George Cutler - (hep B from chronically infected wife) Flashcards
1
Q
MOA of oedema in Hep b?
A
hepatocyte death> reduced production of albumin > decrease oncotic pressure > oedema
2
Q
MOA of bruising in hep b?
A
hepatocyte death > reduced production of coagulation factors > haemorrhagic state > bruising
3
Q
describe the elevation in markers ALT, AST, GGT and ALP
A
Elevated GGT and ALP
- Is due to the destruction and obstruction of bile canaliculi
o GGT: found in the endoplasmic reticulum of hepatocytes and bile duct epithelium. GGT is elevated with alcohol metabolism and biliary obstruction.
o ALP: found in the canalicular surface of the hepatocyte. Its serum level rises in biliary tract obstruction
Elevated ALT and AST
- Due to hepatocyte death (apoptosis)
o ALT: ALT is a cytosolic enzyme. It is released into the blood when hepatocytes are damaged, and is
more specific to liver damage than AST.
o AST: AST is a 80% mitochondrial, 20% cytosolic enzyme (also found in heart, skeletal muscle, kidney,
brain and RBC’s)