AST is?
Enzyme released in response to injury of liver, heart, mm, kidney
ALT is?
Enzyme released in response to injury of liver or kidney
LDH is?
Enzyme released w/ injury or dz of many organs
LDH-5 specific to liver and skeletal mm
Elevated AST/ALT most C w/ what conditions? (5)
EtOH NASH/Fatty liver Meds Hepatitis Hemochromatosis (Fe buildup)
NAFLD test results?
↑AST/ALT
Hemochromatosis tests? (3)
Serum Fe
TIBC
Ferritin
Autoimmune Hepatitis test? (4)
↑AST/ALT
ANA
SMA
IgG
α-1 Antitrypsin Deficiency tests? (2)
↑AST/ALT
↓α-1
Wilson’s Dz tests? (3)
↑AST/ALT
↓Ceruplasmin
24 hr urine copper
Hep A tests? (4)
↑AST/ALT
↑Alk Phos/Bilirubin
IgM anti-HAV + (acute infect)
IgG anti-HAV + (immunity)
Hep B tests? (8)
↑AST/ALT ↑Alk Phos/Bilirubin HBsAg + (active) anti-HBs + (immun) IgM anti-HBc + (acute inf) IgG anti-HBc + (previous inf, now immune) HBeAg (Infective) anti-HBe (long term clearance)
Hep C tests?
↑AST/ALT
↑Alk Phos/Bilirubin
anti-HCV + (past or ongoing)
AST:ALT ratio tells us:
> 2?
< 2?
a/w ↑AST/ALT?
> 2 = liver dz esp if GGT 2x normal
< 2 = acute/chronic viral hep, NASH
a/w ↑AST/ALT = cholestatic dz