LECTURE 19 - Test of liver function Flashcards

1
Q

What are the intracellular/ intrahepatic enzymes

A

ALT and AST

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2
Q

What are the bilary/ cholestatic enzymes

A

ALP
GGT
Billirubin

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3
Q

what percentage of bilirubin is uncongugated/indirect

A

85%

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4
Q

what is insoluble billirubin bound to

A

albumin

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5
Q

what form of bilirubin is soluble

A

bilirubin glucuronide

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6
Q

what does the bacteria in the gut convert billirubin gluconoride into

A

urobillinogen

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7
Q

what percentage of billirubin is conjugated/direct

A

15%

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8
Q

what is uncongugated billirugin

A

billirubin bound to albumen

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9
Q

what is conjugated billirubin

A

billirubin glucuronide

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10
Q

what happens to urobilinogen

A

either excreted in faeces or reabsorbed into the hepatic circulation

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11
Q

what are the 2 pathways of billirubin glucuronide

A

either into the bile where it is converted by bacteria in the gut into urobilinogen

OR

enters the bloodstream as billirubin glucuronide

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12
Q

what happens to billirubin when haemolysis occurs

A

billirubin bound to albumin increases and so dies urobiliongen which means it is more present in faeces and urine

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13
Q

what is ALT involved in

A

in making pyruvate in gluconeogenesis

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14
Q

where is ALT found

A

in the hepatocytes and the cytosol

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15
Q

which enzyme is the most liver specific

A

ALT

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16
Q

when is ALT high

A

in early and late hepatitis

17
Q

What is AST involved in

A

in making glutamate in gluconeogenesis

18
Q

where is AST foun

A

in hepatocytes and in cytosol and mtochondria

19
Q

which has a shorter halflife AST or ALT

A

ALT has a longer half life (48hrs vs 8hrs)

20
Q

when is AST high

A

in hepatitis

21
Q

which enzymes are of billary origin

A

GGT and ALP

22
Q

when is ALP high

A

in obstruction and inflammation of liver billary syst

23
Q

When is GGT high

A

2-3 days after alcohol consumption, due to inflamation/obstruction of billary systm

24
Q

when is billirubin elevated

A

in hepatitis or cancer

25
what does a elevated billirubin indicate
that your liver isn't clearing billirubin properly
26
what does the prothrombin ratio refect
reflects clotting facor sysnthsis- rise indicates Vitamin K deficiency or liver faliure
27
what are the sources of albumin
liver is the only source
28
when does albumin levels fall
indicates impaired liver function - decreased synthesis (cirrhosis) - increased loss (eg kidney) - illness
29
what does high globulin levels reflect
inflammation
30
when are globulin levels high
with chronic hepatitis/ cirrhosis
31
what does it mean if glucose is though
liver damage
32
what are the 2 categories of the causes of jaundice
unconjugated/ indirect conjugated/ direct
33
what are the unconjugated/indirect causes of jaundice
haemolysis, | Gilbert's syndrome= decrease in uptake of billirubin
34
what are the conjugated/ direct causes of jaundice
cholestasis- when bile can't flow from the liver to the duodenum obstruction inside liver (hepatitis, cirrhosis, masses) obstruction outside liver- gall stones, billary/ pancreateic cancer, pancreatitis
35
what is Gilbert's syndrome
decrease in uptake of billirubin other liver function tests will be normal illness/ fasting will worsen
36
common causes of viral hepatitis
infectious mono | hep a and b
37
causes of LFT abnormaliites
fatty liver viral hepatitis alchol haemochromatosis
38
what does increased ammonia indicate
decreased liver function