Liver Function Tests

Question 1

Why are total protein and albumin levels measured in liver function tests?

Answer 1

Measure synthetic function of liver

Question 2

How does cell damage differ depending on if it’s mild or severe?

Answer 2

Mild = bleb formation
Severe = rupture

Question 3

Which enzymes are located on the membrane of hepatocytes?

Answer 3

ALP

GGT

Question 4

What does it mean if liver membrane enzymes are elevated in the blood?

Answer 4

Liver membrane in blood

Question 5

Which enzymes are located in the cytoplasm of hepatocytes?

Answer 5

ALT
AST
LD

Question 6

What does it mean if liver cytoplasmic enzymes are elevated in the blood?

Answer 6

Liver cytoplasm released

Question 7

Which enzymes are located in the nucleus of hepatocytes?

Answer 7

DNA synthase

Question 8

What does it mean if liver nuclear enzymes are elevated in the blood?

Answer 8

Damage must be worse

Question 9

Which enzymes are located in organelles of hepatocytes?

Answer 9

Mitochondrial AST

Lysosomal SOD

Question 10

What does it mean if liver organelle enzymes are elevated in the blood?

Answer 10

Organelles in blood

Question 11

What enzymes are elevated in liver necrosis?

Answer 11

ALT
AST
- Especially with toxins, like alcohol
LD

Question 12

What enzymes are elevated in biliary disease?

Answer 12

ALP

GGT

Question 13

How do inducing drugs increase the presence of enzymes in the blood?

Answer 13

Increase concentration in cell, so normal wear and tear produces increase in blood

Question 14

Where is ALT found in the body?

Answer 14

Liver specific

Small amounts in muscle and kidney

Question 15

Where is AST found in the body?

Answer 15

Liver
Muscle
Blood cells

Question 16

What are the half-lives of ALT, AST, and GGT?

Answer 16

ALT = 36 hours
AST = 18 hours
GGT = 5-7 days

Question 17

What does it mean if AST is higher than ALT?

Answer 17

Acute hepatocellular damage, affecting mitochondria
Especially
- Alcohol
- Toxins

Question 18

What does it mean if ALT is higher than AST?

Answer 18

Chronic/resolving

Especially hepatitis

Question 19

What are some drugs and toxins that cause hepatocellular damage?

Answer 19

Antibiotics
- Flucloxacillin
- Amoxil
Statins
Ethanol
Paracetamol
Kombucha = type of herbal tea

Question 20

Where in the body is ALP found?

Answer 20

Bone
Liver
Placenta

Question 21

Where in the body is GGT found?

Answer 21

Liver
Biliary epithelium
Kidneys

Question 22

What sort of biliary obstruction elevates ALP and GGT only mildly?

Answer 22

Intrahepatic

Question 23

What sort of biliary obstruction elevates ALP and GGT severely?

Answer 23

Extrahepatic

Question 24

What is the commonest cause of elevated liver enzymes?

Answer 24

Fatty liver disease