Biochemistry (liver function tests)
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This document discusses liver function tests and provides normal levels for various liver proteins and enzymes. It also gives equations and examples for calculating levels of alkaline transferase (ALT) and gamma-glutamyl transferase (GGT) from absorption test results. Finally, it provides interpretations of high or normal levels of different proteins and enzymes as indicators of possible liver diseases, biliary obstruction, bone diseases, or alcohol abuse.
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Liver function tests can detect, distinguish, and monitor various types of liver disease. Tests are grouped based on the liver's excretory, metabolic, detoxification, storage and synthetic functions. Enzyme tests like ALT and AST indicate hepatocyte damage, while elevated ALP and GGT suggest cholestasis. Protein tests such as albumin, PT and AFP evaluate synthetic function. Bilirubin, bile salts and dye excretion tests examine excretory function. Together these tests provide insight into liver health and disease categories.
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The document discusses various liver function tests that can help evaluate liver health. Tests that detect liver cell injury include alanine transaminase (ALT) and aspartate transaminase (AST), which are released when the liver cell membrane is damaged. Elevated levels of these enzymes suggest hepatocellular damage. Tests that indicate cholestasis and obstruction of bile flow include alkaline phosphatase, 5' nucleotidase, and leucine aminopeptidase. The ratio of AST to ALT can help differentiate conditions such as alcoholic liver disease. Together these tests provide insight into liver synthetic, metabolic and detoxification functions.
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This document discusses liver function tests (LFTs), which assess the liver's metabolic, synthetic, excretory and detoxification functions. LFTs include tests of bilirubin, bile salts, aminotransferases, alkaline phosphatase, lactate dehydrogenase, ammonia, cholesterol and coagulation factors. Elevations in aminotransferases generally indicate liver injury, while alkaline phosphatase and gamma-glutamyl transferase indicate cholestasis or bile duct injury. Interpretation of LFTs can help diagnose liver diseases and assess disease severity. Limitations include lack of specificity and inability to fully assess liver function.
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Liver function tests Dr.r.mallika
Liver function tests(LFTs) are used to assess the function of liver . The role of LFTs is vital in disease diagnosis.
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Liver function tests can detect, distinguish, and monitor various types of liver disease. Tests are grouped based on the liver's excretory, metabolic, detoxification, storage and synthetic functions. Enzyme tests like ALT and AST indicate hepatocyte damage, while elevated ALP and GGT suggest cholestasis. Protein tests such as albumin, PT and AFP evaluate synthetic function. Bilirubin, bile salts and dye excretion tests examine excretory function. Together these tests provide insight into liver health and disease categories.
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this is a series of notes on clinical pathology, useful for undergraduate and post graduate pathology students. Notes have been prepared from standard textbooks and are in a format easy to reproduce in exams.
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2. A 58-year-old female with diabetes and elevated liver enzymes was evaluated. She had a history of elevated enzymes attributed to lipid medication years ago. Current labs showed elevated AST and ALT with normal ALP and GGT. She had weight gain and abnormal lipid profile.
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1. Bilirubin is formed from heme in reticuloendothelial cells and transported to the liver bound to albumin.
2. In the liver, bilirubin is conjugated with glucuronic acid and secreted into bile.
3. In the intestines, bilirubin is deconjugated by bacteria and converted to urobilinogens which are excreted or reabsorbed, completing the enterohepatic cycle.
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these clearance test plays an very important role in determining the functioning capacity and working status of kidney.
and we estimate how amount of compund is excreted in the urine and absorption too.
and i also attached the mathematical caluculation to identify the metabolic valuve of urea, creatinine, inulin clearance by kidney.
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1) Water is the most abundant component of the body, accounting for 60-70% of total body weight in adults. Humans can survive one month without food but only about a week without water.
2) Water content varies between tissues and changes with age. It is regulated to maintain homeostasis through thirst, antidiuretic hormone secretion, and kidney function.
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The document discusses liver function tests and the clinical significance of various enzymes and biomarkers. It is divided into several sections that cover: the functions of the liver; classification of liver function tests into groups that indicate hepatocellular damage or cholestasis; specific enzymes such as ALT, AST, ALP, GGT and their levels in different liver conditions or diseases; clinical cases and how to interpret abnormal enzyme profiles and biomarkers.
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Liver Function Test
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Uploaded for my own convenience
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this is a series of notes on clinical pathology, useful for undergraduate and post graduate pathology students. Notes have been prepared from standard textbooks and are in a format easy to reproduce in exams.
JAUNDICE
This document discusses hemoglobin and bilirubin metabolism. It describes how bilirubin is formed from the breakdown of heme in red blood cells by heme oxygenase. Bilirubin is conjugated in the liver by UDP-glucuronyltransferase and excreted in bile or urine. Jaundice can result from hemolytic, hepatic, or obstructive causes that increase bilirubin levels. Neonatal jaundice is also discussed, which can cause kernicterus if bilirubin levels become too high.
