Investigation of the liver Flashcards Preview

Clinical Pathology > Investigation of the liver > Flashcards

Flashcards in Investigation of the liver Deck (15):
1

What is the function of the liver?
Carbohydrates
Proteins
Lipids
Excretion / detox
Miscellaneous

1) Carbohydrates:
-Glycogen storage / synthesis

2) Proteins:
-synthesis and metabolism
-clotting factors
-urea synthesis

3) Lipids
-Lipoprotein and cholesterol synthesis
-fatty acid metabolism
-BILE ACID SYNTHESIS / METAB

4) Excretion/ detoxification:
-DRUGS
-BILE ACID
-BILIRUBIN (unconjugated to conjugated)

5) Miscellaneous
-iron storage
-Vit A, D, E and B12 storage and metabolism

2

What are the common tests of liver function?

-Alkaline phosphatase
-ALT (alanine aminotransferase)
-Bilirubin
-Total protein
-GGT (gamma glutamyl transferase)

3

Prothrombin time is used as a measure of .....

Vitamin K metabolism

4

What markers are used for hepatocyte damage?

ALT and AST are found in cells and only released by cellular damage, so increased ALT (alanine) and aspartate (AST) indicate hepatocyte damage

5

Which is a more specific marker for the liver AST or ALT>

ALT is more specific than AST becuase AST is also found in muscle and RBCs.

6

How is biliary tract damage identified?

-Impaired excretory function (ie increased conjugated bilirubin)
-increased synthesis of enzymes by cells that line the bile canaliculi.
- elevated ALP (alkaline phosphatase)
-elevated gamma glutamyltransferase

7

What is the cause of increased alkaline phospatase?

- cholestasis
- cirrhosis

8

isolated ALP enzymes can be secreted from....?

Liver and bone

9

why is gamma glutamyltransferase elevated in biliary tract damage?

alcohol
fatty liver
structural damage

can also be raised in :
heart failure
prostatic disease
pancreatic cancer
kidney damage

10

what bilirubin level causes jaundice?

above 40umol/L

11

Gilberts and Crigler- Najjar are inherited diseases. what do they cause?

Causes jaundice by
decreasing activity of UDP glucuronyl transferase (the enzyme that conjugated bilirubin.

12

What is elevated AST / ALT and normal ALP indicative of in jaundice?

Hepatitis is the cause of jaundice.

13

What is normal AST/ALT and elevated ALP indicative of in jaundice

Obstruction is cause of jaundice

14

Dark urine and pale stools is a sign of?

Post hepatic obstruction causing jaundice

15

What are the systemic effects of liver disease?

1) jaundice
2) excess oestrogen
-gynaecomastia
-spider naevi
-liver palms
-testicular atrophy
3) brusiing
4) pigmentation
5) clubbing
6) oedema
7) ascities
6) encephalopathy
8) osteoporosis (Vit D activation limited)

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