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Extra - Clinical Chemistry > Liver 1 > Flashcards

Liver 1 Flashcards

1
Q

3 cholestatic dz indicators

A

ALP
5NT
GGTP

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2
Q

ALP is found in what 3 main tissues

A

Liver
Bone
Placenta

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3
Q

5NT is only elevated in what dz?

A

Hepatic dz

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4
Q

Which enzyme confirms origin of high ALP values

A

GGTP

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5
Q

What is the GGTP/ALP ratio to monitor compliance of alcoholics

A

> 2.5

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6
Q

Indicators of hepaticellular injury

A

AST or SGOT
ALT or SGPT
LDH

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7
Q

What additional tests needed to confirm source of ALP increase?

A

confirm source of ALP
increase: gamma-glutamyl transpeptidase, 5-
nucleosidase 12

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8
Q
  1. What conditions can cause an increase in ALP? - 2
A 
• Indication of skeletal disease
– Healing fractures
– Osteomalacia
– Values are elevated in teenagers/
children
• Increased in the third trimester of
pregnancy (placental ALP)
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9
Q

Alcoholic Liver Disease – 2 Biochemical

Markers

A

• AST:ALT ratio >2
• High concentra:ons of GGTP with
GGTP:ALP > 2.5

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10
Q

Where are the sources of5-Nucleotidase (5-NT) - 4

A

• Present in liver, heart, brain and blood vessels

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11
Q

What is the source of Gamma-Glutamyl Transpeptidase - 6

A 
Liver
kidney
pancreas
spleen
heart,
brain
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12
Q

Indicators of Hepatocellular Injury - 3

A

Ø Aspartate aminotransferase (AST or SGOT)
Ø Alanine aminotransferase (ALT or SGPT)
Ø Lactate dehydrogenase (LDH)

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13
Q

Aspartate Aminotransferase

(AST) - Very High

A

Very high (20 X ULN): acute viral hepatitis, drug induced hepatic injury

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14
Q

Aspartate Aminotransferase

(AST) - High

A

• High (10-20XULN): severe infectious

mononucleosis, alcoholic cirrhosis

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15
Q

Aspartate Aminotransferase

(AST) - Moderate

A

• Moderate (5-10xULN): chronic hepatitis

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16
Q

Aspartate Aminotransferase

(AST) - Low to Moderate

A

• Low to moderate (2-5xULN): hepatic tumors or unexplained (e.g. vigorous exercise)

17
Q

Where can you find elevated AST Levels

A

Elevated levels found in any disease
with hepatocyte inflammation (hepatitis,
alcoholic cirrhosis)

18
Q

What can elevated ALT levels distinguish?

A

Can be used to distinguish between myocardial and hepatic tissue damage - More specific to Liver

19
Q

Alanine Aminotransferase (ALT) Levels - High

A

• Very high: viral or drug induced hepatitis

20
Q

Alanine Aminotransferase (ALT) Levels - Moderate

A

• Moderate: infectious mononucleosis, chronic

hepatitis, intrahepatic cholestasis, early viral hepatitis, hepatic congestion due to heart failure

21
Q

Alanine Aminotransferase (ALT) - Slight to moderate

A

• Slight to moderate: active cirrhosis, drug

induced or alcoholic hepatitis

22
Q
  1. What are potential reasons for prolonged PT?
A 
Malabsorption
Malnutrition
Warfarin
Antibiotics
Liver failure
23
Q

Cause of Increased Bilirubin - Unconjugated 3 , conjugated 3, Both 1

A 
Unconjugated (>70% indirect)
Hemolytic anemia,
Gilbert’s syndrome
(UGT1A1), drugs
(probenecid, rifampin)
Conjugated (>50% direct)
Bile duct obstruction,
hepatitis, drugs
Both Hepatitis
24
Q

Liver Function Tests and Pregnancy - Increase - 3

A

conjugated bilirubin, ALP, and

α and β globulins

25
Q

Liver Function Tests and Pregnancy - Decrease - 3

A

albumin, total serum protein, and γ globulin

26
Q

Liver Function Tests and Pregnancy - Unchanged - 5

A

total bilirubin, AST, ALT,

GGT and prothrombin time

27
Q

Drugs that Can Cause Cholestasis

A 
• An:bio:cs
– Erythromycin
– Beta-­‐lactams
– Rifampin
• Hormonal
agents
– Estrogens
– Methyltestosterone
– Anabolic
steroids
Not Exhausted
28
Q

Drugs Causing Hepatocellular Injury - 2

A

APAP
Isoniazid
Not Exhausted

29
Q

Hepa88s Biochemical Changes

A
  • Increased bilirubin
  • Decreased serum albumin
  • Increase in gamma globulin
  • ALP (moderate increase)
  • ALT and AST increase up to 10 X
  • Gamma-­‐glutamyl transpep:dase (GGTP) increase

Extra - Clinical Chemistry (3 decks)

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