ARDMS Abdomen board- lab values

Alkaline phosphatase is a marker for

Bone CA

lactate dehydrogenase is a marker for

GI CA & Germ Cell Tumor

Carcinoembryonic antigen (CEA) is a marker for

Colorectal CA, Bile duct CA, breast CA, GI CA, esophageal CA, lung CA, thyroid CA, bladder CA, uterine CA

S 100 is a marker for

melanoma

Neurospecific enolase (NSE) is a marker for

Lung CA

Chromogranin A is a marker for

neuroendocrine tumors

CA19-9 is a marker for

Pancreatic CA, cholangiocarcinoma, GI tract CA, lung CA, colorectal CA

CA 72-4 is a marker for

Gastric, ovarian & colorectal CA

CA 15-3/CA 27-29 markers for

Breast CA

Beta 2 microglobulin is a tumor marker for

Chronic lymphocytic leukemia, multiple myeloma & lymphoma

Biliary obstruction causes

Elevated ALP, direct conjugated bilirubin & GGT

Causes of elevated aminotransferases

Fatty liver, meds, excessive alcohol intake, heart failure, Hep A, B or C, autoimmune hepatitis & inherited disorders

Alkaline Phosphatase (ALP)

Rises in disorders of liver & GB when excretion is impaired (ex obstruction)

Aspartate aminotransferase (AST)

Increase in presence of liver cell necrosis such as in viral hepatitis

Increases with hepatocellular injury (and injury in other tissues, e.g. skeletal and cardiac muscle)

What secretes amylase

Pancreas

Kidneys

Salivary glands

AFP levels are always normal with

Seminomas

Normal LFTs occur with

Simple cysts

Hemorrhagic cysts

Adenoma

Hemangioma

FNH

glycogen storage disease

Cirrhosis causes increased

Indirect bilirubin

Increased serum aldosterone causes

Reduced urine output & increased blood volume in the body

blood urea nitrogen (BUN)

Waste product from protein metabolism

Unsuitable as single measure of renal function because it varies with urine flow rates & production of urea

Serum Creatinine

Breakdown product of skeletal muscle

Filtered out by kidneys

Levels vary from 1.2-2.9

Hypoalbuminemia

Low protein can be caused by liver failure, nephrotic syndrome or malnutrition

Causes of elevated bilirubin

Biliary obstruction

Elevated serum alpha feta protein is caused by pregnancy and

HCC

germ cell tumor

Occasionally pancreatic, stomach or biliary system cancers

Can be modestly elevated in hepatitis & cirrhosis

AST elevation can be caused by

Acute hepatic disease or recent myocardial infarction

Hepatocellular dysfunction (ex hepatitis) Can cause elevated

Indirect bilirubin

Labs to evaluate liver function

GGT

ALT

direct & indirect bilirubin

Aspartate aminotransferase (AST) evals for

Acute hepatic disease

prostate-specific antigen (PSA)

blood test used to screen for prostate cancer

Upper limit of normal 4ng/ny

Increased AST without ALT occurs with

Myocardial infarction, heart failure, muscle injury, CNS disease & nonhepatic disorders

AST (SGOT)

Present in liver, heart, skeletal, muscle, kidney & brain so elevation is not specific but is elevated in almost all significant hepatocellular disease

AFP (alpha-fetoprotein) elevated in

HCC, germ cell tumors, Mets & hepatoblastoma

High levels are very suggestive of HCC

Thyroid venous blood is drained via

Superior & middle thyroid veins into internal jugular vein

Inferior thyroid vein into innominate veins

Glomerular Filtration Rate (GFR)

Calculated by determining creatinine clearance

Requires measurement of serum creatinine, urine creatinine & 24hr urine volume

(Urine creatinine x urine volume)/ serum creatinine

Arteriovenous shunts

Connection btw artery & vein

Presents as bruit or thrill, hypertension, cardiomegaly & heart failure