Liver Enzymes: ALT and AST
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Questions and Answers

What is the primary difference between ALT and AST in terms of their presence in the body?

  • ALT is found in the brain and red blood cells, while AST is found in the liver and kidneys
  • ALT is found predominantly in the liver, with negligible quantities found in other organs (correct)
  • AST is found only in the liver, while ALT is found in the heart and skeletal muscle
  • ALT is found in the liver and kidneys, while AST is found in the heart and skeletal muscle
  • What is the typical pattern of AST elevation in myocardial infarction?

  • AST increases gradually over several days and returns to normal after 1 week
  • AST increases immediately after onset of infarction and returns to normal within 1 hour
  • AST does not increase in myocardial infarction
  • AST increases 4-6 hours after onset of infarction, peaks 16-48 hours, and returns to normal 3-5 days later (correct)
  • Which of the following conditions is associated with an elevation of only AST?

  • Fatty liver
  • Autoimmune hepatitis
  • Hepatocellular carcinoma
  • Myocardial infarction (correct)
  • What is the primary function of alkaline phosphatase (ALP) in the liver?

    <p>To remove phosphate groups from molecules</p> Signup and view all the answers

    Which of the following conditions is associated with an elevation of both ALT and AST?

    <p>Acute liver viral infections</p> Signup and view all the answers

    What is the primary site of alkaline phosphatase (ALP) in the liver?

    <p>Biliary ducts</p> Signup and view all the answers

    Which of the following medications is associated with an elevation of ALT and AST?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of AST elevation in skeletal muscle disease?

    <p>AST increases moderately and persists for a longer duration than CK</p> Signup and view all the answers

    What is the effect of alcohol on GGT production?

    <p>It increases GGT production by inducing hepatic microsomal production</p> Signup and view all the answers

    In what percentage of chronic drinkers is GGT level elevated?

    <p>75%</p> Signup and view all the answers

    In which of the following conditions is GGT elevated?

    <p>Alcoholic liver disease</p> Signup and view all the answers

    What is the primary cause of GGT elevation in toxic hepatitis?

    <p>Stimulation of excess proteins synthesis</p> Signup and view all the answers

    What is the main value of GGT over ALP in diagnosing biliary disease?

    <p>GGT is better in verifying that ALP elevations are due to biliary disease</p> Signup and view all the answers

    What is the primary function of GGT in glutathione metabolism?

    <p>Transferring gamma-glutamyl moiety to form glutamate</p> Signup and view all the answers

    What is the primary function of albumin in the body?

    <p>To maintain vascular volume by preventing movement of fluid from the intravascular to the extravascular space</p> Signup and view all the answers

    Which of the following is NOT a cause of elevated ALP levels?

    <p>Malnutrition</p> Signup and view all the answers

    What is the role of GGT in the liver?

    <p>Transferring gamma-glutamyl functional groups</p> Signup and view all the answers

    Where is albumin synthesized in the body?

    <p>Liver</p> Signup and view all the answers

    What is the effect of GGT elevation in pancreatic disease?

    <p>It is moderately elevated in acute pancreatitis</p> Signup and view all the answers

    Which of the following enzymes is elevated in liver disease?

    <p>All of the above</p> Signup and view all the answers

    What is the correlation between GGT and ALP in detecting biliary disease?

    <p>They are positively correlated</p> Signup and view all the answers

    What is the location of GGT in the liver cell?

    <p>Cell membrane</p> Signup and view all the answers

    Which of the following is a cause of decreased ALP levels?

    <p>Cretinism</p> Signup and view all the answers

    What is the relationship between GGT and glutathione metabolism?

    <p>GGT is involved in glutathione metabolism by transferring gamma-glutamyl moieties</p> Signup and view all the answers

    Study Notes

    Liver Enzymes (SGPT & SGOT)

    • ALT is found predominantly in the liver, with clinically negligible quantities found in kidneys, heart, and skeletal muscle.
    • AST is found in the liver, heart, skeletal muscle, kidneys, brain, and red blood cells.
    • ALT is a more specific indicator of liver damage than AST.
    • Elevation of only GOT (AST) is seen in:
      • Myocardial infarction (increases 4-6h after onset, peaks 16-48h, and returns to normal 3-5 days later)
      • Skeletal muscle disease (e.g., Duchenne muscular dystrophy)
      • Hemolytic anemia (e.g., sickle cell anemia)
    • Elevation of both ALT and AST is seen in:
      • Acute and chronic liver viral infections (e.g., HAV, HCV, HBV)
      • Fatty liver (alcohol related and non-alcohol related conditions)
      • Hepatocellular carcinoma (HCC)
      • Autoimmune hepatitis
      • Some medications (e.g., certain antibiotics, statins, and fenofibrate)
      • Hemochromatosis and Wilson disease
      • Hypothyroidism

    Alkaline Phosphatase (ALP)

    • Sites: ALP is found in cells lining the biliary ducts of the liver, bone, intestine, and placental tissue.
    • Functions: responsible for removing phosphate groups from molecules, including nucleotides and proteins, through dephosphorylation.
    • Elevated ALP levels can be caused by:
      • Bone diseases (e.g., Paget's disease, osteosarcoma, bone metastases of prostatic cancer, fractured bone)
      • Cholestasis-causing drugs (e.g., antidepressants, immunosuppressants)
      • Hepatotoxicity-causing drugs (e.g., paracetamol, antiepileptic)
    • Decreased ALP levels can be caused by:
      • Malnutrition
      • Cretinism (hypothyroidism in infancy)
      • Congenital hypophosphatasia (rare inherited disorder)

    Gamma Glutamyl Transferase (ɣ-GT)

    • Sites: ɣ-GT is found in many tissues, with the liver being the most notable one.
    • Functions: involved in glutathione metabolism, transferring gamma-glutamyl functional groups to various acceptor molecules.
    • Elevated serum ɣ-GT activity can be found in diseases of the liver, biliary system, and pancreas, including:
      • Liver disease (e.g., acute hepatitis, alcoholic liver disease, hepatic malignancies)
      • Biliary disease (e.g., intra and extra hepatic cholestasis)
      • Pancreatic disease (e.g., acute pancreatitis, pancreatic malignancy with hepatobiliary obstruction)

    Albumin

    • Albumin is the most abundant protein in human blood plasma, produced in the liver.
    • Albumin creates 75-80% of plasma colloid oncotic pressure, maintaining vascular volume by preventing fluid movement from the intravascular to the extravascular space.
    • Albumin functions include:
      • Maintaining vascular volume
      • Preventing movement of fluid from the intravascular to the extravascular space

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    Description

    This quiz focuses on the difference between Alanine Transaminase (ALT) and Aspartate Transaminase (AST) in the human body, particularly in relation to liver damage and other organs.

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