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CP > Investigations of the Liver > Flashcards

Investigations of the Liver Flashcards

1
Q

What is included in LFTs?

A 
Alkaline phosphatase
AST (aspartate aminotransferase) 
ALT (alanine aminotransferase)
Bilirubin
Albumin

Total protein
GGT (gamma glutamyl transferase)

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2
Q

What does ALT and AST show?

A

Liver damage/injury

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3
Q

What does bilirubin and albumin show?

A

Liver function

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4
Q

What tests are used to measure the production of metabolites?

A

Urea
Plasma
Plasma proteins

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5
Q

What tests are used to measure the clearance of endogenous substances?

A

Billirubin
Ammonia
Hormones

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6
Q

What tests are used to measure the clearance of exogenous substances?

A

Drugs

Toxins

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7
Q

Is ALT or AST more specific and why?

A

ALT

AST is found in red blood cells and muscle

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8
Q

What is a marker used for liver tumours? In what other circumstance may it be raised?

A

Alpha-fetoprotein

Raised normally in children

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9
Q

What markers would be raised in biliary tract damage?

A

↑ conjugated bilirubin - due to obstruction
↑ ALP
↑ gammaGT - both due to increased synthesis of enzymes by cells lining the bile canaliculi

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10
Q

What other organs apart from the liver is ALP produced?

A

Bone
Intestines
Placenta
Isoenzymes can be separated by electrophoresis

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11
Q

Why is gamma glutamyltransferase raised?

A

structural damage e.g.
Alcohol
Fatty liver
Pancreatic diseases

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12
Q

What is the collection of tests called for biochemical markers of liver fibrosis?

A

ELF (enhanced liver fibrosis) score

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13
Q

What markers/tests would be abnormal in hepatitis?

A

↑ unconjugated bilirubin
↑ conjugated bilirubin - impaired excretion
Normal ALP
↑ AST
↑ ALT
Serology tests
Chronic: Anti smooth muscle, anti liver/kidney, anti microsomal, ANA

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14
Q

What specific marker would be abnormal in alcohol abuse?

A

↑ IgA

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15
Q

What are 5 common disorders of the pancreas?

A 
Acute pancreatitis
Chronic pancreatitis
Pancreatic insufficiency
Cystic Fibrosis
Carcinoma of the pancreas
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16
Q

What is the tumour marker for pancreatic cancer?

A

Ca 199

17
Q

What tests are used to diagnose acute pancreatitis?

A

↑ amylase/lipase
Imagine
Clinical history

18
Q

What tests are used to diagnose chronic pancreatitis?

A 
Imaging
Pancreatic function tests: Direct/indirect
VitD/Calcium
FBC
LFTs
Glucose
Lipid
19
Q

What is the direct (invasive) pancreatic function test?

A

Incubation
Stimulation using IV hormones - secretin, CCK
Collect aspirates in the duodenum
Tested for bicarbonate, amylase, tripsin,

20
Q

What are the indirect (non-invasive) pancreatic function tests?

A

Testing for elastase in stools
Typsinogen in CF screening
Pacreolauryl and NBT-PABA tests - use florescent markers

21
Q

What is the gold standard pancreatic function test?

A

Direct (invasive) test

CP (50 decks)

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