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17 Cards in this Set
- Front
- Back
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Liver enzymes?
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1. AST - ubiquitous, liver, cardiac m, skel m, kidney, brain, pancreas, lung
2. ALT - liver only therefore is elevated AST you can't just say its a problem with the liver...but ALT you can |
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Aminotransferase levels?
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>15000 = CCL4, extensive liver injury
10-15000= viral hep without recovery 800= viral hep 500-1000= acute bile duct obstruction <500 = viral hep in aids, cirrhosis, obstructive jaundice <300 = alcoholic liver disease |
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Obstructive liver function disease
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- slight ast, alt elevation
- high alk phosphatase -norm albumen -norm PTT -norm to elevated bili GGTP = high |
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Parenchymal Liver Function disease
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- high ast, alt
-slight high alk phos -norm albumen -PTT high -bili norm -GGTP = norm to high |
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Intrahepatic liver prob
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high AST ALT
high alk phos norm bili |
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Extrahepatic liver prob
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-slight high AST,ALT
- high alk phos - high bili *CANNOT biopsy!!! |
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Cholestasis
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-slight high AST,ALT
- high alk phos - high bili *CAN biopsy!!!! |
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Hep A
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-1000 to 1200 with AST, ALT...but leaves after 6 to 8 weeks
treat: immune serum globulin and treat friends and family |
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Hep B
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-85 to 90% have cure...15% remain carriers
-when pt develops infection there is an inc in surface ag, but barely recognized -Find ab but no HBsAg = means pt was exposed to HBV, but now is over it Transmitted: via breast milk and vaginally during delivery TX: HBIG upon delivery |
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Hep C
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-85% to 90% stay infected...only 10 to 15% cured
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What is the problem with HBV carriers?
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1. asymp
2. spread blood to blood 3. have HBsAG that reverts to normal |
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Testing for hepatitis?
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1. HBsAG : += HBV...- means not hbv
2. anti HAV: + = HAV...- not HAV or HBV |
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Hep A vs. B
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incuabation: A- 2 to 6 week. B-6 wk to 5 month
Onset: A- acute B- insiduous Season: A-Fall B- year round Age: A- kid, young B- any Transmission: A- fecal oral B-needles Severity: A-mild B- severe Prognosis: A-good B-bad carrier: A-rare B- 1% Ig: B- very good |
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Indications for PTC
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1. jaundice and don't know why
2. extrahepatic obstruction 3. detwermine etiology and exact site of extrahepatic obstruction before surgery 4. clarify abnormal liver scans with pt with cirrhosis |
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Contraindications for PTC
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1. abnormal bleeding study
2. fever, cholangitis 3. ascities 4. lung disease advanced 5. allergy to contrast 6. uncooperative pt |
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Difference btween PTC and ERCP?
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PTC exams GB, liver, bile ducts...use for extrahepatic obstruction
ERCP - exams GB, Liver, bile ducts, pancreas...use for pancreatic obstructions |
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indications for ERCP?
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1. cholestasis
2. pancreatic disease 3. GB disease 4. postcholcystectomy syndromes 5. ab pain 6. therapeutic endoscopy |
