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GI/Nutritional Disorders > Liver Enzymes > Flashcards

Liver Enzymes Flashcards

1
Q

Liver specific/hepatocellular leakage enzymes

A

ALT and AST

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2
Q

Largest elevation of which enzyme is seen with inflammation and necrosis?

A

ALT

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3
Q

This enzyme increases with muscle damage but not significantly

A

ALT

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4
Q

Which drugs can cause an elevated ALT?

A

Corticosteroids, phenobarbital

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5
Q

Which hepatocellular leakage enzyme has a shorter half life?

A

AST

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6
Q

Which enzyme is more increased with muscle damage?

A

AST

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7
Q

What other value should you evaluate if AST&raquo_space;> ALT and you are considering muscle damage?

A

Creatinine kinase

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8
Q

What enzyme is muscle specific?

A

Creatinine kinase

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9
Q

When will you see an elevated ALP?

A

Cholestasis, chronic hepatitis, necrosis, neoplasia

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10
Q

This enzyme is relatively non-specific and an be elevated with many hepatic disorders

A

ALP

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11
Q

Why does ALP have a low specificity in dogs?

A

Can be high in growing animals, w/bone neoplasia, drugs, endocrinopoathies, or chronically ill patients

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12
Q

What bone isoenzyme of ALP exists?

A

B-ALP (seen in growing animals and bone neoplasia)

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13
Q

What isoenzyme of ALP exists in dogs but not in cats?

A

Corticosteroid-induced (C-ALP)

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14
Q

Which dog breed normally has a relatively high ALP compared to other breeds?

A

Scottish terriers

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15
Q

What GI disease can cause ALP elevations?

A

IBD

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16
Q

Which enzyme is much more specific at indicating hepatobiliary disease in cats compared to dogs?

A

ALP

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17
Q

Why is ALP more specific for cats compared to dogs?

A

Hepatic stores are less than in dogs, short half life

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18
Q

What enzyme is more specific than ALP for cholestatic disease in dogs?

A

GGT

19
Q

The liver is the exclusive site of synthesis for which protein?

A

Albumin

20
Q

What are processes that cause decreased albumin other than liver problems?

A

PLE, PLN, acute blood loss, systemic inflammation

21
Q

Are immunoglobulins made by the liver?

A

No

22
Q

Where are immunoglobulins made?

A

Peripheral blood and LNs

23
Q

How is BUN affected by liver dysfunction?

A

Decreased

24
Q

Why does urea production decrease when the liver is atrophied or severely damaged?

A

Accumulation of ammonia

25
Q

When will you see increased ammonia values assoc. w/liver damage?

A

Liver failure must be relatively advanced

26
Q

What is unconjugated bilirubin processed from?

A

Heme

27
Q

How do you differentiate pre-hepatic vs hepatic vs post-hepatic increases in bilirubin?

A

HCT, liver function, and cholesterol/cholestatic enzymes

28
Q

Pre-hepatic hyperbilirubinemia usually has a concurrent _____

A

Anemia

29
Q

Post-hepatic hyperbilirubinemia usually has a concurrent elevation in _____

A

Cholesterol

30
Q

What does the liver extract from plasma?

A

Cholesterol

31
Q

How will cholesterol be affected by decreased liver function?

A

Hypocholesterolemia

32
Q

How will a bile duct obstruction affect cholesterol levels?

A

Elevated (hypercholesterolemia)

33
Q

How much liver function must be lost before you see a decrease in glucose?

A

70%

34
Q

What is the last liver function parameter to drop when you have liver dysfunction/failure?

A

Glucose

35
Q

What is a negative prognostic indicator associated with liver dysfuntion?

A

Hypoglycemia

36
Q

Which liver enzymes are induced by cholestatsis?

A

ALP, GGT

37
Q

Which enzyme is liver specific in cows, sheep, horses, and goats?

A

SDH

38
Q

Where is LDH found?

A

Muscle, heart, liver

39
Q

What is the best measure of liver function?

A

BUN

40
Q

Why might horses develop and increased bilirubin?

A

Response to fasting

41
Q

When the liver fails in a horse, what type of crisis is it?

A

Hemolytic b/c RBCs become more fragile

42
Q

What are clinical signs of hepatoencephalopathy?

A

Chronic wt loss, yawning, unaware of surroundings, neuro signs, UTD on vax

43
Q

What causes hepatoencephalopathy?

A

Increased ammonia, aromatic AAs and ametacaptans to brain

GI/Nutritional Disorders (29 decks)

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