Liver Function Tests Flashcards

1
Q

what two liver function tests signal hepatocellular injury?

A

AST and ALT

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2
Q

what three liver functions tests show cholestasis or obstruction?

A

alkaline phosphatase
GGT
bilirubin

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3
Q

what three liver function tests represent overall liver function?

A

bilirubin
albumin
PT/INR

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4
Q

which of AST or ALT is more specific?

A

ALT because the AST is found in other locations around the body

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5
Q

what are two other diseases that will increase AST?

A

cardiomyopathy

rhabdomyolysis

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6
Q

what do AST and ALT do in the liver?

A

help with gluconeogenesis

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7
Q

do AST/ALT levels go up or down with hepatocellular injury?

A

they go up

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8
Q

alkaline phosphate is found where in liver?

A

bile canaliculi

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9
Q

does alkaline phosphate go up or down with bile issues?

A

goes up

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10
Q

does glutamyl transferase (GGT) go up or down with bili issues?

A

goes up

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11
Q

what happens to albumin with liver damage? what about PT/INR?

A

albumin drops and PT goes up

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12
Q

what is the name of the enzyme that makes turns heme into biliverdin?

A

heme oxygenase

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13
Q

what is the name of the enzymes that makes bilverdin and links it with albumin?

A

biliverdin reductase

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14
Q

does unconjugated or conjugated bilirubin enter liver?

A

unconjugated

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15
Q

what is the name of the molecule in the liver that conjugates bilirubin?

A

UGT1A1

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16
Q

once bilirubin is conjugated in the liver where does it go?

A

the bile duct

17
Q

what two things do gut bacteria break bilirubin into?

A

stercobilinogen and urobilinogen

18
Q

where do we rid of stercobilinogne? what about urobilinogen?

A

sterco in feces and uro in pee

19
Q

how do we measure bilirubin? and get direct and indirect numbers

A

can measure total bilirubin and get the amount of direct bilirubin so you subtract direct from total to get indirect

20
Q

what are the three types of jaundice?

A

pre hepatic
intra hepatic
post hepatic

21
Q

what type of bilirubin is associated with each type of jaundice?

A

pre hepatic is indirect or unconjugated
intra hepatic is mix
post hepatic is direct/conjugated

22
Q

what is the most common bilirubin genetic disordeR?

A

Gilbert syndrome

23
Q

what do you have issue with in Gilbert syndrome? what does this cause?

A

issue with UGT1A1 which leads to lots of unconjugated bilirubin

24
Q

how is Gilbert syndrome passed?

A

AR

25
Q

what is issue in Crigler Najjar syndrome?

A

also issue with UGT1A1…so leads to unconj build up

26
Q

what is the issue in Dubin Johnson syndrome?

A

issue with liver not being able to excrete conjugated bili so it builds up in the liver

27
Q

what are the two types of Crigler Najjar Syndrome? which is worse?

A

type 1 worse

type 2

28
Q

why is type 1 crigler Najjar syndrome worse?

A

total inactivity of UGT1A1 in type 1 but type 2 has a little bit of activity

29
Q

how is crigler najjar syndrome inherited?

A

AR

30
Q

what is rotor syndrome an issue with

A

reuptake of bile in the liver

31
Q

rotor syndrome leads to what type of bili back up?

A

unconj and conj

32
Q

infiltrative liver diseases like TB Sarcoid and amyloid will cause what changes in liver functions tests?

A

increase alkaline phosphate
bili increase or stay same
AST/ALT normal