Exam1- LFTs

Question 1

portal triad?

Answer 1

common bile duct
hepatic artery
portal vein

Question 2

liver

• makes the protein ? and most ?
• metabolizes?
• converts nitrogenous waste to?
• stores?
• breaks down?

Answer 2

albumin, clotting factors
bile
urea
glucose as glycogen
hormones (chronic liver failure- gynecomastia)

Question 3

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

Answer 3

VII, prothrombin

Question 4

loss of albumin, protein urea seen in ?

Answer 4

nephrotic syndrome

Question 5

LFTs

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

Answer 5

ALT
AST
GGT
ALP

Question 6

LFT findings in liver dz

Answer 6

increased ALP & GGT

Question 7

only increased ALP suggests?

Answer 7

no pathology or bone dz

Question 8

need liver fxn panel to obtain ?

Answer 8

direct bilirubin

Question 9

can also cause hepatitis? 2 viruses

Answer 9

EBV

CMV

Question 10

fatty livers changes in alcoholic hep can be ?

Answer 10

reversible

Question 11

alcoholic hepatitis
ast & alt:
ast/alt
alp: 
*ALCOHOL INHIBITS ALT!!!!

Answer 11

^ 1-10x
>/= 2
no change
*+/- increased PT
*increased bilirubin
*can also be aSx

Question 12

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

Answer 12

chronic HCV

Question 13

drug-induced hep:
tb drug?
other anti-tb/ab
NSAIDs
statins
anti-epileptic?
htn drug?
MOST COMMON-OVERDOSE?
herbs?
cocaine, ecstasy, PCP

Answer 13

isoniazid
valproic acid
methyldopa
ACETAMINOPHEN
mistletoe, alkaloids Ma-Huang, hydroxycut

Question 14

autoimmune hep- dx?

Answer 14

dx of exclusion

Question 15

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

Answer 15

^100x

18s

Question 16

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

Answer 16

fulminant, cirrhosis

ammonia

Question 17

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)

Answer 17

acetaminophen
hep B
valproate, phenytoin

Question 18

jaundice seen when serum bilirubin?

Answer 18

> 2.5mg/dL

Question 19

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

Answer 19

sickle cell
transfusion
hemorrhage

Question 20

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)

Answer 20

Gilbert’s syndrome
Crigler-Najjar
probenacid, rifampin

Question 21

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

Answer 21

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

Question 22

MCC of acute hep?

Answer 22

viral hep

Question 23

viral hepatitis:
ast & alt:
ast/alt

Answer 23

^ 10-100x
<1
PT variable**

Question 24

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

Answer 24

Hep B/C

Question 25

caput medusa seen in ?

Answer 25

portal htn (cirrhosis)

Question 26

ascites = ? excess fluid in abdomen

may also have bacterial ?

Answer 26

500+ mL

peritonitis

Question 27

cirrhosis:

• decreased platelets- sequestered in ?
• increased bleeding- can’t make ?

Answer 27

spleen
clotting factors (also decreased vit K)

Question 28

cirrhosis

-spider angiomata, gynecomastia, & testicular atrophy from ?

Answer 28

impaired estrogen metabolism

Question 29

mild elevation of ALP (only finding)

order ?

Answer 29

anti-mitochondrial antibody (AMA), primary biliary cirrhosis