Liver Function Tests (LFTs) Flashcards

1
Q

Aminotransferases:

A

Acute Hepatocellular Injury
Injured cells release Aspartate & Alanine
Aminotransferases (AST & ALT)

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2
Q

ALT > AST b/c

A

↑ AST with muscle/RBC injury

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3
Q

Viral Hepatitis =

A

↑ ALT

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4
Q

Alcohol Hepatitis =

A

↑ AST (AST in mitochondria)

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5
Q

Alkaline Phosphatase:

A

Bile Duct Enzyme: Intrahepatic/extrahepatic injury/obstruction
===> Marker of Bile Duct Obstruction

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6
Q

Alkaline Phosphatase Level correlates with

A

↑ synthesis

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7
Q

Alkaline Phosphatase Isoenzymes:

A

Gut, Bone (cancer metastasis)

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8
Q

Alkaline Phosphatase Pregnancy =

A

↑ Alk Phosphatase in placenta

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9
Q

Gamma Glutamyl Transferase (GGT):

A

↑ GGT with biliary obstruction; back up Alk-P
because Alk-P can be from other location
===> Marker of Bile Duct Obstruction

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10
Q

Gamma Glutamyl Transferase (GGT) Elevated with drugs

A

(Phenytoin)

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11
Q

Gamma Glutamyl Transferase (GGT) Elevated with ethanol =

A

Good test for abuse

So alcohol ==> ↑AST + ↑GGT

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12
Q

Cholglycine:

A

Serum Bile Salt
• Correlates with cholestasis
• Used to distinguish causative agent of extreme
pruritis (intrinsic skin lesion vs. other)

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13
Q

Bilirubin Levels represent:

A

Bilirubin Levels represent measure of hepatic clearance / excretory function; ↑ with impaired liver clearance

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14
Q

Ammonia:

A

Detoxifified in liver via Urea Cycle & Glutamine Synthetase Reaction

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15
Q

Synthetic Capacity Prothrombin Time:

A

↑PT when CF I, II, V, VII, X are deficient (Vit K Definition)

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16
Q

Synthetic Capacity Albumin:

A

Rapidly changes with acute illness

Cirrhosis (chronic disease) ==> ↓albumin

17
Q

LFTs Scores

Child Pugh Score:

A

Incorporates Albumin, Bilirubin, Ascites, Encephalopathy, & PT
• Prognosis before portal-systemic shunt

18
Q

LFTs Scores

Model of End Stage Liver Disease (MELD):

A

Incorporates INR, Bilirubin, Creatinine

19
Q

Bilirubin Metabolism

A
  1. Splenic (RES) macrophages eat senescent RBCs —> recycle globin + iron ===> UCB (lipid soluble)
  2. UCB binds with albumin in blood
  3. UCB (lipid soluble) taken up by hepatocytes
  4. UCB glucorinidation —> CB (water soluble)
  5. CB enters duodenum via common bile duct —> converted to urobilinogen via intestinal bacteria
  6. Urobilinogen excreted in stool, urine or reabsorbed by liver
20
Q

Jaundice =

A

↑UCB +/- CB

21
Q

Extravascular Hemolysis =

A

↑UCB ==> ↑Everything