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50 Cards in this Set
- Front
- Back
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What are the tests for hepatocellular damage?
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Total Bilirubin
Conjugated & unconjugated bilirubin AST ALT |
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What are the tests for obstructive disease?
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Bilirubin
Conjugated & unconjugated bilirubin ALP GGT |
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PT will be what in impaired hepatic function?
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Elevated
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What will the abnormal bilirubin tests look like in pre-hepatic jaundice?
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Increased indirect serum bilirubin
Increased urobilinogen in urine and feces |
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What will the abnormal bilirubin tests look like in hepatic jaundice?
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Increased direct & indirect serum bilirubin
No urobilinogen in urine Conjugated bilirubin in urine |
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What do the abnormal tests look like in post-hepatic jaundice?
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Increased serum direct bilirubin
No urobilinogen in urine Bilirubin in urine |
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What are the most likely explanations for increased indirect bilirubin?
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Hemolysis of RBC
Impaired cellular function of liver |
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What is the most likely explanation for increased direct bilirubin?
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Obstruction to bilirubin excretion
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LDH5 is found where?
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Liver
Skeletal muscle |
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Where is ALP found?
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Bone
Liver Intestine Kidney Leukocytes Placenta |
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What is usually the first enzyme elevated in bile duct obstruction?
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ALP
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What conditions other than liver/bile obstruction would cause an elevated ALP?
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Pregnancy
Pediatric patient Fractured bone |
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What two substances will help differentiate elevated nonspecific ALP as hepatic in origin?
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GGT
5'Nucleotidase |
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What induces the synthesis of GGT?
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Alcohol
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Increased GGT and ALP indicates what?
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Hepatobiliary obstruction
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Where is AST found?
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Heart
Liver Skeletal muscle Kidney |
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What is the old name for AST?
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SGOT
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Where is ALT primarily found?
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Liver
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What is the old name for ALT?
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SGPT
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Which aminotransferase is associated with chronic conditions?
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AST
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Which aminotransferase is associated with acute conditions?
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ALT
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AST > ALT, ratio > 5.0 indicates what?
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Alcoholic hepatitis
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ALT > AST, ratio < 1.0 indicates what?
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Acute viral hepatitis
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AST > ALT, ratio > 1.0 indicates what?
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Chronic or alcoholic hepatitis
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ALT > AST, ratio < 1.5 indicates what?
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Extrahepatic obstructive disease, acute
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AST > ALT, ratio > 1.5 indicates what?
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Intrahepatic obstructive disease, chronic
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What two tests would you look at to evaluate a suspected liver metabolism problem?
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PT
Serum albumin |
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What tests would you look at for a suspected obstruction?
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ALP
GGT Fractionated bilirubin |
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What tests would you look at for suspected cell damage?
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ALT, AST
de Ritis ratio Fractionated bilirubin |
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Which pancreatic enzyme is only produced by the pancreas?
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Lipase
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What are the viral causes of hepatitis?
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Hepatitis viruses
Herpes viruses - CMV, EBV Coxsackie viruses |
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Toxic hepatitis is due to what causes?
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Drugs
Toxic metal exposures Metabolic disorders Metastases |
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How long is Hepatitis A detectable in relation to jaundice?
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14-21 days before jaundice
8 days after jaundice |
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How is Hepatitis A spread?
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Close personal contact
Contaminated food, water Blood exposure |
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When is the hepatitis A virus shed in feces after exposure?
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7-10 days after exposure
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What are the non-specific lab abnormalities in hepatitis A?
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Increased ALT, AST
Slightly elevated ALP Increased serum bilirubin Bilirubin in urine Elevated IgM, lymphocytosis, atypical lymphs |
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What are the specific lab abnormalities in hepatitis A?
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HAV specific IgM antibodies
Virus/antigen in stool 1-2 weeks before symptoms |
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What are the major routes of transmission for Hep B?
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Percutaneous
Mucous membrane exposure Sexual, perinatal |
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What are the major infectious routes of transmission for Hep B?
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Blood
Semen Saliva |
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What is the earliest indicator for Hep B infection?
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Hep B surface antigen
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What percentage of Hep C patients develop chronic infection?
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80%
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What test detects >95% of infected patients?
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EIA
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What is the confirmatory test for detection of HCV antibodies?
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RIBA
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Hep D occurs only with coinfection with what?
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Hep B
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Which hepatitis is endemic in developing countries?
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Hepatitis E
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Where is Hepatitis F seen?
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France
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Which hepatitis is a distant relative of HCV?
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Hep G
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Hep G frequently presents with coinfection with what else?
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Hep B & Hep C
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What is in the acute hepatitis panel?
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Anti-HAV IgM
HBsAg Anti-HBc IgM Anti-ACV IgM |
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What is in the chronic hepatitis panel?
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HBsAg
Anti-HBs HBeAg Anti-HBe |
