Wk 10: Biochemistry: Liver (tests) Flashcards

1
Q

Name the different types of liver disease in order of severity

A
  • Cholestatic
  • Hepatocellular disease: steatosis + hepatitis
  • Fibrosis
  • Cirrhosis
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2
Q

What is chronic liver disease characterised by?

A

Structural changes - compromise liver function

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3
Q

What are the initial symptoms in liver disease?

A
  • Non-specific
  • Easily fatigued
  • Nausea
  • Loss of appetite
  • Weight loss
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4
Q

What are the symptoms of decompensated liver disease?

A
  • Loss of muscle from arms + legs
  • Swelling of abdomen + lower body
  • Abdominal pain
  • Pruritus
  • Bruising
  • Bleeding gums + nose
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5
Q

What are the signs of liver disease?

A
  • Jaundice
  • Ascites
  • Finger clubbing
  • Palmer erythema
  • Spider navei
  • Dupuytren’s contracture
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6
Q

What are the causes of liver disease?

A
  • Alcohol
  • Viral infection
  • Fatty liver
  • Inherited metabolic disorders
  • Drugs + toxins
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7
Q

Give examples of viral infections that cause liver disease

A

Hep A, B, C, D + E

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8
Q

Give examples of fatty liver that cause liver disease

A

NASH + NAFLD

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9
Q

Give an example of an inherited + metabolic disorder that causes liver disease

A
  • Alpha 1-antitrypsin deficiency
  • Wilsons disease
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10
Q

Give an example of drugs that causes liver injury

A
  • Paracetamol
  • Phenytoin
  • Oral contraceptives
  • Methotrexate
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11
Q

What indicates hepatocellular injury?

A
  • AST lower than ALT
  • Chronic liver disease
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12
Q

What indicates alcoholic liver disease?

A
  • AST:ALT = 2:1 or greater
  • Inc GGT
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13
Q

What is gamma-glutamyl transpeptidase?

A
  • Indicates alcohol abuse
  • Indiacted enzyme inducing drug reaction
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14
Q

Give examples of why bilirubin levels may increase

A
  • Damage to liver resulting in jaundice
  • Biliary tract obstruction
  • Haemolysis
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15
Q

What is the clotting factors in the liver?

A

Prothrombin - vit K dependent

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16
Q

What is the prothrombin time + what is it used for?

A
  • Marker of synthetic function
  • Time taken for clot to form
  • Exclude vit K deficiency
17
Q

What is the usual prthrombin time?

A

12-16 seconds

18
Q

What are the indicators of hepatitis?

A

Inc ALT + AST

19
Q

What are the indicators of acute liver disease?

A

Sig rise ALT + AST

20
Q

What are the indicators of chronic liver disease?

A
  • Normal-mild rise ALT + AST
  • Inc ALP + bilirubin
  • Red albumin
  • Rise in prothrombin time
21
Q

What tools are used to grade severity of liver dysfunction?

A

Child-pugh classification

22
Q

What is cirrhosis indicated by?

A

Liver enzymes not elevated much

23
Q

Give examples of drugs that cause drug induced liver disease

A
  • Statin
  • NSAID
  • Penicillin
24
Q

Who is more at risk of cholestatic jaundice?

A
  • Co-amoxiclav + flucloxacillin
  • > 26
  • Treatment > 2wks
  • Male
25
Q

What are the risk factors for developing corrhosis?

A
  • T2 diabetes
  • Cholesterol
  • Male
  • > 50