Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI > LFTs > Flashcards

LFTs Flashcards

1
Q

What are ALT and AST?

A

Enzymes found within liver cells at high concentrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do raised ALT / AST levels in the blood indicate?

A

Marker of hepatocellular injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name a common cause of hepatocellular injury.

A
  • Hepatitis (viral, alcoholic, ischaemic)
  • Liver cirrhosis
  • Drug / toxin-induced liver injury (e.g. paracetamol overdose)
  • Malignancy (hepatocellular carcinoma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does a raised ALT / AST level signify?

A

Inflammation or damage of liver cells (hepatocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What AST:ALT ratio is classical of alcoholic liver disease?

A

> 2:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fill in the blank: The AST:ALT ratio can help determine the _______ of hepatocellular injury.

A

[aetiology]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Gamma-glutamyltransferase (GGT)?

A

A non-specific but highly sensitive marker of liver damage and cholestasis

GGT is found in hepatocytes and biliary epithelial cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does a rise in ALP with normal GGT suggest?

A

Bone disease (e.g. Paget’s disease, vitamin D deficiency, bony metastases)

This indicates that the source of raised ALP is likely not related to cholestasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does a rise in ALP with an associated rise in GGT indicate?

A

Cholestasis

This combination suggests liver-related issues rather than bone disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an isolated rise in GGT classically associated with?

A

Alcohol excess

This finding is important for diagnosing alcohol-related liver issues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which two markers are interpreted together to localize the source of raised ALP?

A

ALP and GGT

Their combined interpretation helps differentiate between liver and bone diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is cholestatic jaundice?

A

A blockage in the bile excretion pathway.

Cholestatic jaundice occurs when bile cannot flow from the liver to the duodenum, leading to an accumulation of bile components in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the form of bilirubin that can be filtered by the kidneys?

A

Conjugated bilirubin

Conjugated bilirubin is water-soluble and can be excreted in urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What effect does the presence of conjugated bilirubin have on urine color?

A

Gives the urine a very dark colour

Dark urine indicates the presence of conjugated bilirubin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In hepatocellular jaundice, what happens to stool color?

A

Stools may also be pale

Pale stools occur due to decreased bilirubin metabolism/excretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why will urine remain a normal color in hepatocellular jaundice despite pale stools?

A

Because the bilirubin in the blood is unconjugated

Unconjugated bilirubin cannot pass into urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What causes pre-hepatic jaundice?

A

Increased red blood cell breakdown producing excess bilirubin

The most common cause is haemolysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of bilirubin is present in the blood during pre-hepatic jaundice?

A

Unconjugated bilirubin

This is because the hepatocytes have not yet metabolised it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the liver function tests (LFTs) results typically like in pre-hepatic jaundice?

A

Generally normal

The liver is otherwise functioning well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What condition may be diagnosed if there is no anaemia present in pre-hepatic jaundice?

