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HEPATOLOGY > LIVER FUNCTION TEST > Flashcards

LIVER FUNCTION TEST Flashcards

1
Q

Markers of Liver Cell Damage

A

ALT
AST

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2
Q

Markers of CHOLESTASIS

A

ALP
GGT
5’ nucleotidase
Lucine aminopeptidase

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3
Q

Markers of SYNTHESIS (SYNTHETIC Markers)

A
  1. Albumin
  2. PT/INR
  3. Cholinesterase
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4
Q

1st SIGN of LIVER FAILURE

A

⬆️ PT/INR

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5
Q

Liver Failure 🌸 TYPES

A
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6
Q

Normal Value of ALT & AST

A

5-45 IU/L

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7
Q

Which is SGOT & SGPT
🧠⚡ L-PG⚡
🧠💡GO-ST💡

A

ALT: SGPT
Alanine transaminase
Serum Glutamate Pyruvate Transaminase

AST: SGOT
Aspartate transaminase
Serum Glutamate Oxalate Transaminase

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8
Q

Normally ALT or AST which is HIGHER?

A

ALT

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9
Q

⭐ ALT/SGPT is specific for

⭐ AST/SGOT is specific for

🧠⚡I ASKED(AST) why Little Men Hate Everybody ⚡

🧠⚡aLt ⚡

A

⭐ LIVER

⭐ Liver, Muscle Heart, Erythrocytes

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10
Q

Which Liver Cell Damage marker is Mitochondrial

🧠⚡ IMAGINE IMAGE OF MITOCHONDRIA ITS A CIRCLE= O MEANS sgOt⚡

A

SGOT/AST is Mitochondrial 80%
20% CYTOSOLIC

SGPT is 100% CYTOSOLIC

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11
Q

AST ⬆️ > 3 times NORMAL
➕
ALT ⬆️ > 3 times NORMAL

💡🪔CLINICAL POINTER🪔

A

Hepatocellular Injury

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12
Q

AST ⬆️ < 3 times NORMAL
➕
ALT ⬆️ < 3 times NORMAL

💡🪔CLINICAL POINTER🪔

A

CHOLESTASIS
(Cholestasis can also lead to Liver call damage)

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13
Q

AST ⬆️
➕
ALT NORMAL

💡🪔CLINICAL POINTER🪔

A

NO HEPATOCELLULAR CELL INJURY

⭐ HEMOLYSIS
⭐ RHABDOMYOLYSIS
⭐ ACUTE MI

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14
Q

AST ⬆️
➕
ALT NORMAL
➕
LDH/AST = ≥ 30
➕
LDH2 > LDH1

💡🪔CLINICAL POINTER🪔

A

Hemolysis

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15
Q

LDH Flip seen in

A

MI

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16
Q

AST ⬆️
➕
ALT NORMAL
➕
LDH1 > LDH2

💡🪔CLINICAL POINTER🪔

A

Acute MI

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17
Q

HEPATOCELLULAR INJURY
Classified by

A

AST/ALT ratio

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18
Q

De Ritis Ratio seen in

A

Alcoholic Hepatitis
AST/ALT ≥ 2

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19
Q

AST/ALT >1
Seen in

A
  1. Alcoholic Hepatitis
  2. Fulminant Liver Failure/Cirrhosis
  3. HCC / METASTASIS
20
Q

ALKALINE PHOSPHATASE
NORMAL Value

A

44-144 IU/L

21
Q

CAUSES: ⬆️ ALP
🧠⚡ Plates of Kidney & Liver Can Be Soaked ⚡

A

Pregnancy (3rd TRIMESTER)
Kidney Disease
Liver Disease
Choriocarcinoma
Seminoma

22
Q

ALP in BILIARY Pathology

ALP in HEPATOCELLULAR Pathology

A

ALP in BILIARY Pathology
🎯 > 2 TIMES Upper Limit of NORMAL

ALP in HEPATOCELLULAR Pathology
🎯 < 2 TIMES Upper Limit of NORMAL

23
Q

ALP ⬆️ is significant only if

A

> 4 times NORMAL

24
Q

Reduced ALP
Causes

A
  1. Wilson’s disease
  2. Hypothyroidism
  3. Zinc deficiency
  4. Pernicious anemia
  5. Hypophosphatemia
25
Q

differentiate between Alkaline phosphatase coming from Liver & Bone
🧠⚡Bone Burns ⚡
🧠⚡Liver Lasts ⚡

A

liver (heat stable)
bone (heat labile).

26
Q

GGT
NORMAL Value

A

10-60

27
Q

⬆️ GGT

A
  1. Biliary pathology: Cholestasis
  2. Alcohol abuse
  3. Phenytoin
  4. Diabetes
  5. CKD
28
Q

Isolated GGT Elevation

A

Alcohol ABUSE

29
Q

Membrane bound enzyme in Biliary tract

A

GGT

30
Q

T½ of Albumin

A

21 days

31
Q

NORMAL Albumin

Low Albumin

A

3.5-5.5 mg/dl

32
Q

PT vs aPTT
🧠⚡ Play Tennis⚡
🧠⚡ Play Table Tennis ⚡

A
33
Q

Elevated PT/INR

A
  1. Liver Disease
  2. Vitamin K deficiency
    ✨ Malnutrition
    ✨ Malabsorption
    ✨ Broad Spectrum Antibiotics
    ✨ Hemorrhagic Disease of Newborn
  3. WARFARIN Therapy
  4. DIC
34
Q

BILIRUBIN HANDLING

A
35
Q

Hepatic Cell: BILIRUBIN METABOLISM

A
36
Q

Transporter which transports UNCONJUGATED BILIRUBIN-ALBUMIN into Hepatocyte

A

LIGANDIN

37
Q

Transporter which transports CONJUGATED BILIRUBIN into BILE DUCT

A

MRP2/CMOAT

38
Q

Enzyme causing CONJUGATION of BILIRUBIN

A

UGT1A1

39
Q

Difference BETWEEN JAUNDICE & ICTERUS

A

Elevation of Serum BILIRUBIN > 3mg/dl: Jaundice

ICTERUS: Clinical sign of Jaundice; Yellowish discolouration of Sclera

40
Q

Serum BILIRUBIN that causes DISCOLOURATION of MUCOUS MEMBRANE

A

Serum BILIRUBIN > 4-5mg/dl

41
Q

NORMAL Serum BILIRUBIN

A

0.2-1.2 mg/dl

42
Q

Approach to JAUNDICE

A
43
Q

Approach to ACUTE HEPATITIS

A
44
Q

Approach to CHRONIC HEPATITIS

A
45
Q

Approach to CHOLESTASIS

A
46
Q

Sequale of LIVER DISEASE

A

Acute HEPATITIS
⬇️
Chronic Hepatitis
⬇️
Cirrhosis ➡️ HCC
⬇️
DECOMPENSATION: Portal Hypertension

47
Q

Cause of Acute HEPATITIS.
🧠⚡Always Go in ORDER ⚡
🧠⚡IDIA Wins ⚡

A
  1. Infective HEPATITIS
    ⚡⚡ MOST COMMON in ADULTS: Hepatitis E
    ⚡⚡ MOST COMMON in CHILDREN: Hepatitis A
  2. DRUGS/TOXIN
  3. ISCHEMIA
  4. AUTOIMMUNE
  5. WILSON’S Disease

HEPATOLOGY (16 decks)

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