EXAM #1: LIVER ENZYMES Flashcards Preview

Gastrointestinal System > EXAM #1: LIVER ENZYMES > Flashcards

Flashcards in EXAM #1: LIVER ENZYMES Deck (41):
1

What is the common term to refer to a elevation in the liver transaminases, AST and ALT?

Transaminitis

2

Which of the transaminases is LESS specific?

AST

3

What is AST?

Aspartate Aminotransferase

4

What are the primary sources of AST?

Liver
Skeletal muscle

5

When is AST released?

Liver and skeletal muscle damage

6

What is ALT?

Alanine Aminotransferase

7

What is the primary source of ALT?

Liver

8

Elevated ALT indicates damage to what organ?

Liver

9

What is the ratio of AST and ALT in alcohol use?

2:1

10

What is an alternative etiology to AST and ALT elevations?

Rhabdomyolysis

11

How do you evaluate for Rhabdomyolysis?

Creatinine Kinase

12

What markers indicate cholestatic injury?

Alkaline Phosphatase
Bilirubin

13

When is there a build-up of direct bilirubin?

If biliary drainage is inadequate

14

When is there a build-up of Indirect bilirubin?

Liver failing to process as quickly as RBCs are lysing

15

What is the source of Total Bilirubin?

Breakdown of Hemoglobin

16

What are the major sources of Alkaline Phosphatase?

Liver
Bone
Placenta

17

What causes an elevation of Alkaline Phosphatase?

1) Stretch or inflammation of the biliary tree
2) Bone disease
3) 3rd trimester of pregnancy

18

What are two examples of classic diseases that will cause an increase in Alkaline Phosphatase related to bone abnormalities?

- Metastatic prostate cancer
- Paget Disease

19

What cardiac related disease can cause an increase in Alkaline Phosphatase?

CHF

20

How do you test for the specific etiology of an elevated ALP?

Gamma Glutamyl Transferase (GGT)

21

Is a GGT part of a normal CMP?

NO

22

What does an elevated GGT tell you?

GGT elevation indicates ALP is increased from liver disease

23

What does a GGT that is NOT elevated tell you?

ALP elevation is from bony etiology

24

What are three indications that liver synthetic function is normal?

Normal labs:
1) Bilirubin
2) Albumin
3) INR

25

What is Alcoholic Hepatitis?

Acute inflammation of the liver (due to alcohol consumption)

26

What lab test is associated with Alcoholic Hepatitis?

Extremely high bilirubin

27

What is the source of ammonia in the body?

Protein metabolism

28

What is ammonia converted to? Where?

Urea in the liver

29

What causes an elevated ammonia?

Severe liver disease

30

What is hyperammonia associated with?

Hepatic Encephalopathy

****This is a big predictor of mortality*****

31

What is ANA?

Antinuclear antibody

32

What is AMA?

Antimitochondrial antibody

33

What is ASMA?

Antismooth muscle antibody

34

What is LKM?

Anti liver-kidney microsomal antibody

35

What are the two major labs associated with Primary Biliary Cirrhosis?

1) Disproprotionate increase in alkaline phosphatase (APL)
1) Positive AMA (antimitochondiral antibody)

36

What patient population in Primary Biliary Cirrhosis associated with?

Middle aged females

37

What is Primary Sclerosing Cholangitis?

Inflammation and obliterative fibrosis of the bile ducts

38

What is Primary Sclerosing Cholangitis associated with?

Ulcerative Colitis

39

What are the red flags for Primary Sclerosing Cholangitis?

1) Disproportionate increase in APL
2) "Beads on a string" in bile ducts
3) Onion skinning of bile ducts on biopsy

40

What antibodies are associated with Autoimmune Hepatitis?

ANA
ASMA

41

What age groups is Autoimmune Hepatitis seen in?

Young females