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Flashcards in Lab Assessment Deck (67)
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1

Changes in the CBC

Anemia
Neutropenia
Thrombocytopenia

2

What is the term for a combination of anemia, neutropenia, and thrombocytopenia?

Pancytopenia

3

GI Reasons for Anemia

Alcoholism
GI blood loss
Nutritional deficiency (B12 & folate)
Alcohol as a direct toxin

4

What type of anemia is due to B12, folate, or myelodisplastic syndrome?

Macrocytic

5

Why does GI issues cause neutropenia?

Sequestering of WBC's in the spleen because of portal hypertension

6

What is the etiology of portal HTN?

Cirrhosis of the liver

7

Why do GI issues cause thrombocytopenia?

Sequestering in the spleen secondary to portal hypertension

8

Applications of LFT's

Screen for the presence of liver disease
Measure efficacy of treatments for liver disease
Monitor progression of liver disease
Reflect the severity of liver disease

9

Cons of LFT's

Do not accurately reflect how well the liver is functioning
Abnormal values can be caused by disease unrelated to the liver
May be normal in advanced liver disease

10

When are enzymes released in the blood stream?

When hepatocytes are injured

11

What are the aminotransferases in the serum?

Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)

12

What is AST produced in?

Hepatocyte injuries
Cardiac muscle
Skeletal muscle
Kidney
Brain
Pancreas
Lungs
Erythrocytes

13

Where are the highest elevations of the serum aminotransferases?

Viral hepatitis
Ischemic hepatitis
Toxicity

14

What can a rapid decline in serum aminotransferases a sign of?

Recovery
Massive destruction of viable hepatocytes signaling acute liver failure

15

Define Alkaline Phosphatase

Group of enzymes that catalyze the hydrolysis of organic phosphate esters at an alkaline pH

16

Where is alkaline phosphatase produced?

Liver
Bone
Intestinal tract (sometimes)

17

Where else can alkaline phosphates be produced?

Placenta in the 3rd trimester
Growing children's bones
Metastatic bone CA
MM

18

Where is 5'-nucleotidase found?

Liver
Intestine
Brain
Heart
Blood vessels
Endocrine pancreas

19

What is suggested when there are elevated AP & 5' nucleotidase levels?

Obstructive liver disease

20

What does Gamma-glutamyl transpeptidase (GGT) play a role in?

Amino acid transport

21

What does an elevated GGT & AP level indicate?

Liver disease

22

When can GGT be elevated?

Acute liver toxicity
Alcohol binge

23

What is elevated bilirubin due to?

Overproduction of bilirubin
Impaired uptake of bilirubin
Impaired conjugation or excretion of bilirubin
Backward leaking from damaged hepatocytes or bile ducts

24

What is bilirubin made from?

Heme metabolism
Other heme proteins

25

What does conjugated bilirubin relate to?

Hepatobiliary disease

26

Why does unconjugated bilirubin not get filtered by the kidneys?

It adheres to the albumin

27

Normal urobilinogen result on a UA

Negative

28

What is the cycle of increased ammonia?

Catabolism of colonic bacteria in the GI tract
Enters circulation via portal vein
Intact liver clears ammonia

29

What can an increased ammonia concentration lead to?

Hepatic encephalopathy

30

Define Hepatic Encephalopathy

Reversible impairment of neuropsychiatric function associated with impaired hepatic function