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Clin Med Lab Med > Exam #1: Liver Function/Hepatic Serology > Flashcards

Exam #1: Liver Function/Hepatic Serology Flashcards

(73 cards)

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1
Q

What two tests are used to determine liver disease specifically from other pathology?

A
  • GGT

- 5NP

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2
Q

Under what two scenarios would GGT be useful?

A
  • ALP elevated (liver specific)

- AST/ALT >2 = ALD

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3
Q

If direct bili is elevated, indirect bili is normal and AST/ALT is elevated, what does this indicate?

A

Liver disease

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4
Q

If direct bili is normal, indirect bili is elevated and and AST/ALT is normal + ANEMIA, what does this indicate?

A

Hemolysis (Hemolytic Anemia)

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5
Q

If direct bili is normal, indirect bili is elevated and AST/ALT is normal WITHOUT Anemia, what does this indicate?

A

Gilbert’s Syndrome

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6
Q

If ONLY Bili is elevated, what other source should you consider?

A

RBCs

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7
Q

If ONLY AST is elevated, what other sources should you consider (4)?

A

Skeletal muscle, cardiac muscle, kidney, brain

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8
Q

If ONLY ALT is elevated, what other sources should you consider (3)?

A

Skeletal muscle, cardiac muscle, kidney

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9
Q

If ONLY ALP is elevated, what other source should you consider?

A

Bone

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10
Q

What two medication groups are often associated with risk factor of liver disease and AST/ALT elevation?

A
  • HTN

- Other chronic disease meds

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11
Q

What two medication groups are often associated with risk factor of liver disease and ALP elevation?

A
  • Abx

- Steroids

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12
Q

If ALT is VERY elevated, what two causes should you consider?

A
  • Liver ischemia

- Liver toxicity

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13
Q

If AST/ALT is >2, what disease should be considered?

A

ALD (Alcoholic Liver Disease)

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14
Q

If AST/ALT is >1, what disease should be considered?

A

Cirrhosis

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15
Q

If AST/ALT is <1 but still elevated, what two diseases should be considered?

A
  • Fatty liver

- Viral etiology

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16
Q

What risk factor of NAFLD is a strong predictor of NASH?

A

Metabolic Syndrome

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17
Q

What is Non-Alcoholic Steatohepatitis (NASH), and what does it create an increased risk for?

A

Fatty liver + inflammation

- High risk for significant fibrosis (scarring)

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18
Q

What is Hereditary Hemochromatosis and what two conditions can it lead to?

What other condition are you at increased risk for?

A

Hereditary disorder of iron metabolism (high iron absorption = too much iron)

  • Can progress to fibrosis or cirrhosis
  • Increased risk for Hepatocellular Carcinoma (HCC)
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19
Q

What two diagnostic tests should be ordered to screen for Hepatocellular Carcinoma (HCC)?

A
  • AFP

- Liver US

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20
Q

To diagnose Hereditary Hemochromatosis, what two labs should be ordered/screened for?

A
  • Transferrin saturation

- Ferritin

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21
Q

What genotype test should be ordered to test for Hereditary Hemochromatosis?

A

HFE genotype

NOTE: should also screen all 1st degree relatives for HFE genotype/iron testing

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22
Q

Which two autoimmune liver diseases are more common in women?

A
  • Primary Biliary Cholangitis (PBC)

- Autoimmune Hepatitis (AIH)

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23
Q

Which autoimmune liver disease is more common in men?

A

Primary Sclerosing Cholangitis (PSC)

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24
Q

What test will be positive if Primary Biliary Cholangitis (PBC) is present? Is this more common in men or women?

