Liver Function Tests - Part 1 Flashcards Preview

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

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

A

TRUE DAT!!!

2
Q

Upon physical examination, Jaundice can be indicitive of what?

A

-Acute hepatitis
-biliary obstruction
-Advanced chronic liver diease

3
Q

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

A

-Cholecystitis
-Inflammatory liver disease

4
Q

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

A

-Spider angioma
-Palmar erythemia
-Gynecomastia
-Testicular atrophy

5
Q

What are some complications of liver disease?

A

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

6
Q

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

A

Serum bilirubin (total, conjugated, and unconjugated bilirubin)

7
Q

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

A

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

8
Q

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

A

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

9
Q

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

A

-Serum ammonia
-Blood glucose

10
Q

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

A

Increased.

11
Q

Elevated levels of unconjugated bilirubin are observed in what?

A

-Hepatocellular disease

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

12
Q

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

A

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

13
Q

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

A

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
Q

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

A

The extent of cholestasis

15
Q

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

A

May also be elevated (along with conjugated)

16
Q

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

A

Not really.

17
Q

What happens to the bile duct in intrahepatic cholestasis?

A

Inflammation of hepatocytes compresses on bile duct

18
Q

What happens to the common bile duct in extrahepatic cholestasis?

A

Gall stone in common bile duct

19
Q

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

A

Conjugated

20
Q

_______ cholestasis may be observed in viral hepatitis and drug toxicity

A

Intra-hepatic

21
Q

Extra-hepatic cholestasis may be observed in what?

A

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

22
Q

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

A

ALT
AST

23
Q

In acute hepatitis, ALT levels _____ AST levels

A

AST&raquo_space; ALT

24
Q

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

A

AST levels&raquo_space; ALT levels
(AST:ALT ratio approx 2:1)

25
Q

Which enzymes indicated hepatocellular injury?

A

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

26
Q

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

A

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

27
Q

Alkaline phosphatase (ALP) is secreted by what?

A

Biliary canaliculi

28
Q

What type of cholestatic obstruction raises ALP?

A

any cause of intra-hepatic or extra-hepatic obstruction

29
Q

Besides cholestasis, when else is ALP levels raised?

A

-Pregnancy
-normal growing children
-bone diseases