Flashcards in Liver Studies Deck (65):
1
which test is used to identify hepatocellular disease?
ALT (found in cytosol of liver)
2
what does ALT stand for?
alanine aminotransferase
3
what are the normal ALT values?
4-36 IU/L
4
what are the interfering drugs for ALT?
PAMS PODP
phenothiazine, acetaminophen, methotrexate, statins, procainamide, OCP, dilatin, propoxyphene
5
myositis, pancreatitis, MI, infections mono and shock would produce what level of ALT/
mildly elevated
6
cirrhosis, cholestasis, hepatic tumor, hepatotoxic drug, obstructive jaundice, severe burns and muscle trauma would produce what level of ALT?
moderately elevate
7
hepatitis, hepatic necrosis and hepatic ischemia would produce what level of ALT/
significantly elevated
8
what does AST stand for?
aspartate aminotransferase (found in liver, heart, skeletal muscle, kidney, pancreas and RBC)
9
what are normal AST values?
0-35
10
how will AST levels change with injury?
elevates at 8hrs
peaks at 24-26 hrs
normal at 3-7 days
11
what drugs interfere with AST levels?
SAVE CODOIC
salicylates, antihypertensive, verapamil, E-mycin, cholinergics, OCP, digoxin, opiates, INH, coumadin
12
acute renal dz, beriberi, DKA, pregnancy would cause what levels of AST?
low
13
liver dz would cause what level of AST/
elevated
14
where is alkaline phosphatase found?
liver, bone, biliary tract
intestine, kidney, placenta, leukocytes
15
what are normal ALP levels?
30-120
16
what is ALP1 isoenzyme specific for?
liver origin
17
what is ALP2 isoenzyme specific for?
bone origin
18
hypophosphatemia, malnutrition, milk-alkali syndrome, pernicious anemia and scurvy would cause what level of ALP?
decreased
19
liver dz, normal pregnancy, normal bone growth, bone tumors, fractures, paget dz, and others would cause what levels of ALP?
increased
20
which drugs interfere with ALP levels?
too many
21
what is GGT?
gamma-glutamyl transpetidase
22
where is GGT found?
biliary tract, liver
kidney, spleen, heart, intestine, brain, prostate
23
what are normal GGT values?
8-38
very high in newborns
24
which is the most sensitive indicator of liver dz?
GGT level
-indicates heavy and chronic EtOH use
25
late pregnancy, clofibrate, OCP, will do what to GGT levels?
lower
26
EtOH, dilantin, liver dz, MI, pancreatic dz and phenobarbital will do what to GGT levels?
elevate
27
what is 5' NT?
5' nucleotidase
28
where is 5' NT found?
hepatocyte plamsa membrane
29
what is normal 5'NT value?
0-1.6
30
how is 5'NT used?
supports dx of obstructive hepatobiliary dz in pts with increased ALP
31
liver dz will do what to 5'NT levels?
increase
32
where is albumin formed?
inside the liver
33
what is the main function of albumin?
maintains colloidal osmotic pressure and transports drugs, hormones and enzymes
34
what are normal albumin levels?
3.5-5
35
dehydration will do what to albumin?
increase
36
inflammation, cirrhosis and nephrotic syndrome will do what to albumin?
decrease
37
what is normal PT value?
11-12.5 seconds
38
what is the best indicator of prognosis in acute liver dz?
PT
39
what top tube will you collect PT?
blue top
40
what is serum ammonia?
byproduct of protein metabolism, converted to urea
41
what is normal serum level?
10-80
42
what is the main interfering factor for serum ammonia?
smoking
43
what are normal bilirubin levels?
.3-1 total
44
how is bilirubin used?
assess liver function, hemolytic anemia and jaundice in newborns
45
which meds will increase bilirubin?
allopurinol
anabolic steroids
antimalarials
cholinergics
sulfonamides
methotrexate
46
what does the liver make?
glucagon
lipoproteins
cholesterol
proteins of all kinds
bile salts
47
what does the liver store?
glucagon
triglycerides
vitamins A, D, E, K, B12, Cu and Fe
48
what is a Kupffer cell?
macrophage of liver
49
what tests are used to dx hepatocellular injury?
ALT, AST, bilirubin
50
what test are used to dx cholestasis?
bilirubin, ALP, GGT
51
what tests are used to assess liver function?
albumin, PT, ammonia, platelets
52
what is the de Ritis ratio?
AST/ALT ratio
53
when would de Ritis ratio be greater than 2?
alcohol related liver dz
54
what doaminotransferase levels greater than 1000 indicate?
necrosis
55
what do ALP levels greater than 4times normal indicate?
ductal injury
56
are isolated elevated GGT levels a good test?
no
57
when coupled with ALP, which test works well to suggest liver dz?
GGT
58
normal GGT with elevated ALP suggests what?
bone dz
59
increased unconjugated bilirubin,
normal serum conj bili
increased gut conj bili
increased urine urobiligen would indicate
pre-hepatic jaundice
60
increased unconjugated serum bili
increased conj serum bili
decreased conj bili in stool, urine would indicate
intrahepatic jaundice
61
normal unconjugated serum bili
increased conj serum bili
decreased conj bili in gut would indicate
post hepatic jaundice
62
when is bilirubin in urine normal?
never
63
what causes prehepatic jaundice?
excess hemolysis
64
what causes intrahepataic jaundice?
damage to liver causes it to be unable to process bilirubin
65