Liver function tests

Question 1

What causes unconjugated hyperbilirubinemia?

Answer 1

• increased production of bilirubin
• impaired or decreased hepatic uptake of bilirubin
• impaired or decreased conjugation

Question 2

What causes conjugated hyperbilirubinemia?

Answer 2

• Hepatocellular injury or disease
• Interhepatic cholestasis
• Extrahepatic cholestasis (biliary obstruction)

Question 3

What is the normal ALT to AST ratio?

Answer 3

ALT > AST

Question 4

What is the AST to ALT ratio in alcoholic liver disease?

Answer 4

2:1 or 3:1

Question 5

Is AST specific to liver tissue? When is it elevated?

Answer 5

• Non specific, found in other tissues

- Elevated in alcohol, hepatitis, and metabolic disease

Question 6

Is AST or ALT more specific to the liver?

Answer 6

ALT

Question 7

What is the half life of albumin and is it a measure of acute or chronic hepatocellular injury?

Answer 7

• 20 days

- Chronic injury

Question 8

What happens to ALT and AST with ischemia?

Answer 8

-Elevation in the thousands

Question 9

-What causes ALP to be elevated?

Answer 9

• cholestasis
• pregnancy
• bone disease/growth

Question 10

Where is GGT produced?

What causes it to be elevated?

Answer 10

• Liver, kidneys, pancreas

- Alcohol and cholestasis

Question 11

Increased ALP and low/normal GGT indicates?

Answer 11

Bone disease