61 Liver and pancreatic disease Flashcards Preview

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

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

Albumin.

2

Is ALT or AST more specific to the liver?
Why?

ALT more specific.
AST also found in muscle and red blood cells.

3

What is the tumour marker for primary hepatocellular carcinoma?

α-fetoprotein.

4

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

Conjugated bilirubin.
ALP and γGT.

5

Where is ALP synthesised? (4)

Liver.
Bone.
Intestine.
Placenta.

6

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

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

7

What is γGT raised in? (8)

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

8

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

PIIINP.
TIMP-1.
Hyaluronic acid.

9

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

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

10

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

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

11

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

Hepatitis.

12

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

Obstructive jaundice.

13

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

IgA.
γGT.

14

What % of abnormal LFTs are caused by liver disease?
Other causes? (5)

1%
Alcohol, Gilberts, Obesity, Diabetes, Medication.

15

Which enzyme is faulty in inherited disorders of bilirubin conjugation?

UDP glucuronyl transferase.

16

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

Bilirubin glucuronide.

17

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

Uraemia
Hypoalbuminaemia
Hypocalcaemia
Hyperglycaemia
Metabolic acidosis
Abnormal LFTs

18

How is acute pancreatitis biochemically diagnosed?

Amylase.
Lipase.

19

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

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

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