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14 Cards in this Set
- Front
- Back
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State which liver "function" the following tests are related to:
Prothrombin Time (PT) T-Bili (Bu) D-Bili (Bc) Alk Phos GGT/Gamma-GT Albumin (ALB) LDH ALT AST Bile Acids Are these tests for screening or for Dx? |
Necrosis:
- AST, ALT, LDH Cholestatsis: - D-Bili - Alk Phos - GGT Organic ion metabolism: Bu, Bc, Bile Acids Protein Synthesis: ALB, PT these are all screening tests. |
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Is GGT a sensitive or specific marker of homeostasis?
Most Serum activity of GGT comes from what? |
sensitive, not very specific at all.
- it is found almost everywhere The liver. |
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What do the following transaminase values suggest?
- Peak ALT & AST > 100X - Peak ALT & AST > 10X - Peak ALT & AST 2-10X |
- massive acute hepatocellular necrosis
- acute viral hepatitis - hepatocellular necrosis related to more chronic forms of liver dz |
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What do AST/ALT ratios tend to be in viral hepatitis pts?
Acute alcoholic hepatitis? Can this be determined after one point of measure? |
</=1.0
>/= 2.0 No, need multiple points of measurement to see the relative elevation curves. |
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What does ALP do?
What can be used to rule out liver dz as the etiology of ALP elevation? Can the degree of ALP and GGT elevation distingusih intrahepatic from extrahepatic cholestasis? Can the GGT/ALP ratio help discern the etiolgy of liver dz? |
metabolite transport across membranes in a variety of tissues
GGT will always be higher than ALP in liver dz elevation; thus, if GGT is normal then the ALP elevation isn't due to liver dz. No. Yes, it can be helpful. > 2 --> liv diz > 5 --> active alcoholic liver dz < 2 non-hepatic source |
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Peak ALP > 3 R.I.
and GGT > 5x 3 R.I. ...suggest what? |
cholestasis
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Is ALP elevated in kids?
Anticonvulsant drugs? Hepatotoxic drugs? |
Yeah, a whooooole bunch (differs by age group and sex, but from what I can tell it's just generally much freaken' higher.
Yes. Yeah, dur. |
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What is T-BIL?
D-BIL? I-BIL? |
Bu + Bc + Bdelta (= conjugated bili / albumin complex)
Bc + Bdelta T-BIL - D-BIL = surrogate for Bu |
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Overproduction of bilirubin due to hemolysis or ineffective erythropoesis usually elevates which bilirubin lvl?
Leakage from damaged hepatocytes or bile ducts? Impaired uptade, conjucation or excretition? Cirrhosis? |
Bu
Bc, B-delta Bu and/or Bc Bu, Bc, Bdelta |
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Can fasting raise bilirubin levels?
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Yes, it can.
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What is the most useful LFT for determining severity of dz?
In which LFT must a pt be vit K corrected for results to be well-interpreted? |
PT
>15s or >4s above control suggests more severe dz. PT |
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What is HCV Fibrosure?
Why is it useful? |
Multi-marker array
- useful for the assessment of fibrosis. Individual LFGs do not detect fibrosis which can be an important predictor of progression to cirrhosis. |
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Which LFTs are usually used to answer the following questions:
Is anything wrong? Can I be sure nothing is Wrong? What is Wrong? How badly wrong is it? |
AST, ALT, ALP
" " + GGT Dz specific stuff: iron, copper, viral markers, ALB, etc. PT, ALB, Globulins, Multi-test Arrays |
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Elevated serum albumin and elevated Ig's *may* suggest what?
AMA are present in ___% of pts with PBC. Pts with chronic hepatitis? |
chronic hepatitis or cirrhosis, but it's too non-specific to be dx.
85-90% 10% |
