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MT2 > LFT - PART 2 > Flashcards

LFT - PART 2 Flashcards

1
Q

markers for hepatocellular necrosis

A

ALT or Alanine Aminotransferase
AST or Aspartate Aminotransferase

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2
Q

ALT is also known as

A

Serum Glutamate Pyruvate Transaminase

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3
Q

ALT is most specific due to ________ in the liver

A

high concentration

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4
Q

best test to assess hepatocellular integrity.

A

ALT

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5
Q

ALT is present in the ______ of liver cells

A

cytosol

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6
Q

____ concentration is higher than ________ in acute liver disease

A

ALT ; AST

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7
Q

significance of ALT

A

hepatocellular disorder exhibit higher level than intra or extrahepatic obstruction

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8
Q

normal range of ALT in male

A

13 to 35 U/L

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9
Q

normal range of ALT in female

A

10 to 30 U/L

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10
Q

AST or Aspartate Amino Transferase is also kown as

A

Serum Glutamic-Oxaloacetic Transaminase

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11
Q

less specific (found in the mitochondria and cytosol liver cell, heart and skeletal muscle)

A

AST

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12
Q

significance of AST

A

4x increased in cirrhosis; 100x increased in viral hepatitis.

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13
Q

ALT and AST > 1000

A

ischaemic hepatitis, viral hepatitis, paracetamol overdose

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14
Q

AST > ALT

A

alcoholism, drug intoxication, cirrhosis

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15
Q

AST requires __________ (PSP or vitamin B6) as a cofactor.

A

pyridoxal 5 phosphate

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16
Q

If a patient is ________ deficient it can lead to false negative AST results in some commercially available assays.

A

vitamin B6

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17
Q

normal range of AST

A

8 to 20 U/L

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18
Q

_____________ least specific – increased in cardiac and hepatic injury.

A

Lactate Dehydrogenase (LD)

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19
Q

Markers that reflect cholestasis

A

Alkaline Phosphatase (ALP)
Gamma-Glutamyl Transferase (GGT)

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20
Q

increased in obstructive diseases.

A

Alkaline Phosphatase (ALP)

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21
Q

found on cell surfaces, sinusoidal and bile canalicular.

A

Alkaline Phosphatase (ALP)

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22
Q

ALP is significantly increased in ______ diseases and _____ disease

A

obstructive ; Paget

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23
Q

ALP is decreased in _______ because of lack of ______

A

hypophosphatasia ; ALP isoenzyme

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24
Q

normally higher in children than adults because of bone growth.

A

ALP

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25
Q

Best test for cholestatic disease (More specific than GGT)

A

ALP

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26
Q

significantly increased in alcoholism.

A

Gamma-Glutamyl Transferase (GGT)

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27
Q

Helps confirm excess alcohol intake, highly sensitive to detecting alcohol abuse.

A

GGT

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28
Q

GGT is increased in _______ despite normal liver function tests.

A

alcoholics

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29
Q

Accompanies ALP increase in biliary obstruction/lesion.

A

GGT

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30
Q

ALP > GGT = ?

A

bone disease, pregnancy

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31
Q

GGT > ALP = ?

A

alcohol, medications

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32
Q

Tests for Biliary Excretion

A

Total Bilirubin, B1, B2

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33
Q

commonly elevated with ALP during cholestasis.

A

Total Bilirubin, B1, B2

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34
Q

elevated with severe liver disease.

A

Total Bilirubin, B1, B2

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35
Q

elevated in non-liver disease (hemolysis)

A

Total Bilirubin, B1, B2

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36
Q

Tests for Liver Synthetic Function

A

Albumin

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37
Q

decrease _______ indicated severe liver injury.

A

Albumin

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38
Q

increase may indicate severe liver injury.

A

PT/INR or Prothrombin Time

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39
Q

Analysis of _______ is important for assessing nutritional status and presence of severe diseases involving the liver, kidney and bone marrow.

A

proteins

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40
Q

_______ and _______ are about 10% higher in ambulatory individuals.

A

Total protein and albumin

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41
Q

Plasma levels of total protein is ______ higher than serum due to fibrinogen.

A

0.2 to 0.4 g/dL

42
Q

Transudates have a total protein of ______ (<50% of the serum total protein)

A

< 3.0 g/dL

43
Q

Exudate gas total protein

A

> 3 g/dL

44
Q

T or F..

In measuring total proteins in serum, fasting may not be required.

A

True

45
Q

Total Protein Det is usually performed on ______, which has no fibrinogen and no anticoagulant that may slightly dilute proteins in plasma.

A

serum,

46
Q

_______ may false elevate the total protein

A

Hemolysis

47
Q

Total protein det. reference value

A

6.5 to 8.3 g/dL

48
Q

Differentiates intrahepatic disorder (prolonged protime) from extrahepatic obstructive liver disease (normal protime)

A

PROTHROMBIN TIME (VITAMIN K RESPONSE TEST)

49
Q

Persistent prolongation of protime despite vitamin K administration indicates loss of _________ to synthesize proteins

A

hepatic capacity

50
Q

In acute viral or toxic hepatitis, prolongation of protime signifies ______________.

A

massive cellular damage

51
Q

In _____, concentration of the protein is inversely proportional to the severity of the liver disease.

