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Ex3GI CM > Labs of GI- Schoenwald > Flashcards

Labs of GI- Schoenwald Flashcards

1
Q

What lab test do you order that contains all of the liver function tests and GI labs we would want?

A

CMP (Comprehensive Metabolic Panel)

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2
Q

Which organ produces albumin?

A

Liver

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3
Q

What are 5 functions of the liver?

A
  • Produce bilirubin
  • AA and carbohydrate metabolism
  • Produces coag factors (vit K dependent) and albumin
  • Lipid metabolism
  • Metabolizes drugs and most hormones
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4
Q

An LFT includes what three values?

A
  • Albumin
  • Prealbumin
  • Prothrombin

(LFT = 3 letters, this is 3 tests)

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5
Q

What is the normal albumin range?

A

3.5-5 g/dl

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6
Q

In cirrhosis, albumin _________ (inc/dec)

A

decreases

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7
Q

Albumin acts as a ______ ________ of hormones, drugs, anions and fatty acids

A

carrier protein

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8
Q

Hypoalbumin is not associated with symptoms until ______________ _____

A

extremely low

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9
Q

Peripheral edema, ascites and pulmonary edema cause albumin to be ____

A

low

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10
Q

What is albumin?

A

Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn’t leak into other tissues

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11
Q

**If album is low, what happens?

A

Remember*** albumin maintains oncotic pressure, if low, fluid leaks form intravascular space into interstitial spaces of tissue or into body cavities

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12
Q

Low albumin levels effect interp of ______ levels

A

Calcium

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13
Q

What is prealbumin?

A

It is the precursor to albumin

Measuring prealbumin can help clinicians detect short-term impairment of energy intake and the effectiveness of nutritional support efforts.

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14
Q

Where is prealbumin synthesized?

A

By the liver

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15
Q

Is albumin or prealbumin more sensitive to dietary intake?

A

Prealbumin

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16
Q

What is included in total protein?

A

albumin + globulin

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17
Q

How do you calculate the globulin?

A

Total protein - albumin = globulin

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18
Q

What is the normal level of globulin?

A

5.5- 8.3 g/dl

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19
Q

Total protein is useful in assessing what?

A

TP useful in assessing immune or hematologic dysfunction

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20
Q

Is total protein synthesized by the liver?

A

No

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21
Q

Prothrombin is produced by the ______ and the function is to

A

Liver & measure extrinsic coagulation pathway

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22
Q

What factors does prothrombin time measure?

A

2,5,7,10

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23
Q

Vitamin K dependent factors are

A

2,7,9,10

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24
Q

Does prothrombin time measure the intinsic or extrinsic coagulation pathway/

A

Extrinsic

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25
Q

Prothrombin time is used to monitor _______ therapy

A

Coumadin

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26
Q

There will be a ________ prothrombin time in liver disease ____% loss of function

A

prolonged, 80

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27
Q

Activated partial thromboplastin (aPTT) measures ______ therapy

A

heparin

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28
Q

aPTT measures the extrinsic or intrinsic pathway?

A

intrinsic

29
Q

What factors foes aPTT measure?

A

2, 5, 8, 9, 10, 11

30
Q

Does an aPTT depend on liver function?

A

NO

31
Q

What are the liver enzymes?

A

AST, ALT, ALP, LDH, GGT

32
Q

Where is alk phos found?

A

Liver, kidneys, bone, placenta, small intestine, leukocytes

33
Q

Most alk phos comes from what two parts of body/organs?

A

Liver & bone

34
Q

ALP > _____ times normal is suggestive of cholestasis (obstruction of the large bile duct)

A

4

35
Q

Why is a GGT helpful?

A

Helps us determine if increased ALP is due to a hepatic source

36
Q

An increased ALP with normal GGT is hepatic or non-hepatic?

A

Non-hepatic

37
Q

GGT is usually elevated in _______ (use paulson’s mnemonic)

A

Alcohol abuse “gonna get tipsy”

38
Q

If you abstain from alcohol for 2 weeks, by what percent could you decrease your GGT?

A

by 50%

39
Q

AST/ALT assess _______ _______

A

cellular damage

40
Q

AST/ALT are released into serum due to what?

A

Leaky cell or necrosis of the cell

41
Q

AST elevations without ALT elevations suggest ________ source

A

cardiac

42
Q

An AST/ALT ratio >1 so AST>ALT is indicative of what?

A

Alcohol abuse

43
Q

An AST/ALT ratio <1 so AST

A

Hepatitis

44
Q

Where is LDH found? Where do elevations occur?

A

Found in liver, heart, blood, brain, skeletal mm, lung

Elevated in liver disease

45
Q

What is the range of bilirubin?

A

0.3-1

46
Q

Billirubin is the sum of what two things?

A

Sum of conjugated and unconjugated (direct + indirect)

47
Q

_________ is a hallmark sign of elevated billirubin

A

jaundice

48
Q

This syndrome is a

elevations in unconjugated (non hepatic source) bilirubin

A

Gilbert’s syndrome

49
Q

Normal ammonia lab values?

A

30-70 ug/dl

50
Q

Where does the majority of ammonia originate from?

A

From intestinal bacterial catabolism

51
Q

If liver is damaged, what happens to ammonia levels?

A

They increase

52
Q

Elevations in ammonia cause what?

A

hepatic encephalopathy and AMS

53
Q

Hep A and E are _______ to _______ spread

A

fecal to oral

54
Q

Hep B, C, D are spread how?

A

Blood borne

55
Q

This is a tumor marker for hepatocellular carcinoma (HCC)

A

Alpha fetoprotein

56
Q

Normal value for alpha fetoprotein

A

10-20 ng/ml

57
Q

The pancreas has two main functions, what are they?

A

Exocrine (secrete chem into ducts to aid in digestion) + endocrine (secrete into circulation)

58
Q

What are the exocrine enzymes in the pancreas involved in?

A

Trypsin, chymotrypsin, amylase, lipase (digestive enzymes)

59
Q

What are the endocrine enzymes in the pancreas involved in?

A

Hormones insulin and glucagon

60
Q

Pancreatitis, or inflammation of the pancreas, is assessed by measuring which two enzymes?

A

Amylase & lipase

61
Q

What are two main causes of pancreatitis?

A

Alcohol abuse and gallstones

62
Q

N/V, severe abdominal pain with radiation to the back are common symptoms of what?

A

Pancreatitis

63
Q

What is the function of amylase?

A

Breaks starch into individual glucose molecules

64
Q

Where is amylase secreted?

A

Secreted by pancreas and salivary gland

65
Q

In pancreatitis, concentrations rise within _____ hr of onset of acute pancreatitis and peak at _____ hours

A

2-6 hr at onset and peak at 20-30 hours

66
Q

What does lipase do?

A

Secreted by pancreas and aids in fat digestion

67
Q

Which one declines faster, amylase or lipase?

A

amylase. lipase declines slower than amylase

68
Q

This is a tumor marker for colorectal carcinomas

A

CEA

69
Q

Is CEA value used to dx cancer?

A

No- only used for monitoring progress of treatment of CA

Ex3GI CM (15 decks)

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