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Flashcards in Liver Function Tests - Part 1 Deck (29):
1

(T/F) The liver function tests (LFTs) are a combination of biochemical tests.

TRUE DAT!!!

2

Upon physical examination, Jaundice can be indicitive of what?

-Acute hepatitis
-biliary obstruction
-Advanced chronic liver diease

3

Upon physical examination, abdominal pain and fever may be indicative of what?

-Cholecystitis
-Inflammatory liver disease

4

Upon physical examination, stigmata of chronic cirrhosis may be indicative of what?

-Spider angioma
-Palmar erythemia
-Gynecomastia
-Testicular atrophy

5

What are some complications of liver disease?

-Encephalopathy
-Ascites
-GI bleeding (esophageal varices)
-Coagulation disorders

6

The liver function tests that checks the excretory function of the liver looks at what?

Serum bilirubin (total, conjugated, and unconjugated bilirubin)

7

The liver function test reveals the serum enzyme levels checks what?

-Enzymes that indicate hepatocellular damage
-Enzymes that indicate cholestasis
-Gamma glutamyl transpeptidase

8

The liver function tests that reveal the synthetic function of the liver look at what?

-Serum albumin
-Clotting factors (prothrombin time)
-Serum alpha feto protein (AFP)

9

The liver function tests that reveal the metabolic function of the liver tests what?

-Serum ammonia
-Blood glucose

10

In patients with hepatitis, serum total, conjugated and unconjugated bilirubin are _____

Increased.

11

Elevated levels of unconjugated bilirubin are observed in what?

-Hepatocellular disease

(Conjugated bilirubin may be elevated in hepatitis, as due to the inflammation, there is an assoc. element of intrahepatic cholestasis.)

12

In cholestatic disease, serum conjugated bilirubin is prodominantly elevated. If the obstruction is complete, what happens to the conjugated bilirubin?

It is not able to be excreted in the bile and it regurgitates into blood and appears in the urine.

13

In cholestatic disease, serum conjugated bilirubin is prodominantly elevated. If the obstruction is complete, what happens to the urobilinogen?

Its not formed in the intestines and stercobilinogen is also not formed, resulting in clay (pale) colored feces. Urobilinogen is also absent in the urine

14

In cholestatic disease, the extent of absence of stercobilinogen in feces and urobilinogen in urine depends on what?

The extent of cholestasis

15

In prolonged cholestatis, what may be characteristic of the serum unconjugated bilirubin?

May also be elevated (along with conjugated)

16

Can serum bilirubin alone help distinguish hepatocellular disorder from cholestatic disorder?

Not really.

17

What happens to the bile duct in intrahepatic cholestasis?

Inflammation of hepatocytes compresses on bile duct

18

What happens to the common bile duct in extrahepatic cholestasis?

Gall stone in common bile duct

19

Serum ________ bilirubin may be elevated in intra-hepatic or extra-hepatic cholestasis

Conjugated

20

_______ cholestasis may be observed in viral hepatitis and drug toxicity

Intra-hepatic

21

Extra-hepatic cholestasis may be observed in what?

-Stone in the common bile duct or gall bladder
-Tumors around the common bile duct or head of pancreas

22

Raised ___ levels is more specific for liver cell damage compared to raised ____.

ALT
AST

23

In acute hepatitis, ALT levels _____ AST levels

AST >> ALT

24

In long standing alcoholic cirrhosis, AST levels ___ ALT levels.

AST levels >> ALT levels
(AST:ALT ratio approx 2:1)

25

Which enzymes indicated hepatocellular injury?

Aminotrasnferases (Transaminases)
- ALT (alanine aminotransferase)
- AST (Aspartate aminotransferase)

26

Which enzyme indicate cholestasis (intra-hepatic and extra-hepatic)?

-Alkaline phosphatase (ALP)
-Gamma glutamyl transpeptidase (GGT)
-5' nucleotide

27

Alkaline phosphatase (ALP) is secreted by what?

Biliary canaliculi

28

What type of cholestatic obstruction raises ALP?

any cause of intra-hepatic or extra-hepatic obstruction

29

Besides cholestasis, when else is ALP levels raised?

-Pregnancy
-normal growing children
-bone diseases