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y3r5: medicine i 🩺 > L1: LFTs > Flashcards

L1: LFTs Flashcards

1
Q

Tests of liver cell integrity (Injury)

A
  • ALT
  • AST
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2
Q

Tests of biliary tract Integrity (Cholestasis)

A
  • ALP
  • GGT
  • 5’-nucleotidase
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3
Q

Tests of Liver cell Function

A
  • Albumin
  • Bili
  • INR
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4
Q

Liver Biochemestries

A
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5
Q

Aminotransferases

A
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6
Q

ALT

A
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7
Q

AST

A
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8
Q

Degree of elevation of → AST and ALT are useful in distinguishing ….

A

acute and chronic liver diseases.

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9
Q

ALT and AST → are the most widely ordered liver chemistries that reflect injury to the liver.

A

….

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10
Q

aminotransferase levels < 300 iu ml

A
  • alcoholic hepatitis
  • non-alcoholic fatty liver disease
  • Chronic viral hepatitis (hepatitis B and C).
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11
Q

patients with levels between 500 iu ml and 5,000 iu ml

A
  • acute viral hepatitis
  • autoimmune hepatitis
  • drug reaction Viral
  • drug induced hepatitis will raise aminotransferase levels steadily and peak in the low thousands within 7-14 days, return to normal over weeks
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12
Q

high levels (greater than 5,000 iu ml)

A
  • acetaminophen related liver failure
  • ischemia
  • herpes simplex hepatitis
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13
Q

what to suspect when ALT > AST?

A

Typical for most liver conditions, including chronic viral hepatitis and NAFLD

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14
Q

what to suspect when ALT < AST?

A
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15
Q

AST > ALT Ratio results from ……

A
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16
Q

Def of Cholestasis

A
  • impairment in bile flow.
  • Cholestasis liver profile characterized by -an elevation in alkaline phosphatase with or without an elevation in bilirubin.
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17
Q

Normal alk phosphate level

A

125 IU/ml

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18
Q

When SAP elevation is detected, …..

A
  • Repeat the test.
  • Confirm the hepatic origin: Serum GGT - 5’Nucleotidase.
19
Q

causes of elevated Serum alkaline phosphate

A
20
Q

Albumin

A
21
Q

PT

A
22
Q

Bilirubin

A
23
Q

Child-Turcotte-Pugh Classification for Severity of Cirrhosis

A
24
Q

Isolated elevated indirect (unconjugated) bilirubin

A
  • Hemolysis
  • Drugs
  • Gilbert’s Disease
  • Crigler-Najjar type Il
25
Q

Drugs

Isolated elevated indirect (unconjugated) bilirubin

A

Probenecid, Rifampicin

26
Q

Gilbert’s Syndrome

Isolated elevated indirect (unconjugated) bilirubin

A
27
Q

CNJ Type II

Isolated elevated indirect (unconjugated) bilirubin

A

A. Caused by gene mutation
B. Reduced activity of Bilirubin UDP glucuronosyl

28
Q

Causes of Intrahepatic Cholestasis

A
29
Q

Causes of Extrahepatic Cholestasis

A
30
Q

Causes of hepatocellular injury

A
31
Q

Etiology of PBC

A

Unknown

32
Q

pathology of PBC

A

Injury of the interlobular or septal bile ducts.

33
Q

CP of PBC

A
34
Q

Investigations for PBC

A
  1. LFTS: Raised serum ALP
  2. Serology positive AMA in 95% of patient, high serum IgM.
  3. Liver biopsy: Injury of the interlobular or septal bile ducts.
35
Q

TTT of PBC

A
36
Q

Symptomatic TTT of PBC

A
37
Q

Causes of Pruritis

A
  • Obstructive jaundice
  • Cholestasis of pregnancy
  • Renal failure
  • Lymphoma
  • PBC
  • DM
  • Leukemia
  • Polycythemia Rubra Vera
38
Q

Def of PSC

A
  • chronic progressive disorder of unknown etiology that is characterized by inflammation, fibrosis, and structuring of medium size and large ducts in the intrahepatic and extrahepatic biliary tree
39
Q

Incidence of PSC

A

90% have inflammatory bowel disease, especially ulcerative colitis

40
Q

Symptoms of PSC

A

Pruritus, fatigue, RUQ pain

41
Q

Dx of PSC

A
  • Ultrasound
  • Cholangiogram: multifocal stricturing and dilation of intrahepatic
42
Q

Prognosis of PSC

A
  • Poor; average life expectancy after diagnosis is -12 years
  • 10-15% risk of developing cholangiocarcinoma
43
Q

what is the ultimate TTT of PSC?

A

Transplant

y3r5: medicine i 🩺 (48 decks)

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