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Clinical Chemistry (CC 1) > (F) L3: Liver Function Tests (Assessment of Liver Function) > Flashcards

(F) L3: Liver Function Tests (Assessment of Liver Function) Flashcards

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1
Q

Tests for Conjugation/Excretion

Give the 3 analytes that can be measured for these tests?

A
  1. Bilirubin
  2. Urobilinogen
  3. Bile Acids
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2
Q

Tests for Conjugation/Excretion

Pre-hepatic and Hepatic Hyperbilirubinemia:

Urine and fecal urobilinogen is increased or decreased?

A

Increased

There is no problem with obstruction, only in the blood and liver itself therefore all of the elevated bilirubin will get passed to the urine and feces as urobilinogen

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3
Q

Tests for Conjugation/Excretion

Post-hepatic Biliary Obstruction:

Fecal urobilinogen is increased or decreased?

A

Decreased

Bilirubin is not excreted properly therefore it is not being converted to urobilinogen

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4
Q

Tests for Conjugation/Excretion

This test uses p-dimethylaminobenzaldehyde (p-dab) with an expected positive (+) result of red

A

Ehrlich’s Method

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5
Q

Tests for Detoxification

  • These differentiate hepatocellular (functional) from obstructive (mechanical) diseases
  • These elevate/released by the hepatocytes when there is liver damage/intoxication
A

Liver Enzymes

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6
Q

Tests for Detoxification

These 2 enzymes are elevated in cases of damaged or necrotic hepatocytes and drug hepatotoxicity

A

AST and ALT (aminotransferases)

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7
Q

Tests for Detoxification

These LD isoenzymes elevate when there is skeletal muscle and liver damage (e.g. acute hepatitis and cirrhosis)

A

LD 4 and 5

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8
Q

Tests for Detoxification

This enzyme increases with drug hepatotoxicity an obstructive jaundice

A

Alcohol Dehydrogenase

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9
Q

Tests for Detoxification

Which LD isoenzyme is markedly increased in liver cancer and toxic hepatitis?

A

LD 5

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10
Q

What is the condition?
ALP: Increased
5’N: Normal
GGT: Normal

A

Not associated to liver disease

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11
Q

What is the condition?
ALP: Increased
5’N: Increased
GGT: Increased

A

Biliary Obstruction

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12
Q

What is the condition?
ALP: Normal OR Slightly Increased
5’N: Normal
GGT: Increased

A

Chronic Alcohol/Drug Intake

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13
Q

These 3 enzymes are used to differentiate between biliary obstruction, chronic alcoholism, and drug intake

A
  1. ALP
  2. 5’N
  3. GGT
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14
Q

Tests for Detoxification

What 3 analytes are measured for this test?

A
  1. Liver Enzymes
  2. Ammonia
  3. Hippuric Acid
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15
Q

Tests for Detoxification

This test uses benzoate which is monitored to see if it can be detoxified by the liver

A

Hippuric Acid Synthesis Test

Benzoate to Hippuric Acid (+) in the urine

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16
Q

Tests Measuring Hepatic Synthetic Ability

What are the 3 types of analytes measured for these tests?

A
  1. Total Protein, Albumin, and Globulin
  2. Prothrombin Time (PT) and Partial Thromboplastin Time (PTT)
  3. Vitamin K Response
17
Q

Tests Measuring Hepatic Synthetic Ability

If there is a problem with the synthesis of clotting factors by the liver, does that shorten or prolong PT and PPT?

A

Prolong

18
Q

Tests Measuring Hepatic Synthetic Ability

In Vit. K Response Test, vitamin K is administered intramuscularly at what dose and for how many days?

A

10mg for 1-3 days

19
Q

Tests Measuring Hepatic Synthetic Ability

This test differentiates intrahepatic disorders vs. extrahepatic obstructive liver disease

A

Vitamin K Response

20
Q

Tests Measuring Hepatic Synthetic Ability

Intrahepatic disorders vs. Extrahepatic obstructive liver disease:

PT and PTT normalize after Vitamin K administration

A

Extrahepatic obstructive liver disease

21
Q

Tests Measuring Hepatic Synthetic Ability

Intrahepatic disorders vs. Extrahepatic obstructive liver disease:

PT and PTT are still prolonged even after administration of Vitamin K

A

Intrahepatic disorders

22
Q

Other Tests for Liver Function

  • A model for end stage liver disease
  • Used for the determination of alcoholic cirrhosis
  • Utilizes the values of serum bilirubin, INR (international normalized ratio), and serum creatinine
  • Determines the probability of survival of patients with liver disease
A

MELD Score

23
Q

Other Tests for Liver Function

High MELD score = what prognosis?

A

Poor (low survival)

These patients are given priority for transplantation

24
Q

Other Tests for Liver Function

This index differentiates alcoholic cirrhosis from alcoholic hepatitis

A

PGA Index

PGA - Prothrombin Time, GGT, and Apo A1

25
Q

Other Tests for Liver Function (PGA Index)

Alcoholic cirrhosis vs. Alcoholic hepatitis:
PT - prolonged
GGT - elevated
Apo A1 - decreased

A

Alcoholic cirrhosis

26
Q

Other Tests for Liver Function (PGA Index)

Alcoholic cirrhosis vs. Alcoholic hepatitis:
PT - prolonged
GGT - elevated
Apo A1 - increased

A

Alcoholic hepatitis

27
Q

Other Tests for Liver Function

This test involves the use of A1-antitrypsin, ceruloplasmin, and AFP

A

Plasma Proteins

AAT and Ceruloplasmin - for excretion
AFP - hepatocellular and testicular cancer

28
Q

Other Tests for Liver Function (Autoimmune Markers)

Associated with primary biliary cirrhosis

A

Antimitochondrial Antibody (AMA)

29
Q

Other Tests for Liver Function (Autoimmune Markers)

Associated with primary sclerosing cholangitis (destruction of the extra- and intrahepatic bile duct)

A

Antineutrophil Cytoplasmic Antibodies (p-ANCAs)

30
Q

Other Tests for Liver Function (Autoimmune Markers)

A titer of > 1:80 is diagnostic of Type 1 Autoimmune Hepatitis

A

Antinuclear Antibody and Anti-Smooth Muscle Antibody

31
Q

Other Tests for Liver Function (Autoimmune Markers)

Associated with Type 2 Autoimmune Hepatitis

A

Antibodies to Liver-Kidney Microsomal Antigen

32
Q

What are the 4 other tests for liver function?

A
  1. MELD Score
  2. PGA Index
  3. Plasma Proteins
  4. Autoimmune Markers

Clinical Chemistry (CC 1) (27 decks)

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