Flashcards in Liver Function Test Deck (24)
Complications of Liver disease
- Synthetic impairment
- Cholestasis (decreased bile flow)
- Decreased Clearance
- Portal Hypertension (portal blood becomes shunted around the liver and not processed(
Where does Portal blood go?
Liver, ding dong
Liver Function Tests are really?
Liver enzyme measures...
More specifically, measures of hepatocyte injury or
impairment of bile flow.
When liver cells are injured, what is released into the blood
Aminotransferases and Alkaline Phosphatase (more commonly seen with Bile Duct Injury)
Testing for these substances tests for direct cell injury to the liver
Tests for clearance?
Bilirubin and Ammonia....both of these are made in the liver and both should be cleared.
Tests of synthetic capacity
-Clotting Factors (done by measuring prothrombin time or INR, one of the results of the clotting cascade)
What are the Aminotransferases
AST and ALT
Remember that AST can be associated with muscle injury as well
ALT more specific for liver
Aminotransferases measure what
Alkaline phosphatase levels elevated suggests what
injury to bile duct
Alk Phos elevation also associated with injury to what other organs?
Cholestasis can be intrahepatic or extrahepatic obstruction to bile flow
Cholylglycine is what
A serum bile salt. Correlates with the degree of cholestasis present
GGT goes up with?
Bile duct impairment, tons of chemicals (dilantyn, ethanol)
Really not that helpful
Bilirubin made from what
Red cell turnover
Bilirubin is an imperfect measure of
hepatic clearance and excretory function
Goes up when clearance is reduced
Prothrombin time is prolonged when?
WHen clotting facters 1,2,5,7,10 are deficient or when Vitamin K is low
Albumin half life
around 20 days
Albumin is made in the liver
rapidly changes with illness and malnutrition
Look at child Pugh Score
High creatinine in liver pts?
Ammonia is detoxified where and how?
Detoxified in the liver by the urea cycle and the glutamine synthetase rxn
Ammonia is high in what condition
Child Pugh scoring:
Child A: score= 5-6
Child B: score= 7-9
Child C: score= 10-15