GI Tests

Question 1

Unconjugated bilirubin is

Answer 1

not water soluble

Question 2

Conjugated bilirubin is

Answer 2

water soluble

Question 3

Unconjugated bilirubin binds to _____ and is taken to the _______ to be conjugated

Answer 3

albumin, liver

Question 4

Large amounts of unconjugated bilirubin is

Answer 4

toxic to the body

Question 5

Once conjugated, the bilirubin goes

Answer 5

into the bile and into small intestine

Question 6

conjugated bilirubin in the large intestine is _______ by bacteria into____________ and ____ is excreted

Answer 6

metabolized into urobilinogen, 90% excreted with feces

Question 7

Urobilinogen makes poo

Answer 7

BROWN

Question 8

10% of Urobilinogen goes back into

Answer 8

Portal vein, and eventually excreted by the kidney

Question 9

Increased Total Bilirubin ddx

Answer 9

CHiCH,BM (a chich had a BM)
cirrhosis of liver
hepatitis
infectious mono
chemotherapy
hemolytic disease
Bile duct obstruction
malignancy of liver or gallbladder

Question 10

Elevated unconjugated bilirubin ddx

Answer 10

RBC destruction from hemolytic anemia, neonatal jaundice, gilbert syndrome, crigler-najjar syndrome

Question 11

High rates of unconjugated bilirubin in neonates can cause

Answer 11

brain damage- kernicterus(jaundice that has reached neurotoxic levels), nnj can be seen on the 2nd or 3rd day of life

Question 12

Alanine Aminotransferase(ALT)(SGPT) specific to

Answer 12

Very specific to liver. lower concentrations are found in heart, kidney, and skeletal muscles.

Question 13

Elevated ALT

Answer 13

"BICHD-hALT"
bile duct obstruction
infectious mono
cirrhosis
hepatitis
Drugs

Question 14

Aspartate Aminotransferase(AST)(SGOT) elevated in

Answer 14

BICHD
had a 
MI-ast
and the
PA SHARTed
;
Myocardial Infarction
acute Pancreatitis
Severe burns
acute Hemolytic anemia
Acute renal dz
Trauma

Question 15

AST/ALT normally is 0.8. AST greater than ALT at a ratio of greater than 2:1 indicates possibly ???

Answer 15

Alcoholic hepatitis

Question 16

AST greater than ALT at a ratio of greater than 1 also suggests the presence of ______ in pt’s with ??

Answer 16

Cirrhosis in pt’s with chronic viral hepatitis

Question 17

AST and ALT values that are upwards of 50 times normal amount ddx

Answer 17

50AvAdtAhAbd and Ischemic hepatitis

Question 18

are elevated liver enzymes always indicative of a liver disease?

Answer 18

unfortunately it ain’t that easy bud

Question 19

GGT

Answer 19

Gamma Glutamyltransferase ( Not part of CMP)- used to determine liver cell disfunction and is most commonly used to detect alcohol induced liver dz.

Question 20

ALP. Major value is in the recognition of

Answer 20

Alkaline Phosphatase. 
Cholestatic disease(think gallbladder!)

Question 21

Albumin increased in

Answer 21

Dehydration

Question 22

Albumin decreased in

Answer 22

albumin falls through the CCRACT
Chronic dz
Cirrhosis
Renal dz
Alcoholism
Crohn's dz
Thyroid dz

Question 23

Total Protein

Answer 23

total amount of albumin and globulin

Question 24

Increased total protein levels indicates

Answer 24

Chronic HepB, C, HIV, Multiple Myeloma

Question 25

Decreased total protein levels indicates

Answer 25

nephrotic syndrome, glomerulonephritis, burns, bleeding, malnutrition

Question 26

Hepatic Function Panel

Answer 26

ALT, AST, Albumin, Alkaline Phosphatase, Conjugated/direct bilirubin and total bilirubin, and total protein.

Question 27

Acute hepatitis panel

Answer 27

Hepatitis A, AB, IgM, hepatitis B core ab, IgM, Hepatitis B surface antigen, IgM, hepatitis C, AB

Question 28

Amylase elevated

Answer 28

Pancreatitis, Obstruction of a pancreatic duct, perforated stomach ulcers, acute appendicitis, and acute cholecystitis.
(55-60% salivary glands, 40-45% pancreas.)

Question 29

When to order amylase

Answer 29

when you are suspicious of pancreatitis. as it rises faster than lipase

Question 30

Lipase will increase and stay increased for….?

Answer 30

24-36 hours after pancreatic damage, stay increased for up to 14 days

Question 31

New onset dyspepsia

Answer 31

aka, upset stomach, or indigestion.