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Liver function tests (LFTs) evaluate liver health and detect liver damage. LFTs measure enzymes released from damaged liver cells (ALT, AST), synthetic function (albumin, clotting factors), and signs of obstruction (bilirubin, ALP, GGT). Elevations in ALT and AST indicate hepatocyte injury while increased bilirubin, ALP, and GGT suggest cholestasis or blockage of bile flow. LFTs help diagnose liver diseases, determine severity, monitor treatment effectiveness, and assess operative risk or need for transplantation.
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The document discusses kidney function testing and the urinary system. It provides information on various tests used to evaluate kidney function, including clearance tests to measure glomerular filtration rate (GFR) using creatinine, urea, and uric acid. Clearance tests determine the rate at which the kidneys filter these waste products from the blood into urine. The document also discusses factors that affect interpretation of test results and when assessment of renal function is recommended.
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GGT is one of a large group of enzymes “Peptidases”.
A membrane bound enzyme whose active site faces the external side of cell.
Hepatobiliary tract enzyme.
Renal function tests
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Enzymes in liver disorders presentation with cases
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1. A 65-year-old male presented with fever, abdominal pain, distension, and jaundice for 4 weeks. Imaging showed a diffuse process in the liver. Liver biopsy revealed adenocarcinoma infiltration of the liver.
2. A 58-year-old female with diabetes and elevated liver enzymes was evaluated. She had a history of elevated enzymes attributed to lipid medication years ago. Current labs showed elevated AST and ALT with normal ALP and GGT. She had weight gain and abnormal lipid profile.
3. The first case describes a patient with diffuse liver lesions found to be metastatic adenocarcinoma on biopsy. The second case involves a patient with metabolic risk factors and elevated aminExamination of sgpt
Alanine aminotransferase (ALT) is an enzyme found primarily in the liver and kidney that was originally referred to as serum glutamic pyruvic transaminase (SGPT). ALT levels are normally low in the serum but increase with liver damage and are used to screen for and monitor liver disease. The ALT test works by measuring the conversion of L-alanine and α-ketoglutarate to pyruvate and glutamate by SGPT, and then measuring the intensity of the brown colored complex formed between pyruvate and 2,4-dinitrophenyl hydrazine. Elevated ALT can indicate liver damage from viral hepatitis, toxins, drugs, tumors, or chronic liver
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Heme catabolism occurs in multiple stages:
1. Bilirubin is formed from heme in reticuloendothelial cells and transported to the liver bound to albumin.
2. In the liver, bilirubin is conjugated with glucuronic acid and secreted into bile.
3. In the intestines, bilirubin is deconjugated by bacteria and converted to urobilinogens which are excreted or reabsorbed, completing the enterohepatic cycle.
urea, creatinine,inulin clearance test.pptx
these clearance test plays an very important role in determining the functioning capacity and working status of kidney.
and we estimate how amount of compund is excreted in the urine and absorption too.
and i also attached the mathematical caluculation to identify the metabolic valuve of urea, creatinine, inulin clearance by kidney.
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This document discusses water and electrolyte balance in the human body. It covers several key points:
1) Water is the most abundant component of the body, accounting for 60-70% of total body weight in adults. Humans can survive one month without food but only about a week without water.
2) Water content varies between tissues and changes with age. It is regulated to maintain homeostasis through thirst, antidiuretic hormone secretion, and kidney function.
3) Sodium, potassium, and chloride are the major electrolytes and their plasma levels are tightly controlled. Imbalances can cause dehydration or water retention.
4) Diuretics are sometimes used to treat water
Albumin
Albumin is the most abundant plasma protein, accounting for about half of plasma protein mass. It serves important functions such as maintaining colloid osmotic pressure and transporting compounds like fatty acids, drugs, and metals. Albumin is synthesized primarily by the liver and has a half-life of 15-19 days. Low albumin levels can result from decreased synthesis, increased losses, or redistribution to extravascular spaces. Key tests for albumin involve dye-binding or immunological methods, with reference intervals of 3.5-5.2 g/dL in healthy adults.
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Rhabdomyosarcoma is a malignant tumor of skeletal muscle that presents with different stages of maturation including immature rounded cells with pink cytoplasm and peripheral nuclei or large polyhedral cells with clear cytoplasm. Synovial sarcoma has variants including rounded cells arranged in sheets separated by clefts or spindle cells arranged in storiform patterns. It exists in monophasic or biphasic forms and is malignant. Leiomyosarcoma is a malignant soft tissue tumor of smooth muscle composed of spindle cells in different patterns including lines and whorls.