A

AMA will be positive (also elevated AST/ALT

- PBC is more common in women

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25
What condition is strongly associated with Primary Sclerosing Cholangitis (PSC)?
IBD (Inflammatory Bowel Disease) - UC and Crohn's
26
If you are concerned about Autoimmune Hepatitis, what four tests should you order?
- ANA - ASMA - LKMA-1 - LC-1
27
What condition can Alpha-1 Antitrypsin Deficiency cause in adults?
Early onset emphysema
28
To diagnose Alpha-1 Antitrypsin Deficiency, what two labs should be ordered?
- Serum alpha-1 antitrypsin (LOW) | - Alpha-1 antitrypsin phenotype
29
What condition involves neurologic/psychiatric problems (ages 5-35 most common) – tremor, dysarthria, muscle spasticity or rigidity, personality/behavior changes?
Wilson's Disease
30
What disease are Kayser-Fleisher rings in cornea associated with?
Wilson's Disease
31
What condition do these labs indicate is present? - Elevated AST/ALT - Low ALP - Low serum ceruloplasmin - 24-hour urinary copper test
Wilson's Disease
32
What condition involves testing with serum ceruloplasmin?
Wilson's Disease
33
What condition involves testing with 24-hour urinary copper test?
Wilson's Disease
34
Can Hep A be chronic?
NEVER
35
What does a positive Anti-HAV IgM indicate?
Acute Hep A
36
Is it more common for Hep B or Hep C to progress to chronic?
``` Hep C (75-85% of time) - Hep B only 5% of time ```
37
If HbsAg is positive, what does this indicate?
Active Hepatitis B | - Acute OR chronic
38
If IgM anti-HBc is positive, what does this indicate?
Acute Hepatitis B | - Negative would mean chronic
39
If anti-HBs is present, what does this indicate?
Immunity for Hepatitis B
40
If IgG anti-HBc or Total anti-HBc are positive, what does this indicate?
Previous exposure to Hepatitis B
41
If HCV RNA is present, what does this indicate?
Hepatitis C (current?)
42
Which type of Hepatitis involves fecal-oral spread; common in homeless population?
Hepatitis A
43
Which type of Hepatitis involves spread by sexual contact, parenteral/percutaneous, person-to-person, perinatal from mother?
Hepatitis B
44
Which type of Hepatitis involves born 1945-1965, transfusion before 1992, tattoos/piercing, intra-nasal drug use, incarceration, high-risk sex, HIV?
Hepatitis C
45
What three co-existing diseases are associated with Hereditary Hemochromatosis?
- Impotence - DM - Arthralgia
46
What four co-existing diseases are associated with NASH?
- DM - Hyperlipidemia - Obesity - HTN
47
Is NAFLD associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
48
Is chronic viral Hepatitis associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
49
Is Hereditary Hemochromatosis associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
50
Is ALD associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
51
Is medication toxicity associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
52
Is Wilson's Disease associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
53
Is Alpha-1 Antitrypsin Deficiency associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
54
Is autoimmune hepatitis associated more with an elevated AST/ALT or an elevated ALP?
Elevated AST/ALT
55
Is PBC associated more with an elevated AST/ALT or an elevated ALP?
Elevated ALP
56
Is PSC associated more with an elevated AST/ALT or an elevated ALP?
Elevated ALP
57
Is neoplasm associated more with an elevated AST/ALT or an elevated ALP?
Elevated ALP
58
Is drug hepatotoxicity associated more with an elevated AST/ALT or an elevated ALP?
Elevated ALP
59
Is autoimmune cholangiopathy associated more with an elevated AST/ALT or an elevated ALP?
Elevated ALP
60
Is sarcoidosis associated more with an elevated AST/ALT or an elevated ALP?
Elevated ALP
61
Is biliary atresia associated more with an elevated AST/ALT or an elevated ALP?
Elevated ALP
62
Is Epstein Barr Virus associated with acute or chronic hepatitis?
ACUTE Hepatitis
63
Is Cytomegalovirus associated with acute or chronic hepatitis?
ACUTE Hepatitis
64
Which two conditions are seen with both acute AND chronic hepatitis?
- Wilson's Disease | - DILI (drug-induced liver disease)
65
Is Celiac disease associated with acute or chronic hepatitis?
CHRONIC Hepatitis
66
Is fatty liver associated with acute or chronic hepatitis?
CHRONIC Hepatitis
67
Is Celiac disease associated with acute or chronic hepatitis?
CHRONIC Hepatitis
68
Is Hereditary Hemochromatosis associated with acute or chronic hepatitis?
CHRONIC Hepatitis
69
Is Alpha-1 Antitrypsin Deficiency associated with acute or chronic hepatitis?
CHRONIC Hepatitis
70
What are three potential causes of Shock Liver?
- Cardiac failure - Respiratory failure - Septic shock
71
What three diagnostic findings/conditions may present with Liver Cirrhosis/End-Stage Liver Disease?
- Anemia - Thrombocytopenia - Elevated PT/INR
72
What is the hallmark ALT level associated with ACUTE Hep B infection?
1000-2000
73
In what age group is CHRONIC Hep B most often seen?
Newborns/children

Clin Med Lab Med (13 decks)

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