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1st Year - Gastroenterology > LFTs > Flashcards

LFTs Flashcards

1
Q

What is bilirubin formed from?

A

Breakdown of RBC porphyrin ring

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2
Q

What organ does insoluble unconjugated iron travel to?

A

Liver

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3
Q

How does insoluble unconjugated iron travel to the liver?

A

Bound to albumin

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4
Q

What happen to insoluble unconjugated bilirubin at the liver?

A

Liver enzymes conjugated it to form bilirubin glucuronide (conjugated bilirubin)

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5
Q

How is conjugated bilirubin excreted?

A

In bile = soluble

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6
Q

How can conjugated bilirubin be excreted directly?

A

In urine

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7
Q

What happens to conjugated bilirubin in bile?

A

It is broken down in the gut into urobilinogen (some reabsorbed and excreted by the kidney) and stercobilinogen (forms brown colour of stool)

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8
Q

What sign can increase bilirubin cause?

A

Jaundice

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9
Q

At what level of bilirubin would jaundice be visible?

A

> 35 micro mol/L

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10
Q

What are the 4 liver enzymes?

A 
Alanine transaminase (ALT)
Aspartase transaminase (AST)
Alkaline phosphate (ALP)
Gama glutanyl transferase (GGT)
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11
Q

What are the 3 intracellular liver enzymes?

A

ALT
AST
ALP

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12
Q

What happens to ALT when liver cells damaged?

A

Release from liver into blood stream

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13
Q

Is ALT specific?

A

Yes, found almost exclusively in the liver

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14
Q

Is AST specific?

A

Not as much as ALT - also found in cardiac tissue and muscle

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15
Q

What happens to AST when liver cells damaged?

A

Released from liver into blood stream

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16
Q

Where is ALP found?

A

Mainly in liver and bone

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17
Q

What is the function of ALP?

A

Involved in transport of substances across the cell membrane

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18
Q

Why might ALP be raised?

A

Physiologically - metabolically active cells e.g. bones growing, pregnant
Bile drainage obstructed

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19
Q

Where is ALP found in the liver?

A

In cells near the bile ducts sad canaliculae

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20
Q

Where is GGT found in the liver?

A

In hepatocytes and biliary epithelial cells

21
Q

What is the purpose of GGT?

A

Plays a role in the metabolism of drugs

22
Q

Name 2 conditions which cause a rise in GGT?

A

Alcohol and certain drugs

Bile duct obsturction

23
Q

Where is albumin synthesised?

A

Liver

24
Q

What happens to albumin levels as liver function deteriorates?

A

Falls

25
Q

Apart from liver function, name 3 other causes of low albumin levels?

A

Protienuria
Poor nutrition
Hormonal imbalances

26
Q

What happens to prothrombin time if liver problem?

A

Increases

27
Q

What causes pre-hepatic jaundice?

A

Increased breakdown of RBCs

28
Q

What causes intra-hepatic jaundice?

A

Problem in the liver

29
Q

What causes post-hepatic jaundice?

A

Bile duct system damaged/ obstructed = unable to move bile into digestive tract

30
Q

Bilirubin in prehepatic jaundice?

A

Raised

31
Q

AST/ ALT in prehepatic jaundice?

A

Normal

32
Q

ALP in prehepatic jaundice?

A

Normal

33
Q

Haemoglobin in prehepatic jaundice?

A

Reduced

34
Q

Jaundice in prehepatic jaundice?

A

Usually mild

35
Q

Urine in prehepatic jaundice?

A

Not dark

36
Q

Bilirubin in intrahepatic jaundice?

A

Raised

37
Q

AST/ ALT in intrahepatic jaundice?

A

Raised

38
Q

ALP in intrahepatic jaudnice?

A

Slightly raised

39
Q

Hb in intrahepatic jaundice?

A

Normal

40
Q

Jaundice in intrahepatic jaudnice?

A

May be marked

41
Q

Other name for post hepatic jaundice?

A

Cholestatic

42
Q

Bilirubin in posthepatic jaundice?

A

Raised

43
Q

AST/ ALT in posthepatic jaundice?

A

slightly raised

44
Q

ALP in posthepatic jaundice?

A

very raised

45
Q

Hb in posthepatic jaudnice?

A

Normal

46
Q

Jaundice in posthepatic jaundice?

A

May be marked

47
Q

Stool in posthepatic jaudnice?

A

Pale

48
Q

What effect on stool does bilirubin have?

A

Make it darker -> pale stool = lack of bilirubin in GI tract

49
Q

What effect does bilirubin have on urine?

A

Makes it darker -> if cholestatic jaundice, urine may be darker as bilirubin can’t be excreted in stool (=light stool, dark urine)

1st Year - Gastroenterology (37 decks)

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