Liver Function Tests

Question 1

what two liver function tests signal hepatocellular injury?

Answer 1

AST and ALT

Question 2

what three liver functions tests show cholestasis or obstruction?

Answer 2

alkaline phosphatase
GGT
bilirubin

Question 3

what three liver function tests represent overall liver function?

Answer 3

bilirubin
albumin
PT/INR

Question 4

which of AST or ALT is more specific?

Answer 4

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

Question 5

what are two other diseases that will increase AST?

Answer 5

cardiomyopathy

rhabdomyolysis

Question 6

what do AST and ALT do in the liver?

Answer 6

help with gluconeogenesis

Question 7

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

Answer 7

they go up

Question 8

alkaline phosphate is found where in liver?

Answer 8

bile canaliculi

Question 9

does alkaline phosphate go up or down with bile issues?

Answer 9

goes up

Question 10

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

Answer 10

goes up

Question 11

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

Answer 11

albumin drops and PT goes up

Question 12

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

Answer 12

heme oxygenase

Question 13

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

Answer 13

biliverdin reductase

Question 14

does unconjugated or conjugated bilirubin enter liver?

Answer 14

unconjugated

Question 15

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

Answer 15

UGT1A1

Question 16

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

Answer 16

the bile duct

Question 17

what two things do gut bacteria break bilirubin into?

Answer 17

stercobilinogen and urobilinogen

Question 18

where do we rid of stercobilinogne? what about urobilinogen?

Answer 18

sterco in feces and uro in pee

Question 19

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

Answer 19

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

Question 20

what are the three types of jaundice?

Answer 20

pre hepatic
intra hepatic
post hepatic

Question 21

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

Answer 21

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

Question 22

what is the most common bilirubin genetic disordeR?

Answer 22

Gilbert syndrome

Question 23

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

Answer 23

issue with UGT1A1 which leads to lots of unconjugated bilirubin

Question 24

how is Gilbert syndrome passed?

Answer 24

AR

Question 25

what is issue in Crigler Najjar syndrome?

Answer 25

also issue with UGT1A1...so leads to unconj build up

Question 26

what is the issue in Dubin Johnson syndrome?

Answer 26

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

Question 27

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

Answer 27

type 1 worse | type 2

Question 28

why is type 1 crigler Najjar syndrome worse?

Answer 28

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

Question 29

how is crigler najjar syndrome inherited?

Answer 29

AR

Question 30

what is rotor syndrome an issue with

Answer 30

reuptake of bile in the liver

Question 31

rotor syndrome leads to what type of bili back up?

Answer 31

unconj and conj

Question 32

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

Answer 32

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