GI20

Question 1

Diagnostic Use:
- Aminotransferases (AST & ALT) (2)
“liver enzymes”

Answer 1

Viral Hepatitis (ALT > AST)

Alcoholic Hepatitis (AST > ALT)

Question 2

Diagnostic Use:

- Alkaline phosphatase (ALP) - (3)

Answer 2

• Obstructive liver disease (hepatocellular carcinoma)
• Bone disease
• Bile duct disease

Question 3

Diagnostic Use:

- y-glutamyl transpeptidase (GGT)

Answer 3

• Increased in various liver and biliary diseases like ALP

* NOT in bone disease

Question 4

Diagnostic Use:

- Amylase (2)

Answer 4

• Acute pancreatitis

- Mumps

Question 5

Diagnostic Use:

- Lipase (1)

Answer 5

-Acute pancreatitis

Question 6

Diagnostic Use:

- Ceruloplasmin (1)

Answer 6

-Wilson’s disease (DEcreased)

Question 7

Reye’s syndrome: Findings

Answer 7

• Mitochondrial abnormalities
• Fatty liver (microvascular fatty change)
• Hypoglycemia
• Vomiting
• Hepatosplenomegaly
• Coma

Question 8

Reye’s syndrome: Associations

Answer 8

Viral infection (especially VZV & influenza B)
 -Treated with Aspirin

Question 9

Reye’s syndrome: Mechanism

Answer 9

• Aspirin metabolites DEcrease B-oxidation by reversible inhibtion of mitochondrial enzyme
• Avoid aspirin in children, EXCEPT Kawasaki’s disease

Question 10

Alcoholic Liver Disease:

- Hepatic steatosis

Answer 10

• Short-term change with moderal alcohol intake

- Microvesicular fatty change that may be REVERSIBLE with alcohol cessation

Question 11

Alcoholic Liver Disease:

- Alcoholic hepatitis

Answer 11

• Sustained, long-term consumption
• Swollen and necrotic hepatocytes w/ neutrophilic infiltration
• Mallory bodies are present
• AST > ALT (ratio >1.5)

“make a toAST with alcohol”

Question 12

Alcoholic Liver Disease:

- Alcoholic cirrhosis

Answer 12

• Final, irreversible form
• Micronodular, irregularly shrunken liver
• “Hobnail” appearance
• Sclerosis around Central vein (zone III)