A

Gilbert’s syndrome

Patients are often anaemic due to excess red blood cell breakdown.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is Gilbert's syndrome?
A congenital disorder resulting from a deficiency of glucosyltransferase ## Footnote This enzyme is responsible for the conjugation of bilirubin within hepatocytes.
26
What percentage of the population is affected by Gilbert's syndrome?
Up to 5% ## Footnote It is a relatively common condition.
27
How does Gilbert's syndrome typically present?
Following viral infection with raised bilirubin but normal LFTs/full blood count ## Footnote The disease is benign and requires no specific management.
28
What occurs in hepatocellular jaundice?
Hepatocytes are damaged and dysfunctional, leading to inability to metabolise unconjugated bilirubin ## Footnote This results in high levels of unconjugated bilirubin in the blood.
29
What laboratory findings are characteristic of hepatocellular jaundice?
Very high ALT/AST levels ## Footnote These levels mark hepatocyte damage.
30
What are common causes of hepatocellular injury?
* Hepatitis * Cirrhosis * Malignancy * Drug or toxin insult ## Footnote Severe liver injury leads to insufficient functioning hepatocytes to metabolise bilirubin.
31
What is cholestatic (obstructive) jaundice?
An interruption in bile flow from hepatocytes to the gut ## Footnote This interruption can lead to increased bilirubin levels in the blood.
32
What type of bilirubin is predominantly found in the blood during cholestatic jaundice?
Conjugated bilirubin ## Footnote The bilirubin has been metabolised in the liver.
33
What laboratory findings are associated with cholestatic jaundice?
High ALP levels and high GGT ## Footnote These levels indicate dysfunction of the biliary system.
34
What are classic symptoms of obstructive jaundice?
* Dark urine * Pale stools ## Footnote Bilirubin cannot enter the gastrointestinal tract due to cholestasis.
35
What happens to stercobilinogen excretion in stools during cholestasis?
Low stercobilinogen excretion ## Footnote This occurs because bilirubin cannot enter the gastrointestinal tract.
36
37
What are the two main types of biliary obstruction that can cause cholestasis?
Intrahepatic and extrahepatic biliary obstruction
38
What are some causes of intrahepatic obstruction?
* Hepatitis * Cirrhosis * Malignancy * Pregnancy * Drugs (e.g. antibiotics, oral contraceptive pills, anabolic steroids)
39
What are some causes of extrahepatic obstruction?
* Gallstones * Primary sclerosing cholangitis * Intraluminal malignancy (cholangiocarcinoma) * Extraluminal malignancy causing duct compression (head of pancreas tumours)
40
What does a split bilirubin test help determine?
It gives further clues as to the aetiology of jaundice
41
What are the causes of predominantly unconjugated hyperbilirubinaemia?
* Pre-hepatic jaundice (e.g. haemolysis) * Gilbert syndrome
42
What are the causes of predominantly conjugated hyperbilirubinaemia?
* Cholestasis * Hepatocellular jaundice
43
True or False: Hepatocellular jaundice can initially cause a mixed conjugated/unconjugated jaundice.
True
44
Fill in the blank: Cholestasis can occur due to either intrahepatic or _______ biliary obstruction.
extrahepatic
45
What is an example of a drug that can cause intrahepatic obstruction?
Antibiotics
46
What type of malignancy is associated with intraluminal obstruction?
Cholangiocarcinoma
47
What severe condition can hepatocellular jaundice lead to regarding bilirubin levels?
Unconjugated hyperbilirubinaemia
48
49
What is albumin synthesised in?
Liver ## Footnote Albumin is crucial for various physiological functions.
50
What role does albumin play in the blood?
Maintaining oncotic pressure ## Footnote Oncotic pressure is essential for fluid balance in the body.
51
What substances does albumin help to bind?
Water, cations, fatty acids, bilirubin ## Footnote These bindings are vital for transport and regulation in the bloodstream.
52
What is a non-specific marker of the synthetic function of the liver?
Albumin ## Footnote It indicates the liver's ability to produce proteins.
53
What can cause decreased albumin levels?
Decreased albumin production, increased albumin loss ## Footnote Conditions like malnutrition and nephrotic syndrome can affect albumin levels.
54
Name a condition that leads to decreased albumin production.
Severe liver disease ## Footnote This indicates a significant impairment of liver function.
55
What does a decrease in synthetic function of the liver indicate?
Severe liver disease ## Footnote This can be assessed by measuring albumin levels.
56
What is the half-life of albumin?
20 days ## Footnote This means that albumin levels will not drop immediately, even in severe liver disease.
57
What test can further assess the synthetic function of the liver?
Coagulation screen ## Footnote The liver synthesizes clotting factors, which can indicate its function.
58
What happens to clotting factors in severe liver disease?
Decreased production and increased prothrombin time (PT) / INR ## Footnote This indicates a coagulopathy related to liver dysfunction.
59
What function does the liver perform related to glucose?
Gluconeogenesis ## Footnote This is the process of producing glucose from non-carbohydrate sources.
60
How can serum blood glucose assessment relate to liver function?
It can indirectly assess the liver's synthetic function ## Footnote However, gluconeogenesis is often one of the last functions to become impaired.
61
Fill in the blank: Severe liver disease leads to decreased production of _______.
Clotting factors ## Footnote This is crucial for understanding bleeding risks in liver disease.
62
63
What does INR stand for?
International Normalized Ratio ## Footnote INR is a blood test that measures how long it takes for blood to clot.
64
What is the primary use of INR in medicine?
To assess liver function, particularly in the context of liver failure ## Footnote INR helps evaluate the clotting ability of blood.
65
What role does the liver play in clotting factor production?
The liver produces clotting factors essential for blood clotting ## Footnote These include factors I (fibrinogen), II (prothrombin), V, VII, IX, X, and XI.
66
What happens to INR levels as liver function declines?
The INR increases ## Footnote This reflects impaired synthesis of clotting factors.
67
What is the normal range for INR in healthy individuals?
0.8–1.2 ## Footnote This range indicates normal clotting function.
68
What does an elevated INR in liver failure indicate?
Impaired liver function and reduced ability to produce clotting factors ## Footnote A high INR suggests an increased risk of bleeding.
69
What INR value is often seen in severe liver failure?
Above 2.0, often exceeding 5.0 in acute liver failure ## Footnote This indicates a critical condition with a very high bleeding risk.
70
What is the impact of cirrhosis on INR levels?
Cirrhosis leads to a mildly elevated INR ## Footnote This is due to compromised production of clotting factors.
71
How does acute liver failure affect INR?
The INR can rise quickly, sometimes exceeding 5.0 ## Footnote This indicates a severe defect in clotting factor production.
72
What is portal hypertension and its relation to INR?
Increased pressure in the portal vein affecting coagulation ## Footnote However, INR elevation is mostly related to liver dysfunction.
73
What score includes INR as a key variable for liver disease severity?
Model for End-Stage Liver Disease (MELD) score ## Footnote A higher INR increases the MELD score, indicating a greater need for a liver transplant.
74
What treatment may help reverse a high INR due to vitamin K deficiency?
Vitamin K administration ## Footnote This promotes clotting factor synthesis.
75
What is Fresh Frozen Plasma (FFP) used for in liver failure?
To correct clotting issues and lower the INR in emergency cases ## Footnote FFP contains clotting factors.
76
What is the potential solution for severe and irreversible liver failure?
Liver transplantation ## Footnote The INR is unlikely to improve without liver recovery.
77
What does an elevated INR in liver failure signify?
Impaired clotting factor production and increased risk of bleeding ## Footnote It is crucial for assessing liver function and determining intervention needs.

GI (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions