liver and kidney function tests

Question 1

What binds to bilirubin to allow it to be transported?

Answer 1

Albumin

Question 2

What abnormality does serum aminotransferase tests (AST, ALT) test for?

Answer 2

Hepatocyte injury

Question 3

What abnormality does serum bilirubin test for?

Answer 3

Assess conjugation and to detect biliary obstruction

Question 4

What abnormality does ALP, GGT test for?

Answer 4

Biliary epithelial damage and biliary obstruction

Question 5

What abnormality does serum albumin test for?

Answer 5

Synthetic function (low levels indicate chronic liver disease)

Question 6

What are the causes of abnormal AST, ALT test results?

Answer 6

Infection (Hep A/B/C), autoimmune hep, toxins (alcoholic liver damage), hepatic inflammation (isolated increased AST/ALT)

Question 7

True or false: most of bilirubin in blood in health is conjugated

Answer 7

False, most is unconjugated

Question 8

Does excess conjugated bilirubin appear in urine?

Answer 8

Yes, can be excreted in urine (dark urine)

Question 9

Does excess unconjugated bilirubin appear in urine?

Answer 9

No, example is haemolytic anaemia

Question 10

What causes increased levels of ALP and GGT?

Answer 10

Bile duct obstructions, and/or bile duct epithelial cells, alcohol consumption

Question 11

What patterns of LFT is severely increased ALT/AST and mildly increased ALP?

Answer 11

Hepatic due to damage to liver cells

Question 12

What pattern of LFT is increased bilirubin, ALP, GGT, and mild/or no increased in ALT/AST?

Answer 12

Cholestatic due to problem with bile rather than intrinsic liver disease

Question 13

What causes increased unconjugated bilirubin?

Answer 13

Overproduction/impaired uptake of bilirubin by liver or abnormal bilirubin conjugation

Question 14

What causes increased unconjugated and conjugated bilirubin?

Answer 14

Hepatocellular diseases and biliary obstruction

Question 15

What causes pre-hepatic increased unconjugated bilirubin?

Answer 15

Haemolytic anaemia (Sickle cell)
Malaria
TFR

Question 16

What causes hepatic increased unconjugated and conjugated bilirubin?

Answer 16

Gilbert’s syndrome
Hepatocellular damage caused by infective agents
Toxins
Drugs

Question 17

What causes cholestatic increased conjugated bilirubin and bilirubinuria?

Answer 17

Intra-hepatic cancers, biliary cirrhosis, drugs
Extra-hepatic biliary tree obstructions (gallstones), tumours

Question 18

What likely test result is present in Gilbert’s syndrome?

Answer 18

Increased unconjugated bilirubin

Question 19

What likely test results is present in acute hepatitis?

Answer 19

Increased ALT/AST, and increased conjugated bilirubin

Question 20

What likely test results is present in chronic hepatitis?

Answer 20

Isolated elevated AST/ALT

Question 21

What likely test results are present in Cholestatic liver disease?

Answer 21

Increased ALP/GGT, increased conjugated bilirubin, mildly increased AST/ALT

Question 22

What likely test results are present in cirrhosis of liver?

Answer 22

Decreased albumin, maybe increased ALP, mildly increased AST/ALT, increased GGT (alcoholism)

Question 23

What causes hyponatraemia?

Answer 23

Fluid retention, sodium loss

Question 24

What causes hypernatraemia?

Answer 24

Normal sodium content, decreased H2O
Dehydration (decreased sodium and H2O)
Increased sodium content, normal H2O

Question 25

What causes hyperkalaemia?

Answer 25

Decreased excretion= renal failure, hypoaldosteronism Increased intake= drugs Redistribution= trauma, damaged cells, haemolysis

Question 26

What causes hypokalaemia?

Answer 26

Reduced intake= severe calories deficit Redistribution= insulin treatment, b-agonism (asthma drugs) Increased loss= GI, urinary issues

Question 27

What causes proteinuria (albuminuria)?

Answer 27

renal function excretion, excess loss of protein in urine