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Questions and Answers
What is the leading cause of intrahepatic cholestasis?
What is the usual cause of extrahepatic obstruction?
Which liver condition is indicated by high titers of antimitochondrial antibody?
What is the main cause of portal hypertension in chronic liver diseases?
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Which is the most common cause of cirrhosis?
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Why are there no good biochemical indicators of cirrhosis in the early and stable period?
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Which type of liver injury results from acute massive liver cell necrosis?
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What clinical manifestation is characteristic of acute liver failure?
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What term describes the accumulation of substances normally excreted in bile in the bloodstream?
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Which substance is NOT mentioned as being elevated in acute liver failure?
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Which of the following is a potential outcome of acute liver disease?
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Which type of liver disease may result from chronic alcohol consumption?
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What condition may present with a mild increase in Alanine Aminotransferase (ALT) levels?
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Which health issue is not typically associated with elevated Aspartate Aminotransferase (AST) levels?
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In which condition would the ALT/AST ratio typically be greater than 1.0?
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What is a significant source of alkaline phosphatase aside from the liver?
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Which condition would likely have both Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) elevated to a similar degree?
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Which liver condition would likely have the highest elevation of Alanine Aminotransferase (ALT)?
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What is the primary reason for the increase in ALP activity in liver disease?
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Which condition could result in a serum ALP level 2 times the reference interval?
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Where is ALP primarily produced in pregnant women?
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What is one of the consequences of increased ALP activity in growing bones?
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In which condition might ALP levels from the intestine be increased?
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Which enzyme is used by the body to synthesize glutathione tripeptide?
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Which enzymes are typically within the normal range in Fatty Liver?
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What is considered the best marker for intrahepatic and extrahepatic cholestasis?
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In which condition are liver enzyme concentrations notably increased, with AST and ALT being prominent?
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Which condition typically results in the largest elevations of ALP, due to gallstones or malignancy?
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What is a common effect of chronic liver failure on prothrombin and factors VII, IX, and X?
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Which statement is true regarding the effect of ethanol intake on cirrhosis?
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Study Notes
Intrahepatic and Extrahepatic Cholestasis
- Leading cause of intrahepatic cholestasis is drugs, particularly certain medications.
- Usual cause of extrahepatic obstruction includes gallstones, tumors, or strictures in the bile duct.
Antimitochondrial Antibody and Liver Conditions
- High titers of antimitochondrial antibody indicate primary biliary cholangitis (previously primary biliary cirrhosis).
- Main cause of portal hypertension in chronic liver diseases is cirrhosis leading to increased resistance to portal flow.
Cirrhosis and Biochemical Indicators
- Most common cause of cirrhosis is chronic hepatitis C infection.
- Absence of good biochemical indicators of cirrhosis in early stable periods is due to adaptations of liver to injury, which may mask dysfunction.
Acute and Chronic Liver Conditions
- Acute massive liver cell necrosis results in acute liver failure characterized by severe liver dysfunction.
- Characteristic clinical manifestation of acute liver failure is encephalopathy and impaired coagulation.
Bile Accumulation and Enzyme Levels
- Accumulation of substances normally excreted in bile in the bloodstream is termed cholestasis.
- Substances not elevated in acute liver failure include alkaline phosphatase (ALP).
Outcomes and Diseases from Liver Conditions
- Potential outcomes of acute liver disease include acute liver failure, hepatic encephalopathy, and multi-organ failure.
- Chronic alcohol consumption may lead to alcoholic liver disease or alcoholic hepatitis.
Enzyme Levels and Liver Disease
- Conditions presenting with a mild increase in alanine aminotransferase (ALT) include non-alcoholic fatty liver disease (NAFLD).
- Elevated aspartate aminotransferase (AST) levels are not typically associated with cholestatic liver diseases.
- ALT/AST ratio greater than 1.0 is typically found in alcoholic liver disease.
Alkaline Phosphatase (ALP) and Liver Function
- Significant source of alkaline phosphatase aside from the liver is bone; particularly during bone growth or disease.
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) may be elevated to a similar degree in conditions like viral hepatitis.
- The highest elevation of ALT is often seen in acute viral hepatitis.
Factors and Enzymes Related to Liver Disease
- Primary reason for increased ALP activity in liver disease is cholestasis.
- Conditions like cholestasis or biliary obstruction could result in serum ALP level 2 times the reference interval.
- ALP is primarily produced in the placenta in pregnant women.
Bone Growth and ALP Activity
- Increased ALP activity in growing bones can result in changes related to bone remodeling and increased osteoblastic activity.
- ALP levels from the intestine may be increased in conditions of intestinal obstruction or cholestasis.
Role of Glutathione and Enzyme Levels
- Enzyme used to synthesize glutathione tripeptide is glutamate cysteine ligase.
- In fatty liver, ALT and AST levels are typically within the normal range, while ALP may be elevated.
Enzyme Concentrations and Cholestasis
- The best marker for intrahepatic and extrahepatic cholestasis is alkaline phosphatase (ALP).
- Liver enzyme concentrations notably increase during viral hepatitis, with significant elevations of AST and ALT.
Gallstones and ALP Elevations
- Largest elevations of alkaline phosphatase (ALP) due to gallstones or malignancy cause significant cholestasis.
- Chronic liver failure commonly effects prothrombin and factors VII, IX, and X through coagulation factor synthesis impairment.
Ethanol and Cirrhosis
- Ethanol intake significantly exacerbates cirrhosis progression through increased liver injury and fibrosis.
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Description
Test your knowledge on conditions with increased ALT levels including hepatocellular disease, active cirrhosis, metastatic liver tumor, obstructive jaundice, and viral hepatitis. Suitable for students in the Clinical Biochemistry department of Pathological Analysis.
