liver labs Flashcards

Describe the lab test patterns which may indicate poor hepatocyte synthesis Describe the lab test patterns which may indicate direct hepatocyte injury Describe the lab test patterns which may indicate obstructive biliary injury Describe the lab test patterns which may indicate improper bilirubin clearance Describe the lab test patterns which may indicate pancreatitis

1
Q

test for intact liver synthesis

A

albumin
PT
INR

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2
Q

why is albumin not a good indicator for acute liver disease

A

albumin has a long half life

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3
Q

protein and albumin in liver disease will be:

A

low

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4
Q

non-hepatic causes of hypoalbuminia

A

protein malnutrition
nephrotic syndrome
severe burns

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5
Q

PT test result in liver damage

A

prolonged

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6
Q

why is PT test good for acutre liver damage

A

PT will respond within 24 hours of insult

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7
Q

PT used for

A

reye’s, acetominaphen OD, acute EtOH hepatitis

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8
Q

can also prolong PT

A

vitamin K deficincy

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9
Q

if hepatocytes are not synthesising properly then:

A

albumin will be low, PT and INR will be long

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10
Q

albumin 1.5 indicates

A

severe, end stage liver disease

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11
Q

lest for hepatocyte injury

A

AST, ALT, LD, GGT

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12
Q

test for liver metabolic function

A

ammonia

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13
Q

elevation of AST withOUT ALT indicates

A

cardiac or muscle disease

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14
Q

most specific liver enzyme test

A

ALT

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15
Q

500-1000 ALT indicates

A

acute viral hep
ischemic hep
acute toxic liver injury
autoimmune hepatitis

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16
Q

ALT and AST 10x the normal range ALMOST ALWAYS indicate

A

severe direct hepatocyte damage

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17
Q

highly suggestive of alchoholic hepatitus

A

AST:ALT greater than 2

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18
Q

tests of biliary excretory function and obstruction of bile flow

A

elevated ALP, GGT, and bilirubin

19
Q

elevated alkaline phosphatase is elevated in thee non-sick people

A

pregnant women

20
Q

alkaline phoshatase 10x normal level can mean

A

extra-hepatobiliary obstruction

21
Q

extra-hepatobiliary obstruction can be caused by

A

common bile duct obstruction or pancreatic cancer

22
Q

Their major use is to determine if an elevated ALP is of hepatic etiology

A

GGT

23
Q

in normal people, almost all bilirubin is

A

unconjugated

24
Q

jaundice indicates elevated

A

bilirubin

25
Q

hereditary unconjugated bilirubin

A

crigler-najjar sydrome

26
Q

worst kind of crigler-najjar sydrome

A

type 1

27
Q

mild jaundice with stress and illness

A

gilbert syndrome

28
Q

conjugated bilirubin with all other normal liver functions intact

A

dubin-Johnson syndrome

29
Q

possible causes of NEWBORN jaundice

A

ABO or RH immune mediated hemolysis

30
Q

moderate/severe Rh hemolysis can cause

A

hydrops fetalis

31
Q

deposition of unconjugated bilirubin in fetal brain

A

kernicturus

32
Q

Markedly elevated unconjugated bilirubin?

Think

A

hemolysis

33
Q

Markedly elevated conjugated bilirubin?

Think

A

hepatic injury or obstruction

34
Q

primary test of pancreatic insuffeciency

A

fecal fat test

35
Q

most common cause of acute pancreatitis

A

gallstones

36
Q

more specific test for pancretitis

A

lipase

37
Q

most common cause of chronic pancreatitis

A

EtOH

38
Q

most COMMON test for pancreatitis

A

amylase

39
Q

amalyse peaks at

A

12-72 hour

40
Q

non pancreatitis cause of high amylase

A

IgG-Amylase Complexes

41
Q

lipase peaks at

A

24 hours

42
Q

can lead to increased lipase (non-pancreatitits)

A

pancreatic duct obstruction or renal impairment

43
Q

non enzyme tests associated with acute pancreatitis

A

hyperTG, high hemocrit,