Module 6: Diagnostic Tests 1 (Liver and Gallbladder)

Liver Function:

• The Liver Function Tests (LFTs) panel checks the level of what 2 things?

• Liver Enzymes (ALT, AST, ALP)

• Liver Proteins (Albumin and Bilirubin)

Liver Function:

• Albumin and Total Protein:

  • What does LOW Albumin indicate as the Liver produces Albumin?

  • A Decrease may signal what?

• LOW = Reduced Liver Synthetic Function

• Decrease = Advances Liver Disease

Liver Function:

• Gamma Glutamyl Transferase (GGT):

  • ELEVATED GGT levels suggest what?

  • GGT is often used along side ____ to do what?

• Elevated = Liver or Bile Duct Issues

• Used alongside ALP to pinpoint liver problems

Liver Function:

• Alanine Aminotransferase (ALT):

  • ELEVATED ALT levels suggest what?

    • Since enzyme is mainly found where?

• Elevated = Liver Cell Damage

  • Found in the Liver

Liver Function:

• Aspartate Aminotransferase (AST):

  • AST is found where?

  • HIGH levels, along with elevated ____, can indicate what?

• Found = Liver (and other organs)

• ALT, HIGH = Indicate Liver Damage

Liver Function:

• Alkaline Phosphatase (ALP):

  • ALP is an enzyme that is present where?

  • HIGH levels can signal what?

    • Particularly issues w what?

• Present in Liver, Bile Ducts, and Bones

• HIGH = Liver Disease

  • Issues w Bile Duct or Obstruction

Liver Function:

• Bilirubin:

  • INCREASED Bilirubin levels lead to what?

    • How can this occur?

      • Due to what?

• INCREASED = Jaundice

  • If Liver is unable to process Bilirubin efficiently

    • Due to Liver Disease or Bile Duct Blockages

Liver Function:

• Prothrombin Time (PT)

  • Measures what?

    • Which can be affected by what?

  • INCREASED time indicates what?

• Measures:

  • How long it takes blood to clot

    • Liver Function

  • INCREASED = Liver Dysfunction

Liver Function:

• Ammonia Levels:

  • ELEVATED in cases of what?

  • Liver converts ammonia to what?

• ELEVATED = Liver Dysfunction

• Urea

Liver Function:

• Alpha Fetoprotein (AFP):

  • When is this elevated?

    • Especially what type?

• Liver Cancers

  • Hepatocellular Carcinoma

Live Function:

• What are the 3 Imaging tests for Liver Function?

• US

• CT Scan and MRI

• FibroScan

Liver Function:

• US

  • Considered what?

  • Can identify what?

  • Can detect what?

• US:

  • FIRST Line Imaging Test

    • General Scan

  • Identify abnormalities in:

    • Liver Shape, Size, or Tecxture

  • Detect:

    • Cysts

    • Tumors

    • Gallstones

Liver Function:

• CT and MRI

  • Provides what?

  • Helps identify what 3 things

• FibroScan:

  • What type of modality is it?

  • Used to assess for what?

  • Often used for what diseases?

• CT MRI:

  • Provide detailed cross sectional images

  • Help identify:

    • Tumors, Cysts, Liver Lesions

• FibroScan:

  • Specialized US

  • Asess Liver Fibrosis and Stiffness

  • Chronic Liver Diseases

Liver Function:

• What does a Liver Biopsy involve?

• What does it provide?

• Involve

  • Removing small tissue sample for mircoscopic exam

• Provide

  • Direct insight into:

    • Inflamm

    • Scarring

    • Other Liver Changes

Gallbladder Function:

• What is the Primary Imaging Test for Gallbladder Problem?

• What can this Imaging Test detect in Gallbladder and Bile Duct? (3)

• US

• Detect:

  • Inflamm

  • Gallstones

  • Signs of Infection

Gallbladder Function: US

• US:

  • What is a Hepatobiliary Iminodiadcetic Acid Scan (HIDA Scan)?

  • What 2 conditions does it help diagnose?

• HIDA

  • Nuclear medicine test that evaluates Gallbladder Function by tracking the flow of bile through the bile ducts

• Helps diagnose:

  • Cholecystitis

  • Bile Duct Obstruction

Gallbladder Function: CT Scan

• CT Scan

  • What is a CT Scan used to detect?

  • What does it provide compared to US?

  • Can visualize what?

• Gallstones, Inflamm, Complications (Gallbladder Rupture or Pancreatitis)

• More detailed image tnan US

• Visualize surrounding structures

Gallbladder Function: EUS

• Endoscopic US (EUS):

  • EUS combines what 2 modalities to obtain what?

  • Especially useful if there are what?

• Endoscopy and US to obtain highly detailed images of the gallbladder, bile duct, and nearby structures

• Small Stones or Sludge in Bile Duct

Gallbladder Function: MRCP

• Magnetic Resonance Cholangiopancreatography (MRCP):

  • Special type of MRI that focuses on what 2 ducts?

  • MRCP is a NON invasive way to detect what?

• Bile and Pancreatic Duct

• Stones, Tumors, or Structures in Bile Duct

Gallbladder Function: ERCP

• Endoscopic Retrograde Cholangiopancreatography (ERCP)

  • Combines what 2 modalities to examine what?

    • Primarily to identify what?

  • Can also be used to:

    • Remove…

    • Place…

• Endoscopy and X ray to examine bile duct

  • Blockages

• Used to:

  • Remove stones

  • Place stents to relieve blockages

Gallbladder Function:

• Blood Tests:

  • Are Blood Tests specific to the Gallbladder?

  • What can Blood tests indicate? (3)

  • Common tests include what 3?

• NAUR

• Indicate:

  • Infection

  • Inflamm

  • Bile Duct Obstruction

• Common

  • Liver Function tests (especially ALP and Bilirubin)

  • Amylase

  • Lipase