OVERVIEW OF LIVER DISEASE AND LIVER FUNCTION TESTS Flashcards Preview

GASTRO-INTESTINAL MEDICINE AND HEPATOLOGY > OVERVIEW OF LIVER DISEASE AND LIVER FUNCTION TESTS > Flashcards

Flashcards in OVERVIEW OF LIVER DISEASE AND LIVER FUNCTION TESTS Deck (80)
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31

What is the half life of albumin?

20 days

32

What part of the liver do AST, ALT, albumin and INR relate to?

The parenchyma of the liver

33

What are the two functions of bile?

Emulsifies fats
To get rid of the haem products

34

What part of the liver do the ALP, GGT, serum bilirubin and bile acids relate to?

Cholestatic part (common hepatic duct, cystic duct and common bile duct)

35

How long is the life of a red blood cell?

120

36

What form is the bilirubin in when it is released from blood cells?

Unconjugated bilirubin (indirect)

37

What does the liver do to bilirubin?

Conjugates it to conjugated bilirubin (direct)

38

Where does the liver excrete conjugated bilirubin?

Into the intrahepatic ducts which then follow out of the liver to be extrahepatic ducts

39

What form(s) of bilirubin can the kidney excrete?

Only the conjugated bilirubin

40

If there is a blockage in the hepatic ducts, what will blood test show in terms of unconjugated and conjugated bilirubin?

Most likely show an increase in both

41

If there is a blockage in the hepatic ducts, what will urine tests show in terms of unconjugated and conjugated bilirubin?

Conjugated bilirubin is the only form of bilirubin to be excreted by the kidneys.

42

What does bilirubinuria tell you about the nature of the elevated levels of bilirubin in the blood?

That the problem is either hepatic or post hepatic, not pre-hepatic. In pre-hepatic jaundice there is only an increase in the levels of unconjugated bilirubin (eg haemolysis)

43

What are the three things that can cause a rise in ALP?

Cholestasis
Pregnancy
Bone disease (bone growth, eg Paget's disease)

44

What is ALP?

Alkaline phosphotase is an inducable enzyme which is released by biliary ductal cells of the intrahepatic bile ducts in liver damage.

45

What is GGT?

Gamma-glutamyltransferase

46

What causes a rise in GGT?

Cholestasis
Alcohol

47

Does bone disease increase GGT?

No

48

What is Gilbert's syndrome?

Most common (5% of population) hereditary cause of increased bilirubin. The cause of this hyperbilirubinemia is the reduced activity of the enzyme glucuronyltransferase, which conjugates bilirubin and a few other lipophilic molecules

49

In Gilbert's syndrome, is there an increase in unconjugated or conjugated bilirubin?

Unconjugated

50

In Gilbert's syndrome, is there an increase in ALP?

No.

51

In hepaticellular jaundice, is there an increase of unconjugated or conjugated bilirubin in the blood?

Both. there is usually interference in all major steps of bilirubin metabolism—uptake, conjugation and excretion. However, excretion is the rate-limiting step, and usually impaired to the greatest extent. As a result, conjugated hyperbilirubinaemia predominates.

52

In an acute infection of hepatitis A virus, what will liver function tests reveal?

Increased ALT
Increased AST
ALT increased more than AST
Maybe increased INR

53

What do you look for in the blood in order to make a diagnosis of hepatitis A?

IgM anti-hepatitis A

54

In an acute infection of hepatitis B virus, what will liver function tests reveal?

Increased ALT
Increased AST
ALT increased more than AST
Maybe increased INR

55

What do you look for in the blood in order to make a diagnosis of hepatitis B?

Hepatitis B surface antigen
IgM Hepatitis B surface antibody
IgM Hepatitis B core antibodies

56

In an acute infection of hepatitis C virus, what will liver function tests reveal?

Increased ALT
Increased AST
ALT increased more than AST
Maybe Increased INR

57

What do you look for in the blood in order to make a diagnosis of hepatitis A?

IgM anti-hepatitis A

58

What do you look for in the blood in order to make a diagnosis of hepatitis B?

Hepatitis B surface antigen
IgM Hepatitis B surface antibody
IgM Hepatitis B core antibodies

59

What do you look for in the blood in order to make a diagnosis of hepatitis C?

IgM anti-hepatitis C
Hepatitis C RNA

60

In acute liver injury as a result of alcohol, what will liver function tests reveal?

Slightly increased ALT
Slightly increased AST
ALT and AST are raised about the same or AST could be higher
Maybe increased INR