Flashcards in Liver Function Deck (36)
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1
what is the other name for AST
serum glutamic oxalocetic transamniase
SGOT
2
what is the other name for ALT
serum glutamic pyruvic transamniase
SGPT
3
AST is found primarily where
liver
heart
kidney
pancreas
muscle
4
AST is elevated when
significant tissue damage
5
what is the normal value for AST
7-40
6
which enzyme is found in liver, heart, kidney, pancreas, and muscle
AST
7
ALT is elevated when
hepatocellular necrosis*
alcohol liver damage
kidney infection
myocardial infarction
8
what enzyme is primarily elevated during hepatocellular necrosis
ALT
9
what is the normal value for ALT
5-36
10
LDH stands for what
lactic acid dehydrogenase
11
LDH is elevated when
cellular death or leakage from the cell
hemolysis --> prehepatic
if other tests are elevated it may indicate -->
myocardial infarction
pulmonary infarction
12
what is the normal values for LDH
50-150
13
ALP is elevated when
biliary obstruction*
blastic bone disease
pregnancy
skeletal growth
14
what is the normal values for ALP
30-120
15
what does GGT stand for
gama glutamyl transpeptidase
16
GGT is elevated when
cholangitis
liver disease
occult bile duct obstruction
alcohol abuse
drug abuse
17
total bilirubin is elevated when
liver disease
hemolytic anemia
drugs
18
what are the lab results seen in prehepatic jaundice
BLOOD
increase unconjugated bilirubin
increase albumin
URINE and POOP
increase or normal urobilinogen - yellow urine
normal steracobilinogen
19
what are the lab results seen in intrahepatic jaundice
BLOOD
increase unconjugated and conjugated bilirubin - BOTH
big increase AST and ALT
slight increase ALP
URINE
increase bilirubin - dark urine
20
what are the lab results seen in posthepatic jaundice
BLOOD
increase conjugated bilirubin
big increase in ALP
slight increase in AST and ALT
URINE and POOP
increase bilirubin in urine - dark urine
urobilinogen and steracobilinogen -->
incomplete obstruction = decrease
complete obstruction = absent
21
what causes prehepatic, intrahepatic, and post hepatic jaundice
prehepatic - hemolysis
intrahepatic - impaired conjugation, viral hepatitis, drugs, cirrhosis, tumors of liver
post hepatic - obstruction of bile ducts, gallstones, and tumors of bile ducts or pancreas
22
what are the symptoms of hemolytic jaundice
weakness, dark urine, anemia, leterus, splenomegaly
23
what gives feces its color
stercobilinogen
24
what are the different types of obstructive jaundice
intrahepatic obstruction - hepatitis, PBC (primary biliary cirrhosis), drugs
extrahepatic obstruction - stones, stricture/stenosis, compression, inflammation, tumors of ampulla of vater, choledochal cyst, biliary atresia
25
what are the causes of intrahepatic jaundice
gilberts syndrome - decreased GT activity - unable to conjugate bilirubin
grigler najjar syndrome - absence of UDPGT activity - unable to conjugate bilirubin
familial disorders - dubin johnson syndrome and rotor syndrome
hepatitis, cirrhosis, drugs
26
intrahepatic jaundice symptoms
weakness, loss of appetite, hepatomegaly, palmar erythema, spider angiolectasis
27
what are the clinical features of cholestasis
pain due to malignancy, disease, or stretching of liver capsule
fever due to ascending cholangitis
palpable or tender gall bladder
enlarged smooth liver
28
what does the proportion of conjugated bilirubin to total bilirubin indicate
<20% - prehepatic, gilberts, crigler najjar
20-40% of total - hepatic
40-60% of total - hepatic or post hepatic
>50% of total - post hepatic
prehepatic is mostly unconjugated so low % and post hepatic is conjugated so high % of conjugated/total bilirubin
29
unconjugated bilirubin is transported with what in the liver
ligandin or Z protein
30
