Gastro enzymes Flashcards
Where is ALT and when is it raised
LIVER enzyme
Raised in: LIVER DYSFUNCTION, ACUTE PHASE REACTON
Where is ALP found
liver
biliary duct
bone
placenta (very non specific)
What ratio of ALP: ALT suggests post-hepatic causes
ALP»_space;> ALT (because it tells you that both are damaged but BILIARY TRACT especially damaged)
what other enzyme can you get that is LIVER SPECIFIC
GGT
Where s AST found and what does it indicateb
LIVER enzyme; liver INJURY
what causes raised AST:ALT = 2:1
alcohol
sx haemochromatosis
fatigue erectile dysfunction arthralgia arthritis bronze skin diabetes heart failure
what stain can you do for haemochromatosis
Pearl stain
mx haemochromatosis
- venesection
2. desferroxamine
sx of chronic panceatitis
pain 15-30 mins after meals
staetorrhoea, diabetes mellitus (a long time after sx begin)
ix for chronic pancreatitis
Bloods: faecal elastase (measures expcrine function), HbA1c, glucose levels (for DM)
USS (exclude gallstones)
CT with contrast
what is GORD
reflux of gastric acid and bile causing oesophagitis
RF for GORD
raised intra abdo pressure (obesity/pregnancy) oesophageal sphincter hypotension (drugs, achalasia, hiatus hernia) acid hypersecretion (smoking, Zollinger Ellison)
what investigations cana you get for suspected GORD
OGD, CXR
consider barium swallow, 24h oesophageal monitoring
How do you treat GORD
conservative: WL; stop smoking, ssmall regular meals, avoid large meals. avoiod alcohol and spices
medical:
(OTC - antacid (gaviscon))
- PPI (omeprazole)
- H2 antagonist (ranitidine)
surgical: nissen fundoplication
