Liver Function Tests Flashcards

1
Q

What is AST?

A

Aspartate aminotransferase

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2
Q

Where is AST normally found?

A
  • Liver
  • Heart
  • Kidneys
  • Skeletal muscle
  • Red blood cells
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3
Q

At what level would AST normally be found in the blood?

A

Low levels

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4
Q

How long would AST levels take to become elevated and how long would the levels remain high?

A

It takes 6-10 hours for them to rise

They stay this way for 4 hours

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5
Q

What may cause raised AST levels?

A

10-20 times normal - MI, alcoholic cirrhosis

20 times normal - viral hepatitis, autoimmune hepatitis, drugs

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6
Q

What is ALT?

A

Alanine aminotransferase

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7
Q

Where is ALT normally found?

A

Mostly in the liver

(also kidneys and heart)

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8
Q

How do ALT levels vary between adults anch children?

A

Children normally have levels twice as high as adults

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9
Q

ALT levels vary throughout the day

True or false?

A

True

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10
Q

High levels of ALT in the blood are specific for what?

A

Liver damage

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11
Q

Levels 50 times higher than normal for ALT are indicative of what?

A

Viral or drug hepatitis

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12
Q

What is ALP?

A

Alkaline phosphotase

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13
Q

Where is ALP normally found?

A
  • In hepatocytes lining the hepatic duct
  • Bone
  • Intestines
  • Placenta
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14
Q

When with ALP levels be high?

A

When there is a raised bone turnover rate, such as during adolescence, during fractures, in the 3rd trimester of pregnancy and if bony metastases is present

It is also associated with liver disease

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15
Q

In terms of the liver, what may high levels of ALP signify?

A

A blockage in the bile duct

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16
Q

Where does bilirubin originate?

A

It is a breakdown product from red lood cells

17
Q

What are the two forms of bilirubin?

A

Conjugated - created in the liver and excreted in urine (water soluble)

Unconjugated - binds to albumin

18
Q

How are unconjugated bilirubin levels calculated?

A

By subtracting conjugated bilirubin levels from total bilirubin levels

19
Q

What does high unconjugated bilirubin levels signify?

A

Breakdown of red blood cells is higher than the liver’s ability to process the breakdown products (unconjugated bilirubin)

20
Q

When are high unconjugated bilirubin levels seen?

A
  • Haemolysis
  • Sickle cell anaemia
  • Gilbert’s disease
21
Q

What do high levels of conjugated bilirubin suggest?

A

The flow of bilirub has been disrupted and there may be an intrahepatic or extrahepatic cause or the patient may have chronic liver disease

22
Q

What is albumin and where is it made?

A

A protein made in the liver

23
Q

In liver disruption, what happens to albumin levels?

A

They decrease

24
Q

Why are albumin levels a poor test for liver function in acute disease?

A

Albumin has a half life of 20 days so decreased function is not immediately evident

25
Q

What is INR?

A

International normalised ratio

Involves at prothromin test

26
Q

How does INR change in liver disruption?

A

It increases

(clotting factors are not produced as efficiently)

27
Q

What is GGT?

A

Gamma-glutamyl transpeptidase

28
Q

Where is GGT found mostly?

A

Kidneys, liver, pancreatic cells

29
Q

When may GGT levels be raised?

A
  • Obstructive jaundice
  • Cholecystitis
  • Alcohol abuse
30
Q

How is GGT useful in interpreting the ALP result?

A

GGT can help determine if an ALP rise is due to problems with the liver or something else

31
Q

Which tests are defined as true liver function tests?

A
  1. Bilirubin
  2. Albumin
  3. Prothrombin time (INR)
32
Q

Which tests are not true liver function tests, but can still aid in determining liver function?

A
  • ALT/AST
  • ALP
  • GGT
  • Bilirubin