Integrative Case Study

Question 1

Liver Serum Enzymes

Answer 1

 ALT – alanine transaminase – involved in protein metabolism produced in hepatocytes; marker for liver disease
 AST – aspartate transaminase – involved in protein metabolism; less specific than ALT because it is found in other tissues
 ALP – alkaline phosphatase – enzyme found in all tissues but especially concentrated in liver, bile duct, kidneys, bone, and placenta; catalyzes the dephosphorylation of molecules
• Can be elevated in liver and non-liver diseases

Question 2

Elevated C-reactive Protein

Answer 2

 Indicator of inflammation; produced by liver and adipose cells in response to elevated plasma IL-6; elevated levels considered a risk factor for diabetes, hypertension and cardiovascular diseas

Question 3

Types of Jaundice

Answer 3

o Prehaptic – increased bilirubin production from increased hemolysis of RBC
o Hepatic – reduced production or secretion of bile (ex: obstructive liver disease)
o Posthepatic – obstructed bile outflow (ex: gasllstones or pancreatic tumor)

Question 4

NASH

Answer 4

o Non-alcoholic steatohepatitis (NASH) – fatty liver disease NOT caused by alcohol abuse
 Chronic alcohol abuse = > 2 glasses per day