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PA3305- Mod 10 > liver (1) > Flashcards

liver (1) Flashcards

1
Q

what are the 4 main liver tests and what are the abnormal results you will see

A 
serum ALT (increased in hepatocellular damage)
serum bilirubin (increased in cholestasis)
Serum ALP (increased in cholestasis)
Serum albumin (decreased in chronic disease)
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2
Q

ALT increases in liver diseases (2x + 10x increase)

A

in all liver diseases this increases (sensitive not spec)

2x increase= block likely
10x increase= indicates hepatitis

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3
Q

if ALT> AST what does it indicate

If AST>ALT what does it indicate

A

if ALT>AST= likely due to drug induced hepatitis/obstruction

if AST>ALT= likely due to alcoholic cirrhosis, metastatic cancer

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4
Q

when is serum bilirubin increased and what to take into consideration when doing it

A

increased in cholestasis

  • normal serum bilirubin is <17 but jaundice is only seen when >40
  • this means liver disease may be missed by only measuring bilirubin
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5
Q

When is serum bilirubin increased (2)

A

increased din cholestasis

increased in cancers/cirhosis

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6
Q

when is serum albumin decreased

A

levels decreased in chronic liver disease, kidney disease, starvation

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7
Q

summary for first line tests for cell damage, bile blockage

A

cell damage- serum ALT

bile blockage- serum bilirubin, ALP increase, Serum GGT increase

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8
Q

when will serum gGT, PT and serum cuerulosplasmin change

A

serum gGT- Increase in all liver diseases, marker for alcoholism

PT- may be first sign of liver damage

Serum cueruloplasmin- increase in inflammation, decrease in wilsons (juv cirrhosis)

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9
Q

hepatocellular disease prodrome (5)

A
  • anorexia
  • nausea
  • malaise
  • abdominal pain
  • liver tenderness
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10
Q

hemolytic (pre liver) lab findings

A

serum bilirubin increased
blood reticulocytes present
blood hemoglobin decreased

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11
Q

hepatocellular liver diseaase lab results

A

serum ALT always elevated (ALP later)

Serum billlirubin later

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12
Q

Cholestatis lab markers

A
  • serum ALP elevated
  • Serum bilirubin elevated
  • serum ALT, AST slightly increased
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13
Q

pre hepatic jaundice causes (4)

A
  • unconjugated hyperbilirubin
  • glu-6-phospatase def
  • spherocytosis
  • gilberts disease
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14
Q

What is hepatic jaundice due to and lab markers

A

caused by poisoning/virus

-serum bilrubin, ALP, ALT increased

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15
Q

Hepatitis prodrome lab

A

serum ALT, urineblinogen increase

-when jaundice appears, serum ALP increases

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16
Q

Hep A- type, trans, dx, `

A

single stand RNA

trans: fecal-oral due to contaminated drinking water (disease of children)
dx: Serum IgM against hep A

17
Q

Heb B: type, dx, symptoms, long term

A

DNA virus
Trans: body fluids
Jt pain/itchy hives
-can lead to chronic hep, cirrhosis

18
Q

3 serologies for Hep B

A

HBsAg- acute/present inf

HBc- core antigen (prior inf)

HBcAg- carrier state

19
Q

Hep C- type, trans, longterm

A

RNA virus
Trans: blood
acute or chronic

20
Q

Hep D: type, trans, serology, loc

A

RNA virus (need co-inf w b)
Acute/chronic
Trans: needles/sex

Serology: IgG/A/M, anti HDV

Italy

21
Q

Hep E: type, trans, Dx

A

RNA virus
trans: fecal/oral
lab dx: antibodies to HEV anigens

22
Q

Epstein barr virus: trans. Lab tests

A

Trans: oral
Lab: monospot, EBV titre

23
Q

Cytomegalovirus dx

A

Rapid screen for IgM

24
Q

Autoimmune hep: pop, tests (3)

A

F>M

  • Seum anti smooth mm antibody
  • serum anti mitochondrial antibody
  • high serum pro
25
Q

post hepatic jaundice (complete and partial blood markers)

A

complete- Serum bilirubin + serum ALP increased

Partial- Serum ALP increased (bilirubin can be normal)

26
Q

liver failure mc cause, and lab resuts

A

mc- acitaminophen (med emergency)

  • electrolyte imbalance (Serum NA, Ca, glu down)
  • Blood ammonia increase
  • serum albumin down
27
Q

chronic hepatic damage causes(2) + symptoms

A
  • alcoholic fatty liver (mc)
  • chronic active hep following B/C virus inf

symptoms- poor appetite, fatigue, itching, fever, upper abdominal discomfort

28
Q

Rarer causes of cirrhosis (3)

A
  • willsons disease (measure copper/ caeruloplasmin)
  • haemochromatosis
  • alpha-1-antitrypsin deficiency
29
Q

Primary liver cancers

A

hepatocellular carcinoma
cholargiosarcoma (bile ducts)
hepatic sarcoma (endothelial cells)

30
Q

Secondary liver cancer and markers

A

spread from liver to other organs

-marker is AFP

PA3305- Mod 10 (9 decks)

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