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NSG 535 Exam 1 questions with correct answers
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NSG 535 Exam 1 questions with correct answers
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NSG 535 Exam 1 questions with correctanswers
Common Liver Function Tests - ANSWER: ➡ -Alanine aminotransferase (ALT)
o o o o o oo o o o
-Aspartate aminotransferase (AST)o o
-Alkaline phosphatase (ALP)
o o
-bilirubin
-albumin
-prothrombin time o
-gamma-glutamyltransferase (GGT) o
-5'nucleotidase
Liver functions - ANSWER: ➡ -destruction of RBCs & formation of bile pigments
o o o oo o o o o o o o o
-protein metabolism
o
-synthesis of plasma proteins, fibrinogens & prothrombin
o o o o o o
-enzyme synthesis o
-conversion of ammonia to urea o o o o
-carbohydrate & fat metabolism o o o
-excretion of drugs, hormoneso o o
-detoxifies
application of liver function tests - ANSWER: ➡ -detect presence of liver disease
o o o o o o oo o o o o o
-distinguish among different types of liver disorders
o o o o o o
-gauges the extent of known liver damage
o o o o o o
-follow response to txt
o o o
,LFT categories/what do they indicate? - ANSWER: ➡ -tests that measure detoxification &
o o o o o o oo o o o o o
excretory functions
o o
-tests for enzymes that reflect damage to hepatocytes
o o o o o o o
-tests for enzymes that reflect cholestasis (flow of bile reduced/blocked)
o o o o o o o o o
-tests that measure synthetic function
o o o o
Tests for enzymes that reflect damage to hepatocytes - ANSWER: ➡ -aminotransferases (AST
o o o o o o o o o oo o o
& ALT)
o o
-AST: enzyme present in liver, cardiac muscle, skeletal muscle, kidneys, brain, pancreases,
o o o o o o o o o o o
lungs, leukocytes, & RBCs
o o o o
-ALT: primary present in the Liver; enzyme
o o o o o o
--more specific indicator of liver cell damage
o o o o o o
--non specific/any type of liver disorder
o o o o o
ALT & AST levels - ANSWER: ➡ -levels >1000 --> extensive hepatocellular injury (viral
o o o o o oo o o o o o o o
hepatitis, ischemic liver disease, drug or toxin induced)
o o o o o o o o
>ACUTE hepatocellular damage: ALT > AST o o o o o
>Alcoholic liver disease: AST:ALT >2:1 (suggestive); >3:1 (highly suggestive)
o o o o o o o o
Tests for enzymes that reflect cholestasis - ANSWER: ➡ >ALP
o o o o o o o oo o
- <3 fold increase: not specific for cholestasis
o o o o o o o
--seen in almost any type of liver disease
o o o o o o o
->4 fold increase: cholestatic liver disorder, infiltrative liver disease (cancer), bone conditions
o o o o o o o o o o o
w/ rapid bone turnover (Pagets disease)
o o o o o o
-ALP is NOT useful to distinguish b/w intra & extra hepatic obstruction
o o o o o o o o o o o
-reflective of liver damage & cholestasis o o o o o
Tests that measure detoxification & excretory functions - ANSWER: ➡ >Bilirubin
o o o o o o o o oo o
,>Van den Bergh assay: determination of total, conjugated (direct) & unconjugated (indirect)
o o o o o o o o o o o
bilirubin
o o
-normal value of total <1-1.5 o o o o
-helps identify if liver is functioning the way it should
o o o o o o o o o
Tests that measure synthetic function - ANSWER: ➡ >Serum albumin
o o o o o o oo o o o
-synthesized exclusively by hepatocytes o o o
-NOT a good indicator of acute/mild hepatic dysfunction
o o o o o o o
-minimum change in viral hepatitis/drug induced hepatitis/obs jaundice
o o o o o o o o
-other causes of decrease: protein malnutrition, protein losing enteropathies, nephrotic
o o o o o o o o o
syndrome, chronic infection
o o o o
>Coagulation factors: o
-except for factor VIII, blood clotting factors are exclusively synthesized in hepatocytes
o o o o o o o o o o o
-rapid turnover; clotting factors are single best acute measure of hepatic synthetic function**
o o o o o o o o o o o o o
-PT (collective measures II/V/VII/X
o o o
---may be elevated in hepatitis, cirrhosis & disorders that result in Vit K deficiency (obs.
o o o o o o o o o o o o o o
jaundice)
o
Tests for enzymes that reflect cholestasis - ANSWER: ➡ >ALP
o o o o o o o oo o
>5'NT
>GGT
Common reasons for abnormal LFTs - ANSWER: ➡ >ALT: hepatocellular damage
o o o o o o oo o o o
>AST: hepatocellular damage
o o
>Bilirubin: cholestasis, impair conjugation or biliary obstruction
o o o o o o o
>ALP: cholestasis, infiltrative disease, biliary obstruction
o o o o o
>PT: synthetic function
o o o
>Albumin: synthetic function o o o
, >GGT: cholestasis or biliary obstruction
o o o o
>5' nucleotidase: cholestasis of biliary obstruction
o o o o o
Amylase - ANSWER: ➡ -digestive enzyme
o o oo o o
-aids in hydrolysis of starch into sugars
o o o o o o
-main sources are the pancreas and salivary glands
o o o o o o o
Lipase - ANSWER: ➡ -digestive enzyme
o o oo o o
-main function of pancreatic lipase is to hydrolyze triglycerides into glycerol & free fatty acids
o o o o o o o o o o o o o o
Pancreatitis - ANSWER: ➡ -acute 3x elevation of amylase &/or lipase
o o oo o o o o o o o
-typically extrapancreatic cause of amylase/lipase elevations are not associated with a >3fold
o o o o o o o o o o o
elevation
o o
-amylase & lipase drawn together o o o o
-often ordered when pt has abdominal pain
o o o o o o
Pancreatitis: Amylase - ANSWER: ➡ -serum amylase rises within 6-12 hrs
o o o oo o o o o o o
-returns to normal 3-5 days o o o o
-3x elevation more specific (85-98%) & sensitive (67-83%) for acute pancreatitis
o o o o o o o o o o
Pancreatitis: Lipase - ANSWER: ➡ -rises within 4-8hrs o o o oo o o o
-peaks at 24 hr o o o
-returns to normal 8-14 days o o o o
-3x elevation sensitive (82-100%) for acute pancreatitis
o o o o o o o
-lipase elevations occur earlier & last longer compared to amylase
o o o o o o o o o
Elevated amylase- extrapancreatic - ANSWER: ➡ -salivary disease
o o o o oo o o
-GI: appendicitis, perforated bowel, celiac disease
o o o o o
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