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Lab Med > LFT & Other GI > Flashcards

LFT & Other GI Flashcards

1
Q

why is PT and INR included in a liver function test?

A

liver makes the clotting factors

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2
Q

what 3 things does the liver metabolize/synthesize?

A
  1. protein
  2. carbohydrates
  3. lipids
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3
Q

what does the liver excrete? (5)

A
  1. bilirubin
  2. bile
  3. hormones
  4. cholesterol
  5. drugs
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4
Q

damage to the hepatocytes (liver cells)

A

hepatocellular disease

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5
Q

abnormality in hepatic synthesis or excretory function (bile excretion)

A

cholestatic disease

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6
Q

what type of cholestasis has defective liver cell function, damaged bile secretion, transport mechanism, or altered metabolism?

A

intrahepatic cholestasis

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7
Q

which type of cholestasis has a mechanical blockade in biliary tree, biliary atresia, or common duct stone?

A

extrahepatic cholestasis

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8
Q

an enzyme that comes from liver, bone, intestines, placenta, and neoplasms

A

alkaline phosphatase

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9
Q

What is an elevated level of alkaline phosphatase most likely associated with?

A

cholestatic disorders

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10
Q

what happens to the result if an ALP is heated?

A

decreased result

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11
Q

enzyme that comes from the liver, brain, heart, and blood vessels

A

5’-nucleotidase

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12
Q

What is 5’-nucleotidase highly sensitive and highly specific for?

A

hepatobiliary cholestatic disorders (liver disease)

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13
Q

if 5’-nucleotidase has _____ levels to ALP, this indicates _____

A

parallel; liver disease

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14
Q

enzyme that comes from liver (biliary tree ducts), kidneys, heart, spleen, pancreas, and brain

A

GGT

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15
Q

if GGT has _____ levels along with _____ and _____, this indicates liver disease

A

increased; ALP; 5’-nucleotidase

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16
Q

which enzyme is used to monitor long-term compliance to alcohol abstinence / hepatitis?

A

GGT

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17
Q

which enzyme comes from all body tissues? (liver, heart, kidneys, intestines, skeletal muscles, erythrocytes, etc.)

A

AST

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18
Q

AST is elevated after _____ _____, within ____ to ____ hours

A

active damage; 24-48

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19
Q

which 2 enzymes must be elevated together to indicate liver damage?

A

AST and ALT

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20
Q

which enzyme comes from hepatocytes, kidney, heart, and skeletal muscle?

A

ALT

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21
Q

which enzyme is both highly sensitive and highly specific for liver damage?

A

ALT

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22
Q

which enzyme rises before clinical symptoms appear?

A

ALT

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23
Q

a patient with mildly elevated ALP, WNL 5’-nucleotidase, GGT, AST/ALT indicates what differential diagnosis?

A

nonhepatic cause (pregnancy)

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24
Q

a patient with moderately elevated ALP, highly elevated 5’-nucleotidase, GGT, WNL AST, and minimally elevated ALT indicates what differential diagnosis?

A

cholestatic disease

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25
Q

a patient with mildly elevated ALP, 5’-nucleotidase, GGT, and highly elevated AST, and ALT indicates what differential diagnosis?

A

hepatocellular disease

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26
Q

yellowish pigment that is the breakdown product of RBCs

A

bilirubin

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27
Q

who should remove bilirubin from the body?

A

liver

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28
Q

what does an elevated total and indirect bilirubin indicate?

A

pre-hepatic problem

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29
Q

what does an elevated total and direct bilirubin indicate?

A

hepatic or post-hepatic problem

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30
Q

colorless end-product of bilirubin metabolism that is oxidized by intestinal flora to brown pigment called urobilin

A

urobilinogen

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31
Q

some urobilinogen is excreted in the urine as _____

A

urobilin

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32
Q

What will high levels in urobilinogen indicate?

A

hemolytic disease

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33
Q

What will low levels in urobilinogen indicate?

A

biliary obstruction

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34
Q

what 3 things will be elevated if there is blood in the urine?

A
  1. urobilinogen
  2. protein
  3. hemoglobin
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35
Q

if total and indirect bilirubin is moderately elevated, direct bilirubin is WNL, and ALT/AST/GGT is WNL, what is our differential diagnosis? (3)

A
  1. hemolysis
  2. gilbert syndrome
  3. neonatal jaundice
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36
Q

if total and direct bilirubin are moderately elevated, and indirect, ALT/AST/GGT are all WNL, what is our differential diagnosis?

A

congenital

37
Q

if total and direct bilirubin is mildly elevated, and indirect, ALT/AST/GGT are all moderately elevated, what is our differential diagnosis?

A

hepatobiliary disease

38
Q

yellow appearance due to deposition of bilirubin in the skin, mucous membranes, and sclera + tea-colored urine or tan-colored stools

A

jaundice

39
Q

increased unconjugated bilirubin due to hemolytic anemia or in a new born

A

prehepatic jaundice

40
Q

what is prehepatic jaundice also known as?

A

hemolytic icterus

41
Q

why is neonatal hyperbilirubinemia so dangerous?

A

it can progress to kernicterus

42
Q

brain damage that can result from high levels of bilirubin in a baby’s body

A

kernicterus

43
Q

test that transmits light through infant’s skin and analyzes specific wavelengths that are reflected

A

transcutaneous bilirubinometry (TcB)

44
Q

bilirubin is lipo-_____

A

lipophilic

45
Q

what kind of jaundice is increased unconjugated and/or conjugated bilirubin present in?

A

hepatic jaundice

46
Q

jaundice that presents with impaired cellular uptake and abnormal removal by hepatocytes that is present in gilbert’s disease

A

hepatic jaundice

47
Q

what is hepatic jaundice also called?

