AST>ALT, slightly raised ALP and high GGT. What does this indicate?

Answer 13

Alcoholic steatophepatitis

Question 14

A patient has a fever, RUQ pain, leukocytosis, high bilirubin, high ALP, high amylase and high lipase. What does this indicate?

Answer 14

Biliary Pancreatitis

Question 15

What is Chvostek’s Sign?

Answer 15

Chvostek’s sign is the facial twitch obtained by tapping the distribution of the facial nerve in front of the tragus.

Question 16

What is Chvostek’s sign caused by?

Answer 16

It is caused by mechanical irritability of peripheral nerves.

Question 17

What is Chvostek’s sign indicative of?

Answer 17

It is indicative of hypocalcemia and is the most reliable test for hypocalcemia.