Amylase and Lipase – Blood Tests for Biliary Disease (Nursing)

00:00 Amylase and lipase are going to tell us what's up with your pancreas.

00:04 So we let's break these down a little bit.

00:07 Oh, you probably didn't even get that joke, right, but amylase, lipase, their job is to break things down.

00:13 So let me break down the knowledge for you right now.

00:16 Blood levels amylase and lipase cries really quickly after an injury.

00:21 So it could be within a shorter time as one hour of damage to the pancreas that you start to see these lab values rise.

00:29 Now usually, we're looking for two to four times the upper limit of the normal value.

00:33 That's what we want to see before we can really diagnose pancreatitis.

00:39 Now have you noticed we kind of switched organs here.

00:42 We're talking about the pancreas when this is a video on cholecystitis, but you're clever, you know how these all fit together, right? You know, there's plumbing.

00:52 There's hepatobiliary duct system that connects the liver, the gallbladder, and the pancreas.

00:59 So if we have a blockage in there in just the right spot with a stone, a gallstone.

01:04 Then things are going to back up and damage the organs that are upstream, the pancreas being one of them.

01:11 So let's talk about this amylase, you know where it starts? Yeah, right here.

01:17 Amylase is secreted in the salivary glands and it's also secreted by the pancreas.

01:23 So when we're talking about the amylase in your spit, it's also amylase secreted by your pancreas to help you digest foods.

01:31 Now it has a pretty short half-life of about 12 hours.

01:35 So we often use lipase as a better option for diagnosing acute pancreatitis, but we use them together.

01:43 Remember when we talked about liver enzymes, AST, ALT, ALT was more specific for liver.

01:50 When it comes to diagnosing pancreatitis, we're going to look more closely at lipase over amylase, but we look at them both.

02:00 Now. Do you remember what amylase does? Oh just start thinking about a really gooey pizza, right, with lots and lots of cheese.

02:08 Well amylase is job is to digest those delicious starches and glycogen. Related to polysaccharide So it just helps us break those apart.

02:20 If I have damage to my pancreas, I'm going to have higher levels in my blood sample.

02:26 So if you come and draw a venous sample of blood, you run it for amylase, if I've had damage to my pancreas, I'm going to have higher serum blood levels of amylase.

02:36 Now normal ranges are 2 to 300, but this can vary by lab, by the patient's age, and even by their gender, so just a gentle reminder that you always need to take specific variables and apply them to your patients current status.

02:53 Eyes on the prize, one lab value does not a diagnosis make, you need to look at it in the context of your whole patient.

03:03 Now, let's take a look at lipase.

03:05 Lipase plays a really important role in the digestion of fats.

03:10 So a key thing about lipases that tissue concentration in the pancreas is hundred times more than the duodenum, the stomach, the adipose tissue, and the lungs.

03:20 Now the takeaway point from there is not for you to memorize all the different places, the concentration of lipase exist.

03:27 The important thing is to know the pancreas has a really high concentration of lipase.

03:34 So if the lipase levels are elevated in the blood that means we have a problem with the pancreas or pancreatitis.

03:42 Lipase increases 3 to 6 hours after onset of pancreatitis and peaks at about 24.

03:49 Now think back to amylase when we talked about that.

03:52 What was the timeframe and when you would see amylase levels rise? Correct.

03:58 It was within about an hour.

04:00 But remember the half-life of amylase is 12 hours, look at lipase, it has a longer half-life, their significant reabsorption in the renal tubules, so it remains elevated for, yeah, that's right, 8 to 14 days.

04:16 So remember as you're studying think about the things that are the same, think about things that are different studying by exception is recognizing the things that are different.

04:25 So lipase is going to take a longer to peak but it's going to stay up there for a lot longer than amylase will.

04:32 Why? Because lipase is reabsorbed by the kidneys.

04:36 And so that's why it can stay elevated for 8 to 14 days.

04:42 Now we have a normal range for you there, lipase serum less than 95, that's usually what we're looking at.

04:48 But sometimes a normal range can be up to a 160, see lipase is this enzyme that is found in pancreatic fluid, right? That's what we're focusing on because we're talking about pancreatitis and its job is remember convert fats to fatty acids and glycerol or other alcohols.

05:09 So one indication of pancreatitis, this is elevated lipase indicating we've got that lipase in the bloodstream instead of in those pancreatic juices.