A

toxic icterus

48
Q

syndrome of defective conjugation, complete absence of UDPG-T, colorless bile, increased unconjugated bilirubin, and patients may die of kernicterus

A

crigler-najjar syndrome type I

49
Q

syndrome of defective conjugation, deficiency of UDPG-T, and increased unconjugated bilirubin

A

crigler-nijjar syndrome type II

50
Q

syndrome of defective excretion of bilirubin into the bile, pigment deposits that causes liver to turn black, increased total bilirubin (conjugated mostly), and AST/ALT is normal

A

dubin-johnson syndrome

51
Q

jaundice that presents with impaired removal of bilirubin from blood, increased conjugated bilirubin, decreased urobilinogen in stool and urine, and clay-colored/chalky white stool

A

post-hepatic jaundice

52
Q

what is post-hepatic jaundice also called?

A

obstructive icterus

53
Q

since calcium is bound to albumin, what would a decrease in albumin cause?

A

decrease in calcium

54
Q

what maintains oncotic pressure and binds/transports hormones, anions, drugs, and fatty acids?

A

albumin

55
Q

what does a shift of albumin out of the intravascular compartment lead to?

A

peripheral/pulmonary edema/ascites

56
Q

what 2 proteins do we test for total protein?

A

albumin
globulin

57
Q

present in tissue cell mitochondria/cytoplasm, is a waste product and excreted by the liver, and is used to form urea eliminated by the kidneys

A

ammonia

58
Q

what does build-up of ammonia metabolism in the blood lead to?

A

hepatic encephalopathy

59
Q

inflammation of the liver

A

hepatitis

60
Q

What will be increased in the acute/chronic markers when testing for hepatitis? (6)

A

AST
ALT
ALP
GGT
TBilirubin
DBilirubin

61
Q

what is the De Ritis ratio?

A

AST/ALT

62
Q

what can be used to determine if alcohol is the cause of hepatitis?

A

De Ritis ratio

63
Q

what are some common symptoms of acute and chronic hepatitis? (8)

A

fatigue
jaundice
N/V
lack of appetite
bleeding/bruising
dark urine
light stools
abdominal tenderness

64
Q

swelling in the liver and brain that presents as protracted vomiting that usually follows within a week of febrile viral illness

A

reye’s syndrome

65
Q

which syndrome has symptoms of lethargy, vomiting, confusion, irritability, seizures, rapid deterioration into stupor / loss of consciousness?

A

reye’s syndrome

66
Q

which syndrome shows labs of low glucose, increased AST/ALT/ammonia, and normal total bilirubin and amino acids?

A

reye’s syndrome

67
Q

a disorder of copper metabolism characterized by copper deposition in the brain, liver, kidney, and cornea

A

wilson’s disease

68
Q

which disorder presents as neurologic degeneration, cirrhosis/jaundice, hepatomegaly, kayser-fleischer rings (eyes), and fluid buildup?

A

wilson’s disease

69
Q

What is the gold standard to check for liver copper levels?

A

liver biopsy

70
Q

type of fatty liver disease that has fat but no liver damage

A

nonalcoholic fatty liver disease (NAFLD)

71
Q

type of fatty liver disease that has fat and signs of liver damage

A

nonalcoholic steatohepatitis (NASH)

72
Q

most cases of fatty liver disease are _____

A

asymptomatic

73
Q

what is the treatment for fatty liver disease?

A

lifestyle changes

74
Q

gradual progressive destruction of the bile ducts in the liver (cholestasis disease) that leads to cirrhosis and liver failure

A

primary biliary cholangitis (PBC)

75
Q

which disorder has early symptoms of choleostasis that includes fatigue, pruritis, jaundice, and deficiencies in fat-soluble vitamins?

A

primary biliary cholangitis

76
Q

which disorder has late symptoms of RUQ pain, splenomegaly, edema, bone/muscle/joint pain, xanthomas, osteoporosis, and high cholesterol?

A

primary biliary cholangitis

77
Q

what 3 things must be elevated/positive to diagnose primary biliary cholangitis?

A
  1. LFTs
  2. cholesterol
  3. AMA
78
Q

inflammation of the pancreas

A

pancreatitis

79
Q

accessory gland that excretes and makes enzymes for digestion and makes hormones like insulin and glucagon to regulate glucose

A

pancreas

80
Q

what is the most common cause of pancreatitis?

A

alcohol abuse

81
Q

a patient the presents with mid-epigastric pain that radiates to midback, nausea, vomiting, ileus, and fever is most likely experiencing …

A

pancreatitis

82
Q

what is in my differential for a patient with suspected pancreatitis?

A
  1. ulcers
  2. biliary disease
  3. MI
  4. intestinal ischemia
  5. abdominal aortic aneurysm
83
Q

2 out of 3 of these criteria are required to diagnose a patient with acute pancreatitis. what are they?

A
  1. abdominal pain
  2. serum lipase or amylase more than 3x normal limit
  3. CT
84
Q

enzyme made by the pancreas and some by the salivary glands, that helps digest carbohydrates

A

amylase

85
Q

when does amylase return back to normal in acute pancreatitis?

A

in 3-5 days

86
Q

enzyme secreted by the pancreas into the duodenum, and helps digest fats and catalyzes the hydrolysis of triglycerides into fatty acids

A

lipase

87
Q

when does lipase return to normal in acute pancreatitis?

A

8-14 days

88
Q

enzyme that comes from the liver, kidneys and heart, and catalyzes the interconversion of lactate and pyruvate to make the body’s energy

A

lactate dehydrogenase (LDH)

89
Q

an enzyme that is used to check for tissue damage, monitor conditions, assess severity of pancreatitis, and monitor treatments such as chemotherapy

A

LDH

Lab Med (19 decks)

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