Liver Function Test

Question 1

Complications of Liver disease

Answer 1

• Synthetic impairment
• Cholestasis (decreased bile flow)
• Decreased Clearance
• Portal Hypertension (portal blood becomes shunted around the liver and not processed(

Question 2

Where does Portal blood go?

Answer 2

Liver, ding dong

Question 3

Liver Function Tests are really?

Answer 3

Liver enzyme measures…
More specifically, measures of hepatocyte injury or
impairment of bile flow.

Question 4

When liver cells are injured, what is released into the blood

Answer 4

Aminotransferases and Alkaline Phosphatase (more commonly seen with Bile Duct Injury)
Testing for these substances tests for direct cell injury to the liver

Question 5

Tests for clearance?

Answer 5

Bilirubin and Ammonia….both of these are made in the liver and both should be cleared.

Question 6

Tests of synthetic capacity

Answer 6

• Clotting Factors (done by measuring prothrombin time or INR, one of the results of the clotting cascade)
• Albumin
• Cholesterol

Question 7

What are the Aminotransferases

Answer 7

AST and ALT

Remember that AST can be associated with muscle injury as well
ALT more specific for liver

Question 8

Aminotransferases measure what

Answer 8

liver injury

Question 9

Alkaline phosphatase levels elevated suggests what

Answer 9

injury to bile duct

Question 10

Alk Phos elevation also associated with injury to what other organs?

Answer 10

bone

Question 11

Cholestasis can be intrahepatic or extrahepatic obstruction to bile flow

Answer 11

truth

Question 12

Cholylglycine is what

Answer 12

A serum bile salt. Correlates with the degree of cholestasis present

Question 13

GGT goes up with?

Answer 13

Bile duct impairment, tons of chemicals (dilantyn, ethanol)

Really not that helpful

Question 14

Bilirubin made from what

Answer 14

Red cell turnover

Question 15

Bilirubin is an imperfect measure of

Answer 15

hepatic clearance and excretory function

Goes up when clearance is reduced

Question 16

Prothrombin time is prolonged when?

Answer 16

WHen clotting facters 1,2,5,7,10 are deficient or when Vitamin K is low

Question 17

Albumin half life

Answer 17

around 20 days

Question 18

Albumin is made in the liver

Answer 18

rapidly changes with illness and malnutrition

Question 19

Look at child Pugh Score

Answer 19

ok

Question 20

High creatinine in liver pts?

Answer 20

important

Question 21

Ammonia is detoxified where and how?

Answer 21

Detoxified in the liver by the urea cycle and the glutamine synthetase rxn

Question 22

Ammonia is high in what condition

Answer 22

hepatic encephalopathy

Question 23

Child Pugh scoring:

Answer 23

Child A: score= 5-6
Child B: score= 7-9
Child C: score= 10-15

Question 24

Model of End Stage Liver Disease score (MELD) looks at what

Answer 24

INR
Bilirubin
Creatinine