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This document summarizes the microscopic features of four different tumor types: liposarcoma, papillary thyroid carcinoma, chondrosarcoma, and squamous cell carcinoma. Liposarcoma is a malignant tumor arising from adipose tissue composed of mature adipocytes. Papillary thyroid carcinoma is a malignant tumor of the thyroid gland forming arborizing papillae. Chondrosarcoma is a malignant tumor of chondroblasts forming chondroblastic cell proliferation. Squamous cell carcinoma is a malignant tumor of squamous epithelium forming cell nests with keratin pearls.
Pathology (growth characters of tumor)
This document summarizes the key characteristics of four different tumor types:
1) Fibroma is a benign tumor arising from fibroblasts that contains mature and immature fibrous tissue with elongated spindle-shaped cells.
2) Leiomyoma is a benign smooth muscle tumor containing bundles of smooth muscle fibers in a whorl pattern and spindle-shaped fibroblast cells.
3) Thyroid adenoma is a benign glandular tumor composed of normal-looking follicles filled with colloid.
4) Adenocarcinoma is a malignant glandular tumor with abnormal acini and epithelium that shows signs of malignancy like irregular shapes and increased mitosis.
Pathology (cell injury and necrosis)
This document summarizes four pathology slides showing different types of cell injury and necrosis: 1) A slide showing inflammatory cells in alveoli, diagnosed as acute pneumonia; 2) A slide showing caseation necrosis, chronic inflammation and giant cells, diagnosed as early tuberculosis; 3) A slide showing infarcted kidney tissue without nuclei, diagnosed as kidney infarction; 4) A slide showing normal and infarcted myocardial tissue, diagnosed as myocardial infarction.
Pathology (cell adaptation)
The document discusses cells showing signs of fatty change in the heart and liver. For the heart sample, slides showed cells with vacuolated cytoplasm and peripheral nuclei, known as signet ring cells, leading to a diagnosis of fatty change in the heart. A similar sample for the liver showed the same cellular features and was diagnosed as fatty change in the liver.
Pathology (atherosclerosis)
This document summarizes four cases:
1. Capillary hemangioma, characterized by dilated vascular channels lined by endothelium containing red blood cells and separated by stroma.
2. Cavernous lymphgioma, characterized by dilated lymphatic channels lined by endothelium containing lymph and inflammatory cells and separated by stroma.
3. Hemangioendothelioma, characterized by nodules of epitheloid cells separated by stroma, containing intracytoplasmic vacuoles with red blood cells.
4. Kaposi Sarcoma, characterized by a dermal nodule of spindle cells forming slit-like vascular spaces containing erythrocytes.
Pathology (acute inflammation)
The document describes a pathology practical examining signs of acute inflammation under a microscope. The slide shows dilated blood vessels filled with red blood cells and the presence of neutrophils. The diagnosis is that these characteristics are signs of acute inflammation.
Pathology (histopathology of the cns)
This document describes four types of astrocytic brain tumors: (1) Pilocytic Astrocytoma, which contains nodules with dense clusters of astrocytic cells and Rosenthal fibers; (2) Fibrillary Astrocytoma, which has an uneven distribution of astrocytes due to increased cell number; (3) Anaplastic Astrocytoma, which exhibits abnormal mitosis and uneven astrocyte distribution with low vascularity; (4) Glioblastoma Multiform, which demonstrates signs of malignancy like abnormal mitosis, hemorrhage and necrosis as well as highly vascular structures.
Skill lab 1 (taking pulses)
1. This document discusses how to take and assess pulses, including rate, rhythm, volume, and abnormalities. Key points include regular vs. irregular rhythm and normal vs. weak volume.
2. Specific locations for taking pulses are outlined, such as radial, femoral, popliteal, dorsalis pedis, and posterior tibial pulses. Differences like a delay between radial pulses or radial and femoral pulses can indicate issues.
3. Diagrams show the locations of peripheral pulses in the upper and lower limbs, such as the carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibial pulses.
Skill lab (plastic surgery)
A 35-year-old patient came to the emergency room with burns on his chest. His weight is 72 kg and the burned surface area is 18% of his total body surface area. Using the formula for calculating IV fluid replacement in burned patients, which is body weight x burned surface area / 2 x 4, the amount of fluid resuscitation needed for this patient is 2.5 liters.
Skill lab (hematology, physiology, microbiology, biochemistry)
The document summarizes several laboratory tests and procedures used in hematology, physiology, microbiology, and biochemistry. It describes bleeding time and coagulation time tests to assess platelet function. It also outlines the hematocrit test procedure to measure red blood cell volume percentage, and the blood grouping test to determine blood type based on antigen-antibody reactions. Procedures for blood culture collection and centrifugation to separate blood components are provided. Finally, it explains hemoglobin electrophoresis to measure different hemoglobin molecules and identify potential abnormalities.
