GI Tests Flashcards
Unconjugated bilirubin is
not water soluble
Conjugated bilirubin is
water soluble
Unconjugated bilirubin binds to _____ and is taken to the _______ to be conjugated
albumin, liver
Large amounts of unconjugated bilirubin is
toxic to the body
Once conjugated, the bilirubin goes
into the bile and into small intestine
conjugated bilirubin in the large intestine is _______ by bacteria into____________ and ____ is excreted
metabolized into urobilinogen, 90% excreted with feces
Urobilinogen makes poo
BROWN
10% of Urobilinogen goes back into
Portal vein, and eventually excreted by the kidney
Increased Total Bilirubin ddx
CHiCH,BM (a chich had a BM) cirrhosis of liver hepatitis infectious mono chemotherapy hemolytic disease Bile duct obstruction malignancy of liver or gallbladder
Elevated unconjugated bilirubin ddx
RBC destruction from hemolytic anemia, neonatal jaundice, gilbert syndrome, crigler-najjar syndrome
High rates of unconjugated bilirubin in neonates can cause
brain damage- kernicterus(jaundice that has reached neurotoxic levels), nnj can be seen on the 2nd or 3rd day of life
Alanine Aminotransferase(ALT)(SGPT) specific to
Very specific to liver. lower concentrations are found in heart, kidney, and skeletal muscles.
Elevated ALT
"BICHD-hALT" bile duct obstruction infectious mono cirrhosis hepatitis Drugs
Aspartate Aminotransferase(AST)(SGOT) elevated in
BICHD had a MI-ast and the PA SHARTed ; Myocardial Infarction acute Pancreatitis Severe burns acute Hemolytic anemia Acute renal dz Trauma
AST/ALT normally is 0.8. AST greater than ALT at a ratio of greater than 2:1 indicates possibly ???
Alcoholic hepatitis
AST greater than ALT at a ratio of greater than 1 also suggests the presence of ______ in pt’s with ??
Cirrhosis in pt’s with chronic viral hepatitis
AST and ALT values that are upwards of 50 times normal amount ddx
50AvAdtAhAbd and Ischemic hepatitis
are elevated liver enzymes always indicative of a liver disease?
unfortunately it ain’t that easy bud
GGT
Gamma Glutamyltransferase ( Not part of CMP)- used to determine liver cell disfunction and is most commonly used to detect alcohol induced liver dz.
ALP. Major value is in the recognition of
Alkaline Phosphatase. Cholestatic disease(think gallbladder!)
Albumin increased in
Dehydration
Albumin decreased in
albumin falls through the CCRACT Chronic dz Cirrhosis Renal dz Alcoholism Crohn's dz Thyroid dz
Total Protein
total amount of albumin and globulin
Increased total protein levels indicates
Chronic HepB, C, HIV, Multiple Myeloma
