NSG 535 Exam 1 QUESTIONS WITH ANSWERS

NSG 535: Exam 1 QUESTIONS WITH
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ANSWERS

Common Liver Function Tests - CORRECT ANSWERS ✔✔-Alanine
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aminotransferase (ALT) |\




-Aspartate aminotransferase (AST)
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-Alkaline phosphatase (ALP)
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-bilirubin
-albumin
-prothrombin time |\




-gamma-glutamyltransferase (GGT) |\




-5'nucleotidase


Liver functions - CORRECT ANSWERS ✔✔-destruction of RBCs &
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formation of bile pigments|\ |\ |\




-protein metabolism
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-synthesis of plasma proteins, fibrinogens & prothrombin
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-enzyme synthesis |\




-conversion of ammonia to urea |\ |\ |\ |\




-carbohydrate & fat metabolism |\ |\ |\




-excretion of drugs, hormones
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-detoxifies

,application of liver function tests - CORRECT ANSWERS ✔✔-
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detect presence of liver disease
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-distinguish among different types of liver disorders |\ |\ |\ |\ |\ |\




-gauges the extent of known liver damage
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-follow response to txt |\ |\ |\




LFT categories/what do they indicate? - CORRECT ANSWERS ✔✔-
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tests that measure detoxification & excretory functions
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-tests for enzymes that reflect damage to hepatocytes
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-tests for enzymes that reflect cholestasis (flow of bile
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reduced/blocked)
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-tests that measure synthetic function
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Tests for enzymes that reflect damage to hepatocytes - CORRECT
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ANSWERS ✔✔-aminotransferases (AST & ALT)
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-AST: enzyme present in liver, cardiac muscle, skeletal muscle,
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kidneys, brain, pancreases, lungs, leukocytes, & RBCs
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-ALT: primary present in the Liver; enzyme
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--more specific indicator of liver cell damage
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--non specific/any type of liver disorder
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ALT & AST levels - CORRECT ANSWERS ✔✔-levels >1000 -->
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extensive hepatocellular injury (viral hepatitis, ischemic liver
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disease, drug or toxin induced)
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>ACUTE hepatocellular damage: ALT > AST
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>Alcoholic liver disease: AST:ALT >2:1 (suggestive); >3:1 (highly
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suggestive)

,Tests for enzymes that reflect cholestasis - CORRECT ANSWERS
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✔✔>ALP
- <3 fold increase: not specific for cholestasis
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--seen in almost any type of liver disease
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->4 fold increase: cholestatic liver disorder, infiltrative liver
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disease (cancer), bone conditions w/ rapid bone turnover (Pagets
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disease)
-ALP is NOT useful to distinguish b/w intra & extra hepatic
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obstruction
-reflective of liver damage & cholestasis |\ |\ |\ |\ |\




Tests that measure detoxification & excretory functions -
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CORRECT ANSWERS ✔✔>Bilirubin |\ |\




>Van den Bergh assay: determination of total, conjugated (direct)
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& unconjugated (indirect) bilirubin
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-normal value of total <1-1.5 |\ |\ |\ |\




-helps identify if liver is functioning the way it should
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Tests that measure synthetic function - CORRECT ANSWERS
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✔✔>Serum albumin |\ |\




-synthesized exclusively by hepatocytes |\ |\ |\




-NOT a good indicator of acute/mild hepatic dysfunction
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-minimum change in viral hepatitis/drug induced hepatitis/obs |\ |\ |\ |\ |\ |\ |\


jaundice |\




-other causes of decrease: protein malnutrition, protein losing
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enteropathies, nephrotic syndrome, chronic infection |\ |\ |\ |\ |\

, >Coagulation factors: |\




-except for factor VIII, blood clotting factors are exclusively
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synthesized in hepatocytes |\ |\




-rapid turnover; clotting factors are single best acute measure of
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hepatic synthetic function** |\ |\ |\




-PT (collective measures II/V/VII/X
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---may be elevated in hepatitis, cirrhosis & disorders that result in
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Vit K deficiency (obs. jaundice)
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Tests for enzymes that reflect cholestasis - CORRECT ANSWERS
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✔✔>ALP
>5'NT
>GGT


Common reasons for abnormal LFTs - CORRECT ANSWERS
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✔✔>ALT: hepatocellular damage |\ |\




>AST: hepatocellular damage
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>Bilirubin: cholestasis, impair conjugation or biliary obstruction
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>ALP: cholestasis, infiltrative disease, biliary obstruction
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>PT: synthetic function
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>Albumin: synthetic function |\ |\ |\




>GGT: cholestasis or biliary obstruction
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>5' nucleotidase: cholestasis of biliary obstruction
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Amylase - CORRECT ANSWERS ✔✔-digestive enzyme
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