EXAM #1: LIVER ENZYMES Flashcards
(41 cards)
What is the common term to refer to a elevation in the liver transaminases, AST and ALT?
Transaminitis
Which of the transaminases is LESS specific?
AST
What is AST?
Aspartate Aminotransferase
What are the primary sources of AST?
Liver
Skeletal muscle
When is AST released?
Liver and skeletal muscle damage
What is ALT?
Alanine Aminotransferase
What is the primary source of ALT?
Liver
Elevated ALT indicates damage to what organ?
Liver
What is the ratio of AST and ALT in alcohol use?
2:1
What is an alternative etiology to AST and ALT elevations?
Rhabdomyolysis
How do you evaluate for Rhabdomyolysis?
Creatinine Kinase
What markers indicate cholestatic injury?
Alkaline Phosphatase
Bilirubin
When is there a build-up of direct bilirubin?
If biliary drainage is inadequate
When is there a build-up of Indirect bilirubin?
Liver failing to process as quickly as RBCs are lysing
What is the source of Total Bilirubin?
Breakdown of Hemoglobin
What are the major sources of Alkaline Phosphatase?
Liver
Bone
Placenta
What causes an elevation of Alkaline Phosphatase?
1) Stretch or inflammation of the biliary tree
2) Bone disease
3) 3rd trimester of pregnancy
What are two examples of classic diseases that will cause an increase in Alkaline Phosphatase related to bone abnormalities?
- Metastatic prostate cancer
- Paget Disease
What cardiac related disease can cause an increase in Alkaline Phosphatase?
CHF
How do you test for the specific etiology of an elevated ALP?
Gamma Glutamyl Transferase (GGT)
Is a GGT part of a normal CMP?
NO
What does an elevated GGT tell you?
GGT elevation indicates ALP is increased from liver disease
What does a GGT that is NOT elevated tell you?
ALP elevation is from bony etiology
What are three indications that liver synthetic function is normal?
Normal labs:
1) Bilirubin
2) Albumin
3) INR
