liver labs Flashcards

Describe the lab test patterns which may indicate poor hepatocyte synthesis Describe the lab test patterns which may indicate direct hepatocyte injury Describe the lab test patterns which may indicate obstructive biliary injury Describe the lab test patterns which may indicate improper bilirubin clearance Describe the lab test patterns which may indicate pancreatitis

1
Q

test for intact liver synthesis

A

albumin
PT
INR

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2
Q

why is albumin not a good indicator for acute liver disease

A

albumin has a long half life

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3
Q

protein and albumin in liver disease will be:

A

low

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4
Q

non-hepatic causes of hypoalbuminia

A

protein malnutrition
nephrotic syndrome
severe burns

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5
Q

PT test result in liver damage

A

prolonged

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6
Q

why is PT test good for acutre liver damage

A

PT will respond within 24 hours of insult

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7
Q

PT used for

A

reye’s, acetominaphen OD, acute EtOH hepatitis

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8
Q

can also prolong PT

A

vitamin K deficincy

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9
Q

if hepatocytes are not synthesising properly then:

A

albumin will be low, PT and INR will be long

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10
Q

albumin 1.5 indicates

A

severe, end stage liver disease

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11
Q

lest for hepatocyte injury

A

AST, ALT, LD, GGT

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12
Q

test for liver metabolic function

A

ammonia

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13
Q

elevation of AST withOUT ALT indicates

A

cardiac or muscle disease

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14
Q

most specific liver enzyme test

A

ALT

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15
Q

500-1000 ALT indicates

A

acute viral hep
ischemic hep
acute toxic liver injury
autoimmune hepatitis

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16
Q

ALT and AST 10x the normal range ALMOST ALWAYS indicate

A

severe direct hepatocyte damage

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17
Q

highly suggestive of alchoholic hepatitus

A

AST:ALT greater than 2

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18
Q

tests of biliary excretory function and obstruction of bile flow

A

elevated ALP, GGT, and bilirubin

19
Q

elevated alkaline phosphatase is elevated in thee non-sick people

A

pregnant women

20
Q

alkaline phoshatase 10x normal level can mean

A

extra-hepatobiliary obstruction

21
Q

extra-hepatobiliary obstruction can be caused by

A

common bile duct obstruction or pancreatic cancer

22
Q

Their major use is to determine if an elevated ALP is of hepatic etiology

23
Q

in normal people, almost all bilirubin is

A

unconjugated

24
Q

jaundice indicates elevated

25
hereditary unconjugated bilirubin
crigler-najjar sydrome
26
worst kind of crigler-najjar sydrome
type 1
27
mild jaundice with stress and illness
gilbert syndrome
28
conjugated bilirubin with all other normal liver functions intact
dubin-Johnson syndrome
29
possible causes of NEWBORN jaundice
ABO or RH immune mediated hemolysis
30
moderate/severe Rh hemolysis can cause
hydrops fetalis
31
deposition of unconjugated bilirubin in fetal brain
kernicturus
32
Markedly elevated unconjugated bilirubin? | Think
hemolysis
33
Markedly elevated conjugated bilirubin? | Think
hepatic injury or obstruction
34
primary test of pancreatic insuffeciency
fecal fat test
35
most common cause of acute pancreatitis
gallstones
36
more specific test for pancretitis
lipase
37
most common cause of chronic pancreatitis
EtOH
38
most COMMON test for pancreatitis
amylase
39
amalyse peaks at
12-72 hour
40
non pancreatitis cause of high amylase
IgG-Amylase Complexes
41
lipase peaks at
24 hours
42
can lead to increased lipase (non-pancreatitits)
pancreatic duct obstruction or renal impairment
43
non enzyme tests associated with acute pancreatitis
hyperTG, high hemocrit,