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Lab Diagnosis 2 > Hepatobiliary, Gallbladder, Pancreas (Exam 1) > Flashcards

Hepatobiliary, Gallbladder, Pancreas (Exam 1) Flashcards

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1
Q

Transaminases like AST and ALT measure what?

A

hepatocyte injury and integrity (are hepatocytes intact?)

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2
Q

What does AST stand for?

A

aspartate aminotransferase

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3
Q

Where is AST found in high concentrations?

A

tissues with high metabolic activity like heart, liver, and skeletal muscle

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4
Q

The amount of AST in blood is directly proportional to ….

A

the number of cells lysed from disease or injury

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5
Q

Most elevations of AST is caused by what type of organ damage?

A

liver

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6
Q

Besides liver damage what are the other elevated causes for AST?

A

reyes syndrome and MI

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7
Q

What does ALT stand for?

A

alanine aminotransferase

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8
Q

Where is ALT found?

A

liver

SPECIFIC for liver!!!

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9
Q

What enzyme is used predominantly to detect liver disease and monitor source of treatment?

A

ALT

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10
Q

What enzyme differentiates between hemolytic jaundice and hepatic jaundice?

A

ALT

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11
Q

What causes increases in ALT?

A

1) liver diseases
2) reye’s syndrome
3) MI

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12
Q

What does GGT or GGTP stand for?

A

gamma glutamyl transpeptide

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13
Q

Where is GGT/GGTP found?

A

liver, kidneys, pancreas

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14
Q

What enzyme is this?
-used to determine liver cell injury and to detect alcohol induced liver disease
-very sensitive to the amount of alcohol consumed by chronic drinkers
-can be used to monitor cessation of reduction of alcohol

A

GGT/ GGTP

memory cue: “gin and tonic” is alcoholic= GGT

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15
Q

What causes increased GGT/ GGTP?

A

-chronic alcohol abuse**
-obstructive jaundice
-intrahepatic cholestasis

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16
Q

Where in the cell is ALP found?

A

plasma membrane

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17
Q

Why does ALP rise in bone disease?

A

bc of osteoblastic activity

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18
Q

Why does ALP rise in hepatobiliary disease?

A

bc of loss of integrity in plasma membrane

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19
Q

Any new bone growth is associated with elevated?

A

ALP

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20
Q

Young children with rapid bone growth have increased ?

A

ALP

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21
Q

What is the best diagnostic test for cholestatic liver disease?

A

ALP

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22
Q

What enzyme is this?
-intracellular enzyme found in kidney, heart, skeletal muscle, brain, liver, and lungs
-not specific
-general indication of tissue damage
-used to support diagnoses of injury or disease of liver, heart, RBCs, kidneys, brain, skeletal muscle, lungs

A

lactate dehydrogenase (LD)

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23
Q

Normally the level of LD2 is ___________ than LD1

A

greater

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24
Q

A flipped patten of LD is when LD1 conc. is ______________ than LD2 and indicates MI

