GI 8 - The Liver, Gallbladder + Pancreas Flashcards
In which cells can AST be found?
- Hepatocytes
- Cardiac cells
- Skeletal muscle cells
- Brain cells
What can cause raised AST levels?
- Viral hepatitis
- Toxic hepatitis
- Ischaemic hepatitis
- Cirrhosis
- Infection
- Myocardial infarction
- Muscular dystrophy
- Haemolytic anaemia
Which of AST and ALT are specific to hepatocytes?
ALT
What can cause raised ALP?
- Biliary obstruction
- Bone metastases
- Hyperparathyroidism
What is the most sensitive serum marker of Liver damage? What is its main drawback?
GGT: gamma-glutamyltransferase
Not specific to Liver damage - present elsewhere in body
What changes in albumin levels and prothrombin time would you expect to see in liver failure? Why?
Reduced albumen
Increased prothrombin time
Liver synthesises albumin and clotting factors
Which clotting factors are not synthesised by the Liver?
- Factor VIII
- vWF
If AST:ALT levels = 1, what is the most common explanation?
Ischaemic hepatitis
If AST:ALT < 1, what are the most common explanations?
Viral hepatitis
Toxic hepatitis
Paracetamol OD
If AST:ALT > 2.5, what is the most common explanation?
Alcoholic hepatitis
List some symptoms of liver cirrhosis:
- Jaundice
- Ascites
- Palmar erythema
- Fatigue/lethargy
- Pale conjunctiva
- Caput medusae
- Oedema
- Mental/personality changes
- Asterixis
What is the simple test for hepatic encephalopathy?
Draw a 5-pointed star
- If positive will be unable to draw it
Name the 3 main sites of porto-systemic anastamoses affected by portal hypertension:
- Oesophagus
- Anorectal junction
- Skin of abdomen (caput medusae)
What is the function of the gallbladder?
- Stores bile
- Concentrated bile (removes salt + H2O)
- Releases bile when CCK present
What stimulates the release of bile from the gallbladder?
- Chyme enters duodenum, stimulates release of CCK
- CCK causes contraction of gallbladder, and relaxation of the sphincter of Oddi
