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MI Clinical Diagnosis > Liver Function > Flashcards

Liver Function Flashcards

1
Q

what is the other name for AST

A

serum glutamic oxalocetic transamniase

SGOT

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2
Q

what is the other name for ALT

A

serum glutamic pyruvic transamniase

SGPT

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3
Q

AST is found primarily where

A 
liver 
heart 
kidney 
pancreas 
muscle
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4
Q

AST is elevated when

A

significant tissue damage

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5
Q

what is the normal value for AST

A

7-40

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6
Q

which enzyme is found in liver, heart, kidney, pancreas, and muscle

A

AST

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7
Q

ALT is elevated when

A

hepatocellular necrosis*
alcohol liver damage
kidney infection
myocardial infarction

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8
Q

what enzyme is primarily elevated during hepatocellular necrosis

A

ALT

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9
Q

what is the normal value for ALT

A

5-36

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10
Q

LDH stands for what

A

lactic acid dehydrogenase

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11
Q

LDH is elevated when

A

cellular death or leakage from the cell
hemolysis –> prehepatic

if other tests are elevated it may indicate –>
myocardial infarction
pulmonary infarction

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12
Q

what is the normal values for LDH

A

50-150

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13
Q

ALP is elevated when

A

biliary obstruction*
blastic bone disease
pregnancy
skeletal growth

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14
Q

what is the normal values for ALP

A

30-120

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15
Q

what does GGT stand for

A

gama glutamyl transpeptidase

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16
Q

GGT is elevated when

A 
cholangitis 
liver disease 
occult bile duct obstruction  
alcohol abuse 
drug abuse
17
Q

total bilirubin is elevated when

A

liver disease
hemolytic anemia
drugs

18
Q

what are the lab results seen in prehepatic jaundice

A

BLOOD
increase unconjugated bilirubin
increase albumin

URINE and POOP
increase or normal urobilinogen - yellow urine
normal steracobilinogen

19
Q

what are the lab results seen in intrahepatic jaundice

A

BLOOD
increase unconjugated and conjugated bilirubin - BOTH
big increase AST and ALT
slight increase ALP

URINE
increase bilirubin - dark urine

20
Q

what are the lab results seen in posthepatic jaundice

A

BLOOD
increase conjugated bilirubin
big increase in ALP
slight increase in AST and ALT

URINE and POOP
increase bilirubin in urine - dark urine

urobilinogen and steracobilinogen –>
incomplete obstruction = decrease
complete obstruction = absent

21
Q

what causes prehepatic, intrahepatic, and post hepatic jaundice

A

prehepatic - hemolysis

intrahepatic - impaired conjugation, viral hepatitis, drugs, cirrhosis, tumors of liver

post hepatic - obstruction of bile ducts, gallstones, and tumors of bile ducts or pancreas

22
Q

what are the symptoms of hemolytic jaundice

A

weakness, dark urine, anemia, leterus, splenomegaly

23
Q

what gives feces its color

A

stercobilinogen

24
Q

what are the different types of obstructive jaundice

A

intrahepatic obstruction - hepatitis, PBC (primary biliary cirrhosis), drugs

extrahepatic obstruction - stones, stricture/stenosis, compression, inflammation, tumors of ampulla of vater, choledochal cyst, biliary atresia

25
Q

what are the causes of intrahepatic jaundice

A

gilberts syndrome - decreased GT activity - unable to conjugate bilirubin

grigler najjar syndrome - absence of UDPGT activity - unable to conjugate bilirubin

familial disorders - dubin johnson syndrome and rotor syndrome

hepatitis, cirrhosis, drugs

26
Q

intrahepatic jaundice symptoms

A

weakness, loss of appetite, hepatomegaly, palmar erythema, spider angiolectasis

27
Q

what are the clinical features of cholestasis

A

pain due to malignancy, disease, or stretching of liver capsule

fever due to ascending cholangitis

palpable or tender gall bladder

enlarged smooth liver

28
Q

what does the proportion of conjugated bilirubin to total bilirubin indicate

A

<20% - prehepatic, gilberts, crigler najjar

20-40% of total - hepatic

40-60% of total - hepatic or post hepatic

> 50% of total - post hepatic

prehepatic is mostly unconjugated so low % and post hepatic is conjugated so high % of conjugated/total bilirubin

29
Q

unconjugated bilirubin is transported with what in the liver

A

ligandin or Z protein

30
Q

unconjugated bilirubin is conjugated with what to form conjugated bilirubin

A

glucouronic acid

31
Q

conjugated bilirubin is converted to what in the GI small intestine

how

where doe it go next

A

urobilinogen

bacterial proteases

urobilinogen will be excreted via feces, enter enterohepatic circulation and go back to liver, or go to kidney to be excreted in the urine

32
Q

__% of urobilinogen reabsorbed from the intestines into the portal vein

__% of urobilinogen excreted in the feces

A

10% rebasorbed and back to the liver

90% excreted in the feces

33
Q

secreted bile salts from the gall bladder are __% new bile salts

and __% old recycled bile salts

A

5% new synthesized bile salts

95% old recycled bile salts

34
Q

what % of bile salts are reabsorbed by the small intestine

what % of bile salts are excreted in the feces

A

95% reabsorbed

5% excreted in feces

35
Q

what is normal GGT value

A

0-30

36
Q

what is normal total bilirubin value

A

0.2 - 1.5

MI Clinical Diagnosis (12 decks)

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