Liver Function Tests - Part 1

Question 1

(T/F) The liver function tests (LFTs) are a combination of biochemical tests.

Answer 1

TRUE DAT!!!

Question 2

Upon physical examination, Jaundice can be indicitive of what?

Answer 2

-Acute hepatitis
-biliary obstruction
-Advanced chronic liver diease

Question 3

Upon physical examination, abdominal pain and fever may be indicative of what?

Answer 3

-Cholecystitis
-Inflammatory liver disease

Question 4

Upon physical examination, stigmata of chronic cirrhosis may be indicative of what?

Answer 4

-Spider angioma
-Palmar erythemia
-Gynecomastia
-Testicular atrophy

Question 5

What are some complications of liver disease?

Answer 5

-Encephalopathy
-Ascites
-GI bleeding (esophageal varices)
-Coagulation disorders

Question 6

The liver function tests that checks the excretory function of the liver looks at what?

Answer 6

Serum bilirubin (total, conjugated, and unconjugated bilirubin)

Question 7

The liver function test reveals the serum enzyme levels checks what?

Answer 7

-Enzymes that indicate hepatocellular damage
-Enzymes that indicate cholestasis
-Gamma glutamyl transpeptidase

Question 8

The liver function tests that reveal the synthetic function of the liver look at what?

Answer 8

-Serum albumin
-Clotting factors (prothrombin time)
-Serum alpha feto protein (AFP)

Question 9

The liver function tests that reveal the metabolic function of the liver tests what?

Answer 9

-Serum ammonia
-Blood glucose

Question 10

In patients with hepatitis, serum total, conjugated and unconjugated bilirubin are _____

Answer 10

Increased.

Question 11

Elevated levels of unconjugated bilirubin are observed in what?

Answer 11

-Hepatocellular disease

(Conjugated bilirubin may be elevated in hepatitis, as due to the inflammation, there is an assoc. element of intrahepatic cholestasis.)

Question 12

In cholestatic disease, serum conjugated bilirubin is prodominantly elevated. If the obstruction is complete, what happens to the conjugated bilirubin?

Answer 12

It is not able to be excreted in the bile and it regurgitates into blood and appears in the urine.

Question 13

In cholestatic disease, serum conjugated bilirubin is prodominantly elevated. If the obstruction is complete, what happens to the urobilinogen?

Answer 13

Its not formed in the intestines and stercobilinogen is also not formed, resulting in clay (pale) colored feces. Urobilinogen is also absent in the urine

Question 14

In cholestatic disease, the extent of absence of stercobilinogen in feces and urobilinogen in urine depends on what?

Answer 14

The extent of cholestasis

Question 15

In prolonged cholestatis, what may be characteristic of the serum unconjugated bilirubin?

Answer 15

May also be elevated (along with conjugated)

Question 16

Can serum bilirubin alone help distinguish hepatocellular disorder from cholestatic disorder?

Answer 16

Not really.

Question 17

What happens to the bile duct in intrahepatic cholestasis?

Answer 17

Inflammation of hepatocytes compresses on bile duct

Question 18

What happens to the common bile duct in extrahepatic cholestasis?

Answer 18

Gall stone in common bile duct

Question 19

Serum ________ bilirubin may be elevated in intra-hepatic or extra-hepatic cholestasis

Answer 19

Conjugated

Question 20

_______ cholestasis may be observed in viral hepatitis and drug toxicity

Answer 20

Intra-hepatic

Question 21

Extra-hepatic cholestasis may be observed in what?

Answer 21

-Stone in the common bile duct or gall bladder
-Tumors around the common bile duct or head of pancreas

Question 22

Raised ___ levels is more specific for liver cell damage compared to raised ____.

Answer 22

ALT
AST

Question 23

In acute hepatitis, ALT levels _____ AST levels

Answer 23

AST&raquo_space; ALT

Question 24

In long standing alcoholic cirrhosis, AST levels ___ ALT levels.

Answer 24

AST levels&raquo_space; ALT levels
(AST:ALT ratio approx 2:1)

Question 25

Which enzymes indicated hepatocellular injury?

Answer 25

Aminotrasnferases (Transaminases)
- ALT (alanine aminotransferase)
- AST (Aspartate aminotransferase)

Question 26

Which enzyme indicate cholestasis (intra-hepatic and extra-hepatic)?

Answer 26

-Alkaline phosphatase (ALP)
-Gamma glutamyl transpeptidase (GGT)
-5’ nucleotide

Question 27

Alkaline phosphatase (ALP) is secreted by what?

Answer 27

Biliary canaliculi

Question 28

What type of cholestatic obstruction raises ALP?

Answer 28

any cause of intra-hepatic or extra-hepatic obstruction

Question 29

Besides cholestasis, when else is ALP levels raised?

Answer 29

-Pregnancy
-normal growing children
-bone diseases