61 Liver and pancreatic disease Flashcards Preview

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Flashcards in 61 Liver and pancreatic disease Deck (19)
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1
Q

Which LFT is the only true test of function (as opposed to damage)?

A

Albumin.

2
Q

Is ALT or AST more specific to the liver?

Why?

A

ALT more specific.

AST also found in muscle and red blood cells.

3
Q

What is the tumour marker for primary hepatocellular carcinoma?

A

α-fetoprotein.

4
Q

Which LFT’s rise in biliary tract damage? (3)

A

Conjugated bilirubin.

ALP and γGT.

5
Q

Where is ALP synthesised? (4)

A

Liver.
Bone.
Intestine.
Placenta.

6
Q

What can ALP be raised by in the bile tract? (4)

A

Cholestasis (bile blockage)
Infiltrative diseases
Space-occupying lesions (tumours)
Cirrhosis

7
Q

What is γGT raised in? (8)

A
Structural liver damage.
Alcohol.
Enzyme inducers.
Fatty liver.
Heart failure.
Prostatic disease.
Pancreatic disease.
Kidney damage.
8
Q

What three biochemical markers of fibrosis make up the ELF score?

A

PIIINP.
TIMP-1.
Hyaluronic acid.

9
Q

What are the hepatic causes of a raised unconjugated bilirubin? (4)

A

Pre-microsomal.
Microsomal.
Inherited conjugation disorders: Gilberts, Crigler-Najjar.

10
Q

What are the hepatic causes of a raised conjugated bilirubin? (4)

A

Post-microsomal.
Intrahepatic obstruction.
Inherited excretion disorders: Dubin-Johnson, Rotor

11
Q

What do 90% of people with a raised AST/ALT and a normal ALP have?

A

Hepatitis.

12
Q

What do 90% of people with a normal AST/ALT and a raised ALP have?

A

Obstructive jaundice.

13
Q

What is characteristically raised in alcoholic liver disease? (2)

A

IgA.

γGT.

14
Q

What % of abnormal LFTs are caused by liver disease?

Other causes? (5)

A

1%

Alcohol, Gilberts, Obesity, Diabetes, Medication.

15
Q

Which enzyme is faulty in inherited disorders of bilirubin conjugation?

A

UDP glucuronyl transferase.

16
Q

Which molecule is unable to be excreted in inherited disorders of bilirubin excretion?

A

Bilirubin glucuronide.

17
Q

How does acute pancreatitis change biochemical features in the blood? (6)

A
Uraemia 
Hypoalbuminaemia
Hypocalcaemia
Hyperglycaemia
Metabolic acidosis
Abnormal LFTs
18
Q

How is acute pancreatitis biochemically diagnosed?

A

Amylase.

Lipase.

19
Q

How is pancreatic function assessed in chronic pancreatitis? (7)

A
Duodenum aspirates.
Secretin, CCK, Lundh Tests.
Elastase in stool.
Trypsinogen in blood (CF screen).
Pancreolauryl & NBT-PABA tests.

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