Abnormal LFTs Flashcards

(35 cards)

1
Q

what determines the size of the liver

A

metabolic requirements

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2
Q

what is ‘splanchinic steal’

A

when the body tries to increase blood supply to the liver which results in low BP in the rest of the body and eventually reduces blood supply everywhere else

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3
Q

which clotting factor is not made in the liver

A

factor 8

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4
Q

lack of what clotting factor causes haemophilia and how much needs to be lost to cause disease

A

factor 8
95%

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5
Q

can you have normal LFTs in liver cirrhosis

A

yes

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6
Q

what is found in liver sinusoids

A

mixed arterial and portal blood

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7
Q

what needs to and doesn’t need to be considered in liver transplants

A

needs to match blood group
don’t need to consider HLA antigens - hepatocytes don’t have any

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8
Q

why is some urobilinogen reabsorbed in the gut

A

due to microbes

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9
Q

what is Gilberts syndrome

A

an isolated rise in bilirubin with no adverse consequences

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10
Q

an isolated rise in bilirubin could be gilberts or

A

haemolysis

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11
Q

at what bilirubin level will you start to jaundice

A

> 50

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12
Q

at what bilirubin level will you have obvious jaundice

A

> 100

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13
Q

where does conjugated bilirubin become urobilinogen

A

in the intestine

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14
Q

is ALT and AST more liver specific

A

ALT

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15
Q

what are ALT and AST

A

enzymes

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16
Q

how do ALT and AST change in advanced NAFLD

A

AST increases relative to ALT

17
Q

when do AST and ALT increase

A

when hepatocytes die and leak them into the blood

18
Q

average ALT or AST in NAFLD

19
Q

what would ALT or AST be if all hepatocytes die and give example of when this could occur

A

10,000
paracetamol overdose

20
Q

what do increased alkaline phosphatase levels indicate

A

there’s something wrong with your bile ducts

21
Q

what do you need to check in addition to alkaline phosphatase when you suspect a problem with the bile ducts

22
Q

is gamma GTP liver specific

23
Q

does a sole rise in GGTP without other LFT abnormalities likely indicate early or late stage disease

24
Q

what is the most abundant protein in the body

25
what type of substances does albumin carry and give an example
water soluble substances including unconjugated bilirubin
26
what is albumin levels in dehydration
high
27
why might albumin levels be low
due to dilution (e.g. increased body volume in pregnancy or oedema) due to reduced synthesis
28
what are albumin levels like in cirrhosis
often normal until liver is failing
29
what type of liver disease is prothrombin time good for
acute liver failure
30
why is prothrombin time rarely very abnormal in cirrhosis
because there is enough reserve in the liver
31
possible cause of increased prothrombin time
paracetamol poisoning
32
what is NASH
non alcoholic steroid hepatitis
33
caeruloplasmin tests for
wilsons disease
34
what investigations are usually triggered after abnormal LFTs
a 'liver screen' hepatitis viruses autoantibodies (ANA, AMA and antiSMAb) ferritin caeruloplasmin alpha-1-antitrypsin immunoglobulins ultrasound scan referral
35
what is ferratin a marker for
haemachromotosis