Skill lab (basic examination)
The document outlines the 4 main techniques of physical examination: inspection which is examining the patient's body visually, palpation which involves touching inflamed areas of the body, percussion which is tapping parts of the body to compare sounds, and auscultation which uses a stethoscope to listen to body sounds. These techniques - inspection, palpation, percussion, and auscultation - form the basic physical examination.
Skill lab endocrineology (hormonal panel with different clinical problem &a...
This document provides information on various endocrine-related topics including glucose tolerance testing, thyroid function testing, clinical examination of thyroid swellings, radiology of the pituitary, thyroid, and adrenal glands, and anti-thyroid drugs. It includes definitions, test types, results and interpretations, descriptions of clinical findings, imaging views and structures seen, and indications and side effects of drugs. The document aims to educate on evaluating and managing endocrine-related conditions through laboratory and imaging tests and pharmacological treatment.
Skill lab emergency (first aid and iv injection)
Triage is the process of prioritizing patients' treatment based on the severity of their condition. There are four categories ranging from red/immediate for life-threatening conditions to black/expectant for those who are dead. The ABCDE method is used to assess airway, breathing, circulation, disability, and exposure during triage. Intravenous cannulation involves inserting a tube into a patient's vein for infusions. The procedure has 15 steps including preparing equipment, identifying a vein, inserting the cannula, securing it, and checking for proper placement.
Skill lab physiology (motor examination tests)
This document outlines the components and process of performing a motor examination. It describes examining muscle mass, tone, power, coordination, gait, and reflexes. Deep tendon reflexes are tested using a reflex hammer at sites including the biceps, triceps, patella, and Achilles tendons. Abnormal reflex responses include spasticity, rigidity, and hypotonia. Motor strength is graded on a scale from 0 to 5. The plantar reflex test assesses upper motor neuron function.
Physiology (sensory examination tests)
1. The document outlines various tests used in sensory examination including tests for touch, pain, temperature, vibration, hearing, vision, and cortical sensations.
2. It describes the instruments used and procedures for tests like the two point discrimination test, Rinne's test, and Weber's test.
3. The tests assess primary sensations, cortical sensations, hearing, vision, and help identify lesions in the sensory cortex.
Physiology (measurement of arterial blood pressure)
This document summarizes the measurement of arterial blood pressure. It defines systolic and diastolic blood pressure as the force exerted on blood vessel walls during contraction and relaxation. It explains that blood pressure is typically measured in the brachial artery using a sphygmomanometer and stethoscope, by listening for sounds during inflation and deflation to determine the systolic and diastolic readings in mmHg. Finally, it outlines two methods for measuring blood pressure - palpation of the radial pulse to find systolic pressure only, or auscultation of the brachial pulse over the brachial artery to determine both systolic and diastolic pressure.
Physiology (heart sounds)
This document describes the four main heart sounds and how to auscultate them using a stethoscope. It explains that the first heart sound corresponds to closure of the atrioventricular valves and the R wave of an ECG. The second heart sound corresponds to closure of the semilunar valves and the T wave of an ECG. The third heart sound occurs during rapid ventricular filling between the T and P waves. The fourth heart sound corresponds to atrial contraction between the P and Q waves. It identifies the best areas over the heart to auscultate each sound using a stethoscope.
Physiology (electrocardiography ecg)
An electrocardiogram (ECG) records the electrical activity of the heart over time using electrodes placed on the skin. An ECG is used to detect abnormalities in heart rhythm and function by measuring the heart's electrical signals through 12 leads that include 6 chest leads and 6 limb leads. The heart rate can be calculated from an ECG by counting the number of big squares between two R waves in a cycle and dividing 300 by that number.
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- 1. Biochemistry Practical (Liver Function Tests) By : Osama Al-Zahrani @OSAMA_Z96
- 2. Normal Levels Liver Protein & Enzymes 7 - 55 U/LAlkaline Transferase (ALT)1 8 - 48 U/LAspartate Transferase (AST)2 45 - 115 U/LAlkaline Phosphatase (ALP)3 3.5 - 5 g/dLAlbumin4 6.3 - 7.9 g/dLTotal protein5 0.1 - 1.2 mg/dLBilirubin6 9 - 48 U/LGamma-Glutamyl Transferase (GGT)7 122 - 222 U/LLactate Dehydrogenase (LD)8 9.5 - 13.5 secondsProthrombin Time (PT)9 Normal blood test results for typical liver function tests include:
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- 5. Sample Start (25C) : Sample : 100 uL Monoreagent : 1000 uL 405 nm X 1158 Monoreagent : (4 Part of R1 + 1 Part of R2) Mix Gamma-Glutamyl Transferase (GGT)
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