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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
Prothrombin time is used to monitor _______ therapy
Coumadin
26
There will be a ________ prothrombin time in liver disease ____% loss of function
prolonged, 80
27
Activated partial thromboplastin (aPTT) measures ______ therapy
heparin
28
aPTT measures the extrinsic or intrinsic pathway?
intrinsic
29
What factors foes aPTT measure?
2, 5, 8, 9, 10, 11
30
Does an aPTT depend on liver function?
NO
31
What are the liver enzymes?
AST, ALT, ALP, LDH, GGT
32
Where is alk phos found?
Liver, kidneys, bone, placenta, small intestine, leukocytes
33
Most alk phos comes from what two parts of body/organs?
Liver & bone
34
ALP > _____ times normal is suggestive of cholestasis (obstruction of the large bile duct)
4
35
Why is a GGT helpful?
Helps us determine if increased ALP is due to a hepatic source
36
An increased ALP with normal GGT is hepatic or non-hepatic?
Non-hepatic
37
GGT is usually elevated in _______ (use paulson's mnemonic)
Alcohol abuse "gonna get tipsy"
38
If you abstain from alcohol for 2 weeks, by what percent could you decrease your GGT?
by 50%
39
AST/ALT assess _______ _______
cellular damage
40
AST/ALT are released into serum due to what?
Leaky cell or necrosis of the cell
41
AST elevations without ALT elevations suggest ________ source
cardiac
42
An AST/ALT ratio >1 so AST>ALT is indicative of what?
Alcohol abuse
43
An AST/ALT ratio <1 so AST
Hepatitis
44
Where is LDH found? Where do elevations occur?
Found in liver, heart, blood, brain, skeletal mm, lung Elevated in liver disease
45
What is the range of bilirubin?
0.3-1
46
Billirubin is the sum of what two things?
Sum of conjugated and unconjugated (direct + indirect)
47
_________ is a hallmark sign of elevated billirubin
jaundice
48
This syndrome is a | elevations in unconjugated (non hepatic source) bilirubin
Gilbert's syndrome
49
Normal ammonia lab values?
30-70 ug/dl
50
Where does the majority of ammonia originate from?
From intestinal bacterial catabolism
51
If liver is damaged, what happens to ammonia levels?
They increase
52
Elevations in ammonia cause what?
hepatic encephalopathy and AMS
53
Hep A and E are _______ to _______ spread
fecal to oral
54
Hep B, C, D are spread how?
Blood borne
55
This is a tumor marker for hepatocellular carcinoma (HCC)
Alpha fetoprotein
56
Normal value for alpha fetoprotein
10-20 ng/ml
57
The pancreas has two main functions, what are they?
Exocrine (secrete chem into ducts to aid in digestion) + endocrine (secrete into circulation)
58
What are the exocrine enzymes in the pancreas involved in?
Trypsin, chymotrypsin, amylase, lipase (digestive enzymes)
59
What are the endocrine enzymes in the pancreas involved in?
Hormones insulin and glucagon
60
Pancreatitis, or inflammation of the pancreas, is assessed by measuring which two enzymes?
Amylase & lipase
61
What are two main causes of pancreatitis?
Alcohol abuse and gallstones
62
N/V, severe abdominal pain with radiation to the back are common symptoms of what?
Pancreatitis
63
What is the function of amylase?
Breaks starch into individual glucose molecules
64
Where is amylase secreted?
Secreted by pancreas and salivary gland
65
In pancreatitis, concentrations rise within _____ hr of onset of acute pancreatitis and peak at _____ hours
2-6 hr at onset and peak at 20-30 hours
66
What does lipase do?
Secreted by pancreas and aids in fat digestion
67
Which one declines faster, amylase or lipase?
amylase. lipase declines slower than amylase
68
This is a tumor marker for colorectal carcinomas
CEA
69
Is CEA value used to dx cancer?
No- only used for monitoring progress of treatment of CA

Ex3GI CM (15 decks)

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