Liver Function

Question 1

what is the other name for AST

Answer 1

serum glutamic oxalocetic transamniase

SGOT

Question 2

what is the other name for ALT

Answer 2

serum glutamic pyruvic transamniase

SGPT

Question 3

AST is found primarily where

Answer 3

liver 
heart 
kidney 
pancreas 
muscle

Question 4

AST is elevated when

Answer 4

significant tissue damage

Question 5

what is the normal value for AST

Answer 5

7-40

Question 6

which enzyme is found in liver, heart, kidney, pancreas, and muscle

Answer 6

AST

Question 7

ALT is elevated when

Answer 7

hepatocellular necrosis*
alcohol liver damage
kidney infection
myocardial infarction

Question 8

what enzyme is primarily elevated during hepatocellular necrosis

Answer 8

ALT

Question 9

what is the normal value for ALT

Answer 9

5-36

Question 10

LDH stands for what

Answer 10

lactic acid dehydrogenase

Question 11

LDH is elevated when

Answer 11

cellular death or leakage from the cell
hemolysis –> prehepatic

if other tests are elevated it may indicate –>
myocardial infarction
pulmonary infarction

Question 12

what is the normal values for LDH

Answer 12

50-150

Question 13

ALP is elevated when

Answer 13

biliary obstruction*
blastic bone disease
pregnancy
skeletal growth

Question 14

what is the normal values for ALP

Answer 14

30-120

Question 15

what does GGT stand for

Answer 15

gama glutamyl transpeptidase

Question 16

GGT is elevated when

Answer 16

cholangitis 
liver disease 
occult bile duct obstruction  
alcohol abuse 
drug abuse

Question 17

total bilirubin is elevated when

Answer 17

liver disease
hemolytic anemia
drugs

Question 18

what are the lab results seen in prehepatic jaundice

Answer 18

BLOOD
increase unconjugated bilirubin
increase albumin

URINE and POOP
increase or normal urobilinogen - yellow urine
normal steracobilinogen

Question 19

what are the lab results seen in intrahepatic jaundice

Answer 19

BLOOD
increase unconjugated and conjugated bilirubin - BOTH
big increase AST and ALT
slight increase ALP

URINE
increase bilirubin - dark urine

Question 20

what are the lab results seen in posthepatic jaundice

Answer 20

BLOOD
increase conjugated bilirubin
big increase in ALP
slight increase in AST and ALT

URINE and POOP
increase bilirubin in urine - dark urine

urobilinogen and steracobilinogen –>
incomplete obstruction = decrease
complete obstruction = absent

Question 21

what causes prehepatic, intrahepatic, and post hepatic jaundice

Answer 21

prehepatic - hemolysis

intrahepatic - impaired conjugation, viral hepatitis, drugs, cirrhosis, tumors of liver

post hepatic - obstruction of bile ducts, gallstones, and tumors of bile ducts or pancreas

Question 22

what are the symptoms of hemolytic jaundice

Answer 22

weakness, dark urine, anemia, leterus, splenomegaly

Question 23

what gives feces its color

Answer 23

stercobilinogen

Question 24

what are the different types of obstructive jaundice

Answer 24

intrahepatic obstruction - hepatitis, PBC (primary biliary cirrhosis), drugs

extrahepatic obstruction - stones, stricture/stenosis, compression, inflammation, tumors of ampulla of vater, choledochal cyst, biliary atresia

Question 25

what are the causes of intrahepatic jaundice

Answer 25

gilberts syndrome - decreased GT activity - unable to conjugate bilirubin grigler najjar syndrome - absence of UDPGT activity - unable to conjugate bilirubin familial disorders - dubin johnson syndrome and rotor syndrome hepatitis, cirrhosis, drugs

Question 26

intrahepatic jaundice symptoms

Answer 26

weakness, loss of appetite, hepatomegaly, palmar erythema, spider angiolectasis

Question 27

what are the clinical features of cholestasis

Answer 27

pain due to malignancy, disease, or stretching of liver capsule fever due to ascending cholangitis palpable or tender gall bladder enlarged smooth liver

Question 28

what does the proportion of conjugated bilirubin to total bilirubin indicate

Answer 28

<20% - prehepatic, gilberts, crigler najjar 20-40% of total - hepatic 40-60% of total - hepatic or post hepatic >50% of total - post hepatic prehepatic is mostly unconjugated so low % and post hepatic is conjugated so high % of conjugated/total bilirubin

Question 29

unconjugated bilirubin is transported with what in the liver

Answer 29

ligandin or Z protein

Question 30

unconjugated bilirubin is conjugated with what to form conjugated bilirubin

Answer 30

glucouronic acid

Question 31

conjugated bilirubin is converted to what in the GI small intestine how where doe it go next

Answer 31

urobilinogen bacterial proteases urobilinogen will be excreted via feces, enter enterohepatic circulation and go back to liver, or go to kidney to be excreted in the urine

Question 32

__% of urobilinogen reabsorbed from the intestines into the portal vein __% of urobilinogen excreted in the feces

Answer 32

10% rebasorbed and back to the liver 90% excreted in the feces

Question 33

secreted bile salts from the gall bladder are __% new bile salts and __% old recycled bile salts

Answer 33

5% new synthesized bile salts 95% old recycled bile salts

Question 34

what % of bile salts are reabsorbed by the small intestine what % of bile salts are excreted in the feces

Answer 34

95% reabsorbed 5% excreted in feces

Question 35

what is normal GGT value

Answer 35

0-30

Question 36

what is normal total bilirubin value

Answer 36

0.2 - 1.5