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Adv. Clinical Chem

Exam 1 - LFT

Name 5 functions of the liver. Protein Synthesis, Metabolism, Detoxification, Storage, and Exretion
What does ALP stand for? Alkaline Phosphatase
Where is ALP found? In the liver, bone, intestines, placenta, and cancer cells.
ALP will be 3 to 10 times the upper limit of normal in which diseases? Obstructive Liver Disease - gallstones or hepatic tumors
What is analyzed to determine the source of ALP? Isoenzymes
ALP will be (increased/decreased) in children and the elderly? Increased - due to bone growth or repair
The analysis of isoenzymes is based on what characteristic of each isoenzyme? temperature denaturation point
What is the order of most heat stable to least stable when it comes to the source of ALP? Placenta > Intestine > Liver > Bone
True or false: When differentiating between the Regan or the Nagao ALP isoenzyme,when heated at 65°C for 30 minutes, the Regan isoenzyme will be destroyed. False- neither will be destroyed at 65 deg C for 30 min unless the appropriate inhibitor is added.
What does ALT stand for? Alanine Aminotransferase
An ALP level that is 10 times the ULN represents which diseases? Primary biliary cirrhosis or congenital atrezia of intrahepatic ducts.
An ALP level that is 1 to 3 times the ULN represents which diseases? Alcoholic liver disease
If AST/ALT > ALP, what liver disease is most likely present? Chronic Active Hepatitis
What liver enzyme is the most specific for Liver Function? ALT
True or False: Clinical symptoms will arise before ALT during a viral infection. False - ALT rises before clinical symptoms, especially in viral infections.
AST stands for what? Aspartate Aminotransferase
Fill in the blanks: AST is especially rich in ___________ ____________? Skeletal muscle
AST is increased in which disease states (3)? AMI, Muscular dystrophy, and kidney damage
What is the "sister enzyme" of Alkaline Phosphatase? Acid Phosphatase
When comparing AST and ALT: Which enzyme is most abundant in the liver? ALT
When comparing AST and ALT: Which enzyme shows moderate sensitivity during acute inflammation? AST
The De Ritis Ratio is represented by what equation AST/ALT
What is the De Ritis ratio used for? To further differentiate between specific liver diseases as to whether they are acute or chronic, and intra-hepatic or extra-hepatic.
What is GGT an abbreviation for? Gamma Glutamyl Transpeptidase
Where is GGT found (2)? In the Liver and Kidney
Fill in the blank: GGT is specific for ________ disease. hepatobiliary
Which enzyme is very sensitive to alcohol consumption? GGT
GGT is located where? Within the membranes of the smooth endoplasmic reticulum.
Any substance which causes ___________ ___________ will increase GGT synthesis. microsomal proliferation
In which of the following would you NOT see an increase in GGT? a.Sepsis b.AML c.Neurological Diseases d.Liver Disease b. AML
Fill in the blank: __________ is the colorless end product of bilirubin metabolism. Urobilinogen
What is the amount(%) of direct bilirubin within circulation? Approximately 20%
High levels of what substance is found within hemolytic disease? Urobilinogen
During biliary obstruction, you would find (increased/decreased) levels of urobilinogen. Decreased
What is the common name for hemolytic icterus? Pre-hepatic Jaundice
Pre-hepatic jaundice is characterized by increased (conjugated/unconjugated) bilirubin. Unconjugated
Pre-hepatic jaundice within the newborn is also known as __________ jaundice. Physiologic
What is the reason that 50% of newborns are born with physiologic jaundice? Immature liver function
What is a concern with transcutaneous bilirubinometry? High levels may be inaccurate depending on the race of the baby
Fill in the blank: Hemolytic icterus arises when excessive _________ is presented to the liver for metabolism. bilirubin
Fill in the blank: Hepatic Jaundice is also known as ________ _______. Toxic Icterus
True or False: Gilbert's Syndrome involves impaired cellular uptake. True
What would you expect to find in increased levels in Gilbert's Syndrome? Unconjugated (<3mg/dL) and total bilirubin
What is the role of the enzyme UDPG-T? This enzyme conjugates bilirubin
True or false: Crigler-Nijjar Syndrome Type II results from complete absence of UDPG-T enzyme. False - Type I results from complete absence of the UDPG-T enzyme while Type II results from a deficiency of the enzyme.
Fill in the blank: ___________ results from excess bilirubin deposits within the brain and leads to death. Kernicterus
Dubin-Johnson Syndrome results from what? Defective excretion of bilirubin into the bile.
Is Dubin-Johnson Syndrome acquired or genetically linked? Genetically linked
In Dubin-Johnson Syndrome, what is the predominant from of bilirubin? Conjugated
Fill in the blank: Post-hepatic jaundice is caused by impaired __________ of bilirubin from the blood Excretion
Is post-hepatic jaundice a kidney problem? No, the function of the kidney is normal.
What is the cause of post-hepatic jaundice? Mechanical obstruction of bile flow into the GI tract.
Fill in the blank: In post-hepatic jaundice, you would expect to see ________ conjugated bilirubin and ________ urobilinogen. Increased conjugated bilirubin and Decreased urobilinogen
How would you expect the stool to appear within a patient who has post-hepatic jaundice? clay colored or chalky white
Reyes Syndrome is present in which specific population? Children ages 6 - 12 years old
Which unique compound is seen in elevated levels in Reyes Syndrome? NH3 (Ammonia)
True or False: Reyes Syndrome is treated with aspirin? False - Reyes Syndrome is worsened by Aspirin
A patient exhibiting symptoms of Reyes Syndrome will also be (hypo/hyper)glycemic. Hypoglycemic
The excretion of bile is affected in which disease? Cholestasis
Fill in the blank: Defective liver cell function is a cause of ___________ cholestasis. Intrahepatic
Fill in the blank: In Wilson's Disease, __________ is deposited within the brain, liver, kidney, and cornea. Copper (Cu+)
Neurological degeneration and Kayser-Fleischer rings are present in what disease? Wilson's Disease
Ceruloplasmin is (increased/decreased) in Wilson's Disease? Decreased
What are 3 hepatic manifestations seen in Wilson's Disease? Hepatomegaly, Subacute or Chronic Hepatitis, and Cirrhosis of the liver.
ACP stands for what? Acid Phosphatase
Which liver enzyme is used to detect prostate cancer? ACP
Fill in the blank: ALP requires a pH of ____ in order to be measured, while ACP requires a pH of ____. ALP needs a pH of 10; ACP needs a pH of 5.4
5’ Nucleotidase is found within which organ(s)? The liver
In hepatobiliary disease, 5' Nucleotidase in (increased/decreased) Increased
The major sources of Aldolase are found within the _________ and __________. Skeletal muscle and heart
In Duchenne type muscular dystrophy, 10-50 times the ULN can be found of which enzyme? Aldolase
True or False: Adolase is not very often used as a diagnostic tool. True
Created by: UTHSCSA-CLS