Liver Function Lab

Question 1

Where is AST in highest concentrations

Answer 1

Heart muscle
Cells of the liver
Cells of skeletal muscle

Question 2

Is AST concentration specific of hepatic disease

Answer 2

No

Also used to control patients after myocardial infection/skeletal muscle disease

Question 3

What reaction does AST catalyse

Answer 3

Reversible transfer of
aspartate to ɑ-ketoglutarate
glutamate + oxalacetate
oxalacetic acid + NADH = malate + NAD+ + H+

Question 4

Where is ALT found in highest concentrations

Answer 4

Liver and kidney

Question 5

When would ALT levels be increased

Answer 5

Hepatitis
Muscle disease
Traumatisms

[better indication than AST of liver diseasee]

Question 6

Relationship between AST & ALT in myocardial infarction

Answer 6

ALT stays in normal levels when AST is elevated

Question 7

What reaction does ALT catalyse

Answer 7

Alanine to ɑ-ketoglutarate
Pyruvate + gluatamate
pyruvate + NADH = lactate + NAD+ + H+

Question 8

Where is ALP in highest concentrations

Answer 8

Bone
Liver 
Placenta 
Intestine 
Kidney

Question 9

Reasons for increased ALP

Answer 9

Obstructive liver disease
Pagets disease of bone
Hepatitis
Hepatotoxicity caused by drugs or osteomalacia

Question 10

Reasons for decreased ALP

Answer 10

Cretinism

Vitamin C deficiency

Question 11

What reaction does ALP catalyse

Answer 11

Hydrolysis of p-nitrophenyl phosphate at pH 10.4

Liberating nitrophenol and phosphate

Question 12

Normal AST and ALT level

Answer 12

5-40 U/l

Question 13

Normal ALP level

Answer 13

30-125 U/l

Question 14

Additional tests for assessing liver function

Answer 14

Albumin
Bilirubin
Prothrombin time

Question 15

AST:ALT ratio in alcoholic hepatitis

Answer 15

Greater than 1

90% patients greater than 2

Question 16

Reason for increased level of bilirubin

Answer 16

Jaundice & cholestasis