Lab Review (liver/GI focused)

Question 1

Describe what conditions urinary bilirubin can test for

Answer 1

Increased levels can indicate hepatitis, infection/toxic agents, obstructive biliary tract disease

Question 2

Describe what urine urobilinogen can test for

Answer 2

• increased: hemolysis, liver disease
• decreased: biliary obstruction (gallstones or pancreatic cancer)

Question 3

List the 7 components of a BMP

Answer 3

also sometimes calcium

Question 4

List the 5 components of a CBC

Answer 4

Question 5

Describe amylase

Answer 5

• pancreatic enzyme
• normalizes faster than lipase

Question 6

Describe some causes of increased & decreased serum amylase

Answer 6

• increased: pancreatitis, pancreatic obstruction, gallbladder inflammation
• decreased: pancreatic insufficiency, liver dz

Question 7

Describe lipase

Answer 7

• pacnreatic enzyme
• stays elevated longer than amylase in pancreatitis

Question 8

Describe some causes of increased lipase

Answer 8

• pancreatitis
• pancreatic cancer
• gallbladder inflammation

Question 9

What is AST (aspartate aminotransferase)

Answer 9

• liver enzyme (also in heart, muscle, kidney)
• released when there is tissue injury
• normal 9-40 U/L

Question 10

Describe some causes of increased serum AST

Answer 10

• liver problems (hepatocellular or mixed injury)
• heart attack

indicates recent liver cell injury/inflammation with low specificity

Question 11

Describe ALT (alanine aminotransferase)

Answer 11

• liver enzyme (also in muscle & heart)
• released when there is tissue injury
• normal 0-35 U/L

Question 12

Describe when a serum ALT may be increased

Answer 12

Liver damage: infection, meds, alcohol, cancer, hepatocellular or mixed injury

indicates recent liver cell injury/inflammation with high specificity

Question 13

Describe alkaline phosphatase

Answer 13

• liver enzyme (also in many other cells: biliary tract, intestines, placenta, bone, kidney)
• released when cells are destroyed or during growth
• helps breakdown proteins
• normal 30-120 U/L

Question 14

Describe when an alk phos may be increased or decreased

Answer 14

• Increased: liver problems (cholestatic or mixed injury), bone disorders, biliary tract disorders
• decreased: osteoporosis, vit deficiency

Question 15

Describe bilirubin

Answer 15

• comes from breakdown of RBCs
• conjugated in the liver & excreted in bile
• unconjugated in circulation bound to albumin

Question 16

Describe when serum bilirubin may be increased or decreased

Answer 16

• increased: hemolysis, liver injury , bile duct obstruction
• decreased: anemia

Question 17

Describe the components of a CMP

Answer 17

• everything on a BMP (Na, Cl, K, BUN, Cr, glucose, HCO3)
• AST
• ALT
• Alk phos
• bilirubin
• total protein
• albumin

Question 18

What is gamma-glutamyl trasnferase (GGT)

Answer 18

• liver enzyme (also in kidney, prostate, spleen)
• higher in men
• helps metabolize drugs & toxins

Question 19

Describe when a serum GGT may be elevated

Answer 19

alcohol induced liver problems (indicates elevated alk phos)

Question 20

List the 9 components of LFTs

Answer 20

• ALT
• AST
• Alk phos
• bilirubin
• GGT
• prothrombin
• INR
• total protein
• albumin

Question 21

Describe albumin

Answer 21

complex protein made in liver
- synthetic function/actual liver function test

Question 22

Describe prothrombin/INR for liver testing

Answer 22

• reliable fora cute & chronic hepatocellular disease
• most sensitive test for liver problems
• confounded by low Vit K, coumadin, hemophilia