A

greater

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25
Albumin is a measure of what?
hepatic synthetic function
26
Albumin is a major protein in the blood that is synthesized by?
liver
27
What is the primary function of albumin?
maintenance of colloidal pressure in the vascular and extravascular spaces (fluid balance)
28
What is the most abundant protein in blood?
albumin
29
Albumin is a negative acute phase reactant. What does this mean?
it decreases in response to inflammatory processes
30
___________________ is an independent risk factor for older adults for mortality
Hypoalbuminemia
31
Decreased albumin in blood= increased ?
albumin in urine and edema (indicator for liver disease)
32
What is the half-life of albumin?
12-18 days so severe impairment may not be recognized until much later
33
What is the most common cause of hyperalbuminemia?
dehydration
34
What are the causes of hypoalbuminemia?
1) malnutrition 2) liver disease 3) acute or chromic inflammatory responses
35
What is bilirubin?
hemoglobin/RBC/ heme breakdown
36
A rise of bilirubin occurs when there is....
1) excessive destruction of RBCS 2) liver is unable to excrete normal amounts of bilirubin produced 3) blockage in biliary system
37
What is total bilirubin?
sum of unconjugated and conjugated bilirubin
38
What is another name for unconjugated bilirubin?
indirect
39
What is another name for conjugated bilirubin?
direct
40
Is it normal to have a higher unconjugated bilirubin or conjugated bilirubin in total bilirubin?
unconjugated
41
Unconjuagted bilirubin circulates freely, binds to albumin until it reaches the liver where it conjugates with?
glucoronic acid and then it is excreted into bile
42
Bile is converted to urobilinogen in the intestines by what?
bacterial proteases
43
What are the lab findings for prehepatic/hemolytic jaundice?
-increased unconjugated bilirubin in blood -increased urobilinogen in urine
44
What are the lab findings for hepatic jaundice (ex: from hepatocellular disorders like hepatitis, cirrhosis, infectious mononucleosis, liver cancer, neonatal jaundice, gilbert's disease)?
-increased conjugated bilirubin in blood -increased unconjugated bilirubin in blood -increased, decreased, or normal urobilinogen in urine -bilirubinuria
45
Neonatal jaundice is what type of jaundice?
hepatic
46
What are the lab findings for post hepatic jaundice/ obstructive jaundice?
-increased conjugated bilirubin in blood -bilirubinuria -pale stool
47
Is ammonia toxic to the body?
YES its alters acid base balance and brain function
48
ammonia is the end product of what?
protein catabolism
49
In normal cases, how is ammonia removed from the body?
converted to urea and excreted out
50
Ammonia cannot be catabolized to urea with severe hepatocellular dysfunction which results in a buildup where?
the blood
51
What causes increased ammonia levels?
-reye's syndrome -liver disease, hepatic encephalopathy, hepatic coma -cirrhosis -portal HTN
52
What does AFP stand for?
alpha fetoprotein
53
AFP is an oncofetal protein that is normally produced by?
fetal liver and yolk sac (only present during fetal development or in times of cancer)
54
What is the main fetal protein in the 1st trimester of fetal development?
AFP
55
Which cancer would show AFP as a marker?
hepatocellular carcinoma (can also be used for ovarian or testicular cancers)
56
Abnormally high levels of AFP during pregnancy can indicate what?
neural tube defects or abdominal wall defects OR 2+ babies in womb
57
What does AAT stand for?
alpha 1 antitrypsin
58
Where is AAT produced?
liver
59
What is AAT?
protease/ enzyme inhibitor
60
Deficiency in AAT can lead to?
lung diseases like emphysema and liver diseases like cirrhosis
61
AAT is a _________ acute phase reactant protein
positive (increases with inflammation)
62
What is the most common cause of hepatitis?
viruses
63
Which hepatitis is transmitted through fecal oral route?
hep A and E "vowels by bowels"
64
Which hepatitis is transmitted as a blood borne pathogen?
hep B and C (parenteral route)
65
Which hepatitis co-infects with hep B?
hep D
66
Which ab is present during acute phase of hep A?
IgM
67
Which ab is present during convalescent/chronic phase of hep A?
IgG
68
Which hepatitis has a lifelong immunity after infection?
hep A
69
Someone who has been exposed to hep A in the past and recovered or has been vaccinated and now has what Ab?
IgG
70
Which hepatitis is an oncovirus?
hep C and B
71
What is the most common cause of chronic viral hepatitis?
hep C
72
Which hepatitis is the most infectious?
hep B
73
What is unique about hep B structure and testing?
has 3 parts: 1) outer capsule/ surface 2) inner core 3) envelope there can be antigens and antibodies for each part
74
What antigen is used to make the hep B vaccine?
surface antigen/ HBsAg
75
What is the 1st indicator of hepatitis infection?
HBsAg, person is infectious/carrier
76
What antigen is active during hepatitis replication and early in the infection process?
HBeAg
77
Which antibody is the first to appear on onset of hep symptoms? hint: think specifics
HBcAb
78
Which Ab persists for life from hepatitis exposure?
HBcAb
79
Which Ab gives us immunity from vaccine or exposure to virus and provides us with lifelong immunity? hint: think specifics
HBsAb
80
Which Ab is present after acute phase and patient has low infectivity?
HBeAb
81
What is the only hep B antigen that cannot be detected in serum?
HBcAg

Lab Diagnosis 2 (6 decks)

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