A

Albumin

52
Q

Decrease serum albumin concentration may be due to decrease ______.

A

synthesis

53
Q

Low protein + low albumin =

A

hepatic cirrhosis or nephrotic syndrome

54
Q

Dye used for measurement of Albumin

A
  • Bromcresol Green
  • Methyl Orange
  • Hydroxyazobenzene Benzoic Acid (HABA)
  • Bromcresol Purple
55
Q

Increased serum albumin is also called/known as

A

Hyperalbuminemia

56
Q
  • Severe Hydration
  • Prolonged tourniquet application – artifactual hyperalbuminemia.
A

Increased Serum Albumin (Hyperalbuminemia)

57
Q

Decreased Serum Albumin is also known/called as

A

Hypoalbuminemia

58
Q

3 that is included in Decreased Serum Albumin (Hypoalbuminemia)

A

Reduced Synthesis
Increased Loss
Increased Catabolism

59
Q

Chronic Liver Disease, Malabsorption Syndrome, Malnutrition, and Muscle Wasting Disease

A

Reduced Synthesis

60
Q

Nephrotic Syndrome, Massive Burns, Orthostatic Albuminuria

A

Increased Loss

61
Q

Massive Burns, Malignancy, Thyrotoxicosis

A

Increased Catabolism

62
Q

In measuring conjugation and excretion function, the specimen should be free of _____ and ______

A

hemolysis and lipemia

63
Q

In measuring conjugation and excretion function, the specimen should be stored in the ______ and measured _____

A

dark ; ASAP

64
Q

In measuring conjugation and excretion function, the specimen should have ___ visible icteria

A

> 25mg/dL

65
Q

belongs to bilirubin assay

A

Van Den Berg Reaction
Evelyn and Malloy
Jendrassik and Grof

66
Q

Principle of Bilirubin Assay

A

Van Den Berg Reaction – diazotization of bilirubin

67
Q

Coupling Accelerator of Evelyn and Malloy

A

Methanol

68
Q

Final Reaction in Evelyn and Malloy

A

(+) Pink to Purple

69
Q

o Popular technique for Discreet Analyzer
o Not affected by Hemolysis

A

Jendrassik and Grof

70
Q

Jendrassik and Grof coupling accelerator

A

Caffeine Sodium Benzoate

71
Q

In Jendrassik and Grof, _________terminates initial reaction and destroy excess diazo

A

Ascorbic Acid

72
Q

diazo is made up of …

A

sulfanilic acid in hydrochloric acid and sodium nitrite

73
Q

Jendrassik and Grof final reaction

A

(+) = Pink to Blue

74
Q

It is a test for hepatocellular function and potency of bile duct; rarely used

A

Bronsulfothalein (BSP) Dye Extraction Test

75
Q

Double collection method in Bronsulfothalein (BSP) Dye Extraction Test

A

Rosenthal White

76
Q

Single collection method in Bronsulfothalein (BSP) Dye Extraction Test

A

Mac Donald Method

77
Q

Colorless end product of bilirubin

A

UROBILINOGEN

78
Q

Excreted in urine and feces or reabsorbed into the portal blood and return to the liver.

A

UROBILINOGEN

79
Q

Absence of substance + complete biliary obstruction

A

UROBILINOGEN

80
Q

method of testing in urobilinogen

A

Ehrlich Method

81
Q

NV of UROBILINOGEN in Feces

A

75-225

82
Q

NV of UROBILINOGEN in 24 hours urine

A

75-400

83
Q

In test for detoxification function, it involves ______ and ______ test

A

enzyme and ammonia

84
Q

Any injury to the liver that results to _____ and _________ causes liberation of enzymes.

A

cytosis ; necrosis

85
Q

Used to assess the extent of liver damage and to differentiate hepatocellular from jaundice.

A

Enzymes

86
Q

examples or the enzymes included are

A

ALT, AST, ALP, GGT 5’nucleoside, LDH

87
Q

Arise from the deamination of amino acid

A

Ammonia

88
Q

Released from the skeletal muscle during exercise

A

Ammonia

89
Q

Elevated level of ammonia are ___________ and often associated with ________

A

neurotoxic ; encephalopathy

90
Q

ammonia clinical significance

A

diagnosis of hepatic failure and Reyes syndrome.

91
Q

ammonia Normal value

A

11 to 35 mmol/dL

92
Q

in test for detoxification function, ______ is a source of contamination

A

smoking

93
Q

in test for detoxification function, preferred specimen is

A

arterial blood

94
Q

in test for detoxification function, specimen requirement is

A

Heparin, EDTA kept in ice water immediately.

95
Q

in test for detoxification function, method of testing is

A

Berthelot reaction, Glutamate dehydrogenase.

96
Q

in test for detoxification function, digestion includes

A

Kjehdal Method

97
Q

in test for detoxification function, measurement for ammonia is

A

o Nesslerization Reaction
o Berthelot Reaction

98
Q

characterized by necrosis and inflammation of the hepatocytes that results in a decrease in functional ability and abnormal liver function test results.

A

HEPATITIS

99
Q

In hepatitis, changes can be caused by ______ and/or ______ agents

A

infectious ; toxic

100
Q

6 hepatitis viruses

A

Hepa A, Hepa B, Hepa C, Hepa D, Hepa E and Hepa G.

MT2 (45 decks)

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