Liver Enzymes & Dx Flashcards
AST and ALT are enzymes found where?
Cellular
Ferroxidase and proteases are enzymes found where?
Blood
Where is glutamate dehydrogenase found?
mitochondria
What was the older view of liver cell death?
swelling (mild)
rupture (severe)
What is the newer view of liver cell death?
rupture (severe) bleb formation (mild)
hepatocyte apoptosis sequence?
nuclear degen
cytoskeleton degen
membrane blebbing
shrinking
What liver enzymes are in membrane?
ALP
GGT
What liver enzymes are in cytoplasm
ALT
AST
LD
What liver enzymes are in mitochondria?
mAST
SOD
is ALT of AST more liver specific? why?
ALT
there is mAST in every cell that has mitochondria
AST>ALT means what?
acute, affecting mitochondria
Alcohol/toxins
ALT>AST means what?
chronic/resolving hepatitis
Why is AST removed faster than ALT?
AST smaller 36vs. 18 hours
What other viruses can cause hepatitis besides Hep A-E?
EBV
CMV
Q-Fever
Rubella
ALT levels for mild, moderate, severe Hep A infection?
250
1000
5000 (fulminant)
why is ALT elevated in the first place? Viruses don’t want to kill hepatocytes
Immune system CD8s apoptosing everything!!
Acute Hep A ALT levels are what?
1000-5000
Acute Hep B ALT core IgM levels what what?
2500-5000
Chronic Hep B and C ALT surface Ag levels are what?
50–250
Number one and two drug induced liver disease is?
Flucloxacillin
Amoxyclav
4 drugs/toxins for hepatitis
antibiotics
statins
ethanol
paracetamol
2 enzymes involved in biliary disease?
ALP
GGT
What is GGT important for?
making glutathione
2 kinds of biliary obstruction, they are? what are the GGT and ALP levels?
extrahepatic +++ GGT, ALP
intrahepatic +GGT, ALP
correlation between alcohol and GGT induction?
Nope
What is the most common enzyme elevated?
ALT/GGT
what a huge risk factor for raised ALT/GGT?
obesity
What’s the significant of increased fructose in our diet?
Fructose get made into fat rather than used as energy like glucose, could contribute to NAFLD
