Liver Enzymes

Question 1

As a rule of thumb, ALT over 10,000 means what?

Answer 1

DEATH

Question 1

What level is ALT in a severe hepatitis?

Answer 1

5000

Question 2

According to the newer model of cell injury, what is the cell’s response to mild injury?

Answer 2

Bleb formation - blistering off of the cell membrane releasing packets of cytoplasm into the blood stream

Question 3

Which liver enzymes are cytoplasmic?

Answer 3

ALT - alanine transanimase

AST - asparate transanimase

LD - lactate dehydrogenase

Question 3

What does elevated ALT and AST mean when ALT is higher?

Answer 3

Chronic/resolving liver injury

eg chronic viral,

Question 4

What is the function of AST?

Answer 4

Shift malate in and out of the mitochondria

Question 5

What is one of the most important events in the lead up to cell death?

Answer 5

Destruction of cell cytoskeleton

Question 5

Which liver enzyme is most correlated with BMI?

Answer 5

ALT

Question 6

Which liver enzymes are located on the membrane?

Answer 6

ALP

GGT

(one the biliary membrane in particularly)

Question 7

How high do you expect GGT and ALP when there is an extrahepatic obstruction?

Answer 7

10x normal

Question 7

Which results in LFTs truely reflect the liver’s function?

Answer 7

Albumin

Bilirubin

Question 8

Which has the shorter half life, ALT or AST?

Answer 8

AST

Question 9

Which enzymes are released in liver cell necrosis?

Answer 9

AST, ALT and LD

Question 10

What are ALT in acute viral hepatitis?

Answer 10

2500-5000

Question 11

Which liver enzymes are released with biliary disease?

Answer 11

GGT

ALP

Question 12

What liver enzyme profile do a intrahepatic obstruction produce?

Answer 12

Mildly elevated GGT and ALP

Question 12

What is the most common cause of liver enzyme elevation in Australia?

Answer 12

Obesity

Question 13

What is the liver GGT involved in?

Answer 13

Production of glutathione

Question 15

Why are ALP and GGT released with biliary disease?

Answer 15

Bile salts that accumulate dissolve cell membranes

Question 17

What other viruses can cause hepatitis?

Answer 17

Q fever

Rubella

CMV

EBV

Question 19

Which enzyme does the liver possess two of?

Answer 19

AST

Question 20

Why does alcohol upregulate GGT?

Answer 20

Alcohol depletes the amount of NAD > glutathione is required > GGT is upregulated for glutathione producton

Question 22

What does elevated ALT and AST mean when AST is higher?

Answer 22

Acute injury affecting mitochondria - eg acute viral or alcohol

Question 23

Why isn’t fructose converted into glucose most of the time?

Answer 23

Because it is consumed with glucose therefore no more glucose is required

Question 24

What are ALT levels in chronic hep B and C

Answer 24

50-250

Question 25

Which liver enzymes are elevated with alcohol/drug induction?

Answer 25

ALP and GGT

Question 26

Which organs can fructose enter?

Answer 26

Liver only

Question 28

Do liver cells have more AST or ALT?

Answer 28

AST because it’s in the cytoplasm and mitochondria

Question 29

How high is ALT for hepatitis symptoms to appear?

Answer 29

500-1000

Question 30

What is the relationship between alcohol and GGT levels?

Answer 30

There isn’t one

Question 31

Which is more specific for the liver ALT or AST?

Answer 31

AL(liver)T