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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

what causes posthepatic jaundice?

biliary system becomes inflammed or obstructed and bilirubin does not move into the digestive system

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