Liver Enzymes Flashcards Preview

Hugh's MD1 Abdominal > Liver Enzymes > Flashcards

Flashcards in Liver Enzymes Deck (31):
1

As a rule of thumb, ALT over 10,000 means what?

DEATH

1

What level is ALT in a severe hepatitis?

5000

2

According to the newer model of cell injury, what is the cell's response to mild injury?

Bleb formation - blistering off of the cell membrane releasing packets of cytoplasm into the blood stream

3

Which liver enzymes are cytoplasmic?

ALT - alanine transanimase

AST - asparate transanimase

LD - lactate dehydrogenase

3

What does elevated ALT and AST mean when ALT is higher?

Chronic/resolving liver injury

eg chronic viral, 

4

What is the function of AST?

Shift malate in and out of the mitochondria

5

What is one of the most important events in the lead up to cell death?

Destruction of cell cytoskeleton

5

Which liver enzyme is most correlated with BMI?

ALT

6

Which liver enzymes are located on the membrane?

ALP

GGT

(one the biliary membrane in particularly)

7

How high do you expect GGT and ALP when there is an extrahepatic obstruction?

10x normal

7

Which results in LFTs truely reflect the liver's function?

Albumin

Bilirubin

8

Which has the shorter half life, ALT or AST?

AST

9

Which enzymes are released in liver cell necrosis?

AST, ALT and LD

10

What are ALT in acute viral hepatitis?

2500-5000

11

Which liver enzymes are released with biliary disease?

GGT 

ALP

12

What liver enzyme profile do a intrahepatic obstruction produce?

Mildly elevated GGT and ALP

12

What is the most common cause of liver enzyme elevation in Australia?

Obesity

13

What is the liver GGT involved in?

Production of glutathione

15

Why are ALP and GGT released with biliary disease?

Bile salts that accumulate dissolve cell membranes

17

What other viruses can cause hepatitis?

Q fever

Rubella

CMV

EBV

19

Which enzyme does the liver possess two of?

AST

20

Why does alcohol upregulate GGT?

Alcohol depletes the amount of NAD > glutathione is required > GGT is upregulated for glutathione producton

22

What does elevated ALT and AST mean when AST is higher?

Acute injury affecting mitochondria - eg acute viral or alcohol

23

Why isn't fructose converted into glucose most of the time?

Because it is consumed with glucose therefore no more glucose is required

24

What are ALT levels in chronic hep B and C

50-250

25

Which liver enzymes are elevated with alcohol/drug induction?

ALP and GGT

26

Which organs can fructose enter?

Liver only

28

Do liver cells have more AST or ALT?

AST because it's in the cytoplasm and mitochondria

29

How high is ALT for hepatitis symptoms to appear?

500-1000

30

What is the relationship between alcohol and GGT levels?

There isn't one

31

Which is more specific for the liver ALT or AST?

AL(liver)T