Exam1- LFTs Flashcards Preview

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Flashcards in Exam1- LFTs Deck (29)
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1
Q

portal triad?

A

common bile duct
hepatic artery
portal vein

2
Q

liver

  • makes the protein ? and most ?
  • metabolizes?
  • converts nitrogenous waste to?
  • stores?
  • breaks down?
A
albumin, clotting factors
bile
urea
glucose as glycogen
hormones (chronic liver failure- gynecomastia)
3
Q

factor ? made by liver- acute changes in liver can result in increased ? time

A

VII, prothrombin

4
Q

loss of albumin, protein urea seen in ?

A

nephrotic syndrome

5
Q

LFTs

  • specific to liver
  • nonspecific
  • most sensitive for liver injury
  • demonstrates bile flow/obstruction
A

ALT
AST
GGT
ALP

6
Q

LFT findings in liver dz

A

increased ALP & GGT

7
Q

only increased ALP suggests?

A

no pathology or bone dz

8
Q

need liver fxn panel to obtain ?

A

direct bilirubin

9
Q

can also cause hepatitis? 2 viruses

A

EBV

CMV

10
Q

fatty livers changes in alcoholic hep can be ?

A

reversible

11
Q
alcoholic hepatitis
ast & alt:
ast/alt
alp: 
*ALCOHOL INHIBITS ALT!!!!
A
^ 1-10x
>/= 2
no change
*+/- increased PT
*increased bilirubin
*can also be aSx
12
Q

MCC of chronic liver dz & most frequent indicator for liver transplantation

A

chronic HCV

13
Q
drug-induced hep:
tb drug?
other anti-tb/ab
NSAIDs
statins
anti-epileptic?
htn drug?
MOST COMMON-OVERDOSE?
herbs?
cocaine, ecstasy, PCP
A
isoniazid
valproic acid
methyldopa
ACETAMINOPHEN
mistletoe, alkaloids Ma-Huang, hydroxycut
14
Q

autoimmune hep- dx?

A

dx of exclusion

15
Q

fulminant hepatitis
ast & alt:
ast/alt:
increased ? because liver can’t make proteins

A

^100x

18s

16
Q

hepatic encephalopathy associated w/ ? hepatitis & ?; increased ? levels
mood, neuro Sx

A

fulminant, cirrhosis

ammonia

17
Q
causes of fulminant hepatitis:
? overdose/kids
viral hep- hep ?
shock- cardiogenesis, sepsis
antiseizure Rx i.e. ? 
herbs
metabolic i.e. Wilson's dz, Reye's syndrome
autoimmune
anamita phalloides (poison mushroom)
A

acetaminophen
hep B
valproate, phenytoin

18
Q

jaundice seen when serum bilirubin?

A

> 2.5mg/dL

19
Q
unconjugated hyperbilirubinemia 
(too much bilirubin):
hemolytic anemia- ? dz
hemolytic- ? rxn
resorption of major ?
A

sickle cell
transfusion
hemorrhage

20
Q

unconjugated hyperbilirubinemia
(too little conjugation):
-? syndrome- no conjugation enzyme; induced by stress
-dz that can’t metabolize bilirubin? less common,, more severe, auto-recessive
-drugs that stop bilirubin uptake into liver? (2)

A

Gilbert’s syndrome
Crigler-Najjar
probenacid, rifampin

21
Q

conjugated hyperbilirubinemia

  • greater than ? of total bilirubin
  • dipstick + b/c only conjugated passes thru bc?
  • huge increase in ? & ?; mild increase in ?
  • Dubin Johnson syndrome, Rotor syndrome
  • causes include viral hep, EtOH, drugs, toxins, AI, severe hypotension
A

30%
unconjugated binds to albumin and doesn’t pass
AST, ALT; ALP

22
Q

MCC of acute hep?

A

viral hep

23
Q

viral hepatitis:
ast & alt:
ast/alt

A

^ 10-100x
<1
PT variable**

24
Q
cirrhosis causes:
EtOH
viral - Hep ? & ?
biliary dz
hemachromatosis
uncommon- Wilson's, alpha 1 antitrypsin def
A

Hep B/C

25
Q

caput medusa seen in ?

A

portal htn (cirrhosis)

26
Q

ascites = ? excess fluid in abdomen

may also have bacterial ?

A

500+ mL

peritonitis

27
Q

cirrhosis:

  • decreased platelets- sequestered in ?
  • increased bleeding- can’t make ?
A
spleen
clotting factors (also decreased vit K)
28
Q

cirrhosis

-spider angiomata, gynecomastia, & testicular atrophy from ?

A

impaired estrogen metabolism

29
Q

mild elevation of ALP (only finding)

order ?

A

anti-mitochondrial antibody (AMA), primary biliary cirrhosis