Liver CPC Flashcards
Functions of the liver
Intermediary metabolism
Protein synthesis
Xenobiotic metabolism
hormone metabolism
Bile
reticuloendothelial function (immune modulation, clearance of infection and LPSs, Ag presentation, erythropoiesis)
What are LFTs?
Liver anatomy
What do ALT and AST do?
ALT: amino acid metabolism and switching amino acids
AST:
ALT - where is it found?
liver
muscle
brain
pancreas
ALT goes up more than AST in liver damaahe
AST:ALT ratio
> 2.0 in alcohol suggests advanced diseasea
in absence of alcohol:
What does gamma GT do>
amino acid metabolism
Where is GGT found?
liver, kidney, pancreas, spleen, heart, brain, seminal vessels, duct
ALP - where is it localised?
sinusoidal and caclicular membranes.
ALP - where is it localised?
sinusoidal and caclicular membranes.
Causes of ALP raised
bone
small intestine
kidney
WBC
placenta (pregnancy!)
half life of albumin
20dq
INR for acute
albumin is a marker for chronic liver disease
AFP
tumour marker
increased in hepatocellular carcinoma raised in hepatic damage
raised in testicular cancer.
Why pale stools in obstructive?
bile not passing through
xxx
Liver panel - investigations?
fasting
coeliac serology
hepatitis serology (HBV surface, HCV)
alpha-1-antitrypsin
ceruloplasmin (if <50yo)
Liver AAbs (LKM, aSMA, AMA)
Immunoglobulins
Ferritin
ANCA
what ceruloplsamin is diagnostic of Wilsons disease?
low
Is haemochromatosis common?
relatively common
presents earlier in men
managed with venesection
fibroscan
can tell you how fibrotic a liver is
ELF
enhanced liver fibrosis scan
Hep A sx
diarrhoeal illness
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