Sanders Chapter 10 - Abnormal Liver Function Tests

Question 1

Enzyme that catalyses the cleavage of inorganic phosphate. Elevated with biliary obstruction.

Answer 1

Alkaline Phosphatase

Question 2

Enzyme involved in protein metabolism. Increased in alcoholic hepatitis, jaundice, and cirrhosis. Formerly called serum glutamic-pyruvic transaminase (SGPT).

Answer 2

ALT. Alanine aminotransferase

Question 3

The point at which the common bile duct and pancreatic ducts enter the duodenum.

Answer 3

Ampulla of Vater

Question 4

Enzyme involved in synthesis of amino acids. Elevated in acute hepatitis and cirrhosis. Formerly called serum glutamic oxaloacetic transaminase (SGOT) .

Answer 4

AST. Aspartate aminotransferase

Question 5

Progressive obliteration of the extrahepatic and proximal intrahepatic bile ducts, as well as the gallbladder. Usually diagnosed within the first 2 weeks of life.

Answer 5

Biliary Atresia

Question 6

Yellowish pigment in bile formed by red blood cell breakdown. Increases with hepatic disorders in which metabolism is impaired, such as cirrhosis or hepatitis. Also increases with obstructive disease such as gallstones.

Answer 6

Bilirubin

Question 7

excreted in urine.

Answer 7

Direct (conjugated ) bilirubin

Question 8

calculated by subtracting the direct value from the total.

Answer 8

indirect (unconjugated)

Question 9

The extrahepatic portal vein becomes thrombosed and is replaced by numerous collateral veins in the porta hepatis.

Answer 9

Cavernous Transformation of the Portal Vein

Question 10

A malignant neoplasm arising from the bile ducts.

Answer 10

Cholangiocarcinoma

Question 11

Congenital dilatation of the common bile duct. Usually found in children but may not be diagnosed until adulthood.

Answer 11

Choledochal Cyst

Question 12

Stones in the biliary tree.

Answer 12

Choledocholithiasis

Question 13

Progressive hepatocellular disease . Common causes include excessive alcohol or drug use and viral infection, although there are many other etiologies . May result in fibrosis , jaundice, portal hypertension, and liver failure.

Answer 13

Cirrhosis

Question 14

Also called varices. Dilated veins that occur with portal hypertension. Seen principally in the region of the porta hepatis, pancreas, and splenic hilum.

Answer 14

Collaterals

Question 15

Portion of the biliary duct formed by the confluence of the common hepatic duct and the cystic duct.

Answer 15

Common Bile Duct

Question 16

Portion of the biliary duct formed by the confluence of the right and left hepatic ducts.

Answer 16

Common Hepatic Duct

Question 17

Vein that arises from the splenic vein in the midline and courses superior and to the left. Becomes dilated in the setting of portal hypertension.

Answer 17

Coronary Vein

Question 18

Enlarged, palpable gallbladder. Results from distal obstruction of the common bile duct (CBD) secondary to a pancreatic head mass.

Answer 18

Courvoisier Gallbladder

Question 19

Drains the gallbladder. Joins the common hepatic duct to form the CBD.

Answer 19

Cystic Duct

Question 20

Infiltration of hepatocytes by lipids. Eventually results in fat cells being surrounded by fibrous material. Common causes include hepatitis, diabetes, metabolic disorders, and pregnancy. May be focal or diffuse.

Answer 20

Fatty Infiltration

Question 21

Biliary enzyme that increases with obstructive jaundice and liver disease.

Answer 21

GGT, Gamma glutamyl transferase

Question 22

Fibrous membrane that surrounds the liver, as well as the portal triads within the liver.

Answer 22

Glisson’s Capsule

Question 23

Disease process in which large quantities of glycogen are abnormally deposited within the liver, resulting in fatty infiltration and tumors.

Answer 23

Glycogen Storage Disease

Question 24

Anemia resulting from destruction of red blood cells. Either congenital or acquired from a variety of causes including various infections.

Answer 24

Hemolytic Anemia

Question 25

Inflammation of the liver due to viral infection or less commonly, autoimmune disease. May be acute or may become chronic after an acute episode.

Answer 25

Hepatitis

Question 26

Diffuse disease affecting the liver parenchyma such as cirrhosis, fatty infiltration , or hepatitis.

Answer 26

Hepatocellular Disease

Question 27

Portal vein flow away from the liver. This pattern can be seen in patients with severe portal hypertension.

Answer 27

Hepatofugal

Question 28

Normal portal vein flow, toward the liver.

Answer 28

Hepatopetal

Question 29

Yellow pigmentation of the skin due to excessive bilirubin accumulation. Usually secondary to liver or biliary disease.

Answer 29

Jaundice (Icterus)

Question 30

A type of cholangiocarcinoma, an adenocarcinoma of the common hepatic duct bifurcation.

Answer 30

Klatskin Tumor

Question 31

Enzyme that catalyses the formation and removal of lactate. Elevated with liver disease.

Answer 31

LDH. Lactic dehydrogenase

Question 32

Transverse fissure on the visceral surface of the liver in which the CBD, proper hepatic artery, and main portal vein (MPV) run alongside each other as they leave or enter the liver.

Answer 32

Porta Hepatis

Question 33

Increased portal venous pressure usually secondary to liver disease (most commonly cirrhosis); leads to dilatation of the portal vein with splenic and superior mesenteric vein enlargement, splenomegaly, and formation of collaterals. Can also be caused by portal or splenic vein thrombosis.

Answer 33

Portal Hypertension

Question 34

Portal vein, hepatic artery, biliary duct. Primary Biliary Cirrhosis. Autoimmune disease resulting in irreversible destruction of the liver and bile ducts.

Answer 34

Portal Triad

Question 35

Regenerating areas of hepatocytes surrounded by fibrotic septa.

Answer 35

Regenerating Nodule

Question 36

Annular sheath of muscle contracting around the ampulla of Vater.

Answer 36

Sphincter of Oddi

Question 37

Dilated veins.

Answer 37

Varices