Which of the following not a function of the liver?

This enzyme found only in liver tissue and when elevated is suggestive of hepatocellular injury.

Common causes which may result in ALT and AST that are elevated <5 times the UNL (AST: 10-40 u/L, ALT: 7-56 u/L) includes which of the following?

Evaluation of liver chemistries include all of the following except

A patient presents to the ED for abdominal pain. LFTs show transaminitis with ALT of 75 (10-40 u/L) and AST of 187 (7-56 u/L). This ALT:AST ratio is indicative of which of the following?

Medications classes that can cause LFT elevations include which of the following?

The most common cause of acute liver failure in the US is?

A patient with a hx of IVDA is admitted to the ICU after being found to have acute liver failure. 2 weeks later his ALT and AST have returned to WNL, but he has hypoalbuminemia, an increased PTT, and thrombocytopenia. Which of the following would be you be most concerned about in this patient?

Markedly high transaminitis with ALT:AST >5x UNL (AST 10-40 u/L, ALT 7-56 u/L) raises concern for which of the following?

To determine the presence of acute HAV infection, which of the following lab should be ordered?

Immunity from HAV from either vaccination or previous infection will show which of the following?

Which of the following is most indicative of acute HBV infection?

A patient presents to your clinic for routine wellness check. When discussing vaccination the patient reports receiving the HBV, but would like to check a titer to confirm immunity. Which of the following tests should you order?

A patient is dx with Hep B. Their initial viral load is 2000 IU/mL or 2000 x 10⁴ copies/mL. The patient is started on TDF and instructed to follow-up. On repeat visit which lab test would be most helpful to assess the patients response to treatment?

The period in which HBsAg declines and HBsAb begin to accumulate typically occurring around 22 weeks after exposure is known as the ______ window?

To check for exposure to HCV which of the following tests should be ordered?

You are working at a GI clinic. A patient with a hx of chronic HCV presents for routine follow-up. They state during their last visit the hepatitis specialist told them they needed a "blood biopsy" to check for cirrhosis. Which of the following tests would you order to screen for cirrhosis?

Unconjugated bilirubin from old RBCs undergoes conjugation in which organ?

Bilirubin is bound to what protein to become conjugated bilirubin?

Lack of albumin production in the liver can result in increased levels of unconjugated bilirubin in the blood. This lipid soluble molecule can bypass the blood brain barrier resulting in a condition known as?

The most common causes of conjugated hyperbilirubinemia is decreased transport of bilirubin into the bile canaliculus or biliary tract obstruction.

Which of the following is not a symptom of hyperbilirubinemia?

A 28 y/o AA F presents to your clinic after noticing some yellowing tinting of her eyes and skin. PMH is positive for sickle cell anemia. Labs show an elevated bilirubin of 5.2 mg/dL (0.3-1.2 mg/dL) and LDH of 316 (140-280 U/L). You suspect this patient has what form of hyperbilirubinemia?

An 18 y/o M presents to the ER complaining of jaundice. The patient reports that he is currently taking his final exams in college and has been up all night cramming and eating junk food. He states he is asymptomatic and PE is unremarkable. Total bilirubin is 3.0 mg/dL (0.3-1.2 mg/dL) and direct bilirubin is 0.1 mg/dL (0.0-0.2 mg/dL). What is the most likely diagnosis?

Obstruction of bile flow from the liver which show an elevation in which of the following labs?

In situations where Alkaline phosphatase is elevated, what other labs should be ordered to help guide the diagnosis?

Elevations of AST/ALT compared to Alk phos are concerning for cholestasis.

GGT increases with age in men, but not in women.

Patients with chronic alcohol use who drink ≥3 beverages/day GGT has a limited specificity.

Gamma glutamyl transpeptidase plays an important role which of the following functions of the liver?

A patient that is currently pregnant would likely have an increase in which of the following tests?

A patient with a hx of chronic HCV infection presents for follow-up. Screening labs show an AFP of 25 ng/mL. Elevations of AFP are most indicative of what form of hepatic malignancy?

Elevated AFP is a diagnostic test for the presence of HCC?

Which of the following measure the synthetic function of the liver?

S/Sx of hypoalbuminemia include which of the following?

Albumin plays a role in maintaining oncotic pressure of blood vessels, thereby keeping fluid ___ blood vessels and ____ surrounding tissue.

Which of the following is not associated with hypoalbuminemia?

Which of the following measures the duration that a sample of blood takes to coagulate?

Patients who have cirrhosis will have an ____ PT/INR.

If a patient has cirrhosis and thrombocytopenia, what diagnostic study can be performed that can potentially be life saving?

Which of the following may be the reason for development of ascites?

Which of the following ascitic fluid tests is the best screen for the presence of portal HTN?

A SAAG of ___ g/L or greater can predict portal HTN with 97% accuracy.

An ascitic fluid with a protein concentration of <2.5 g/dL is suggestive of a _____ cause, while a protein concentration of >2.5 g/dL is suggestive of a _____ cause.

A patient with a hx of chronic ascites presents to the ED for severe abd pain that began 2 hours ago. Bedside paracentesis revels the following:

Gross appearance: Turbid (Clear)

Cell Count: WBC 750/uL (<250/uL), RBC: None (None)

Total Protein: 8g/dL (0.3-4.0g/dL)

Glucose: 5 mg/dL (7-10mg/dL)

Next step in treatment for this patient should include which of the following?

Patients with a ascitic fluid protein concentration <1 mg/dL have an increased risk of spontaneous bacterial peritonitis