00:01
Now, let's take a look at
the liver function tests.
00:03
Okay.
00:04
Don't feel overwhelmed.
00:06
That's normal when you look at
all this like, oh my goodness.
00:09
How am I going to
remember all this?
Relax, we've got you covered.
00:14
Okay these are the
four specific enzymes
we're going to look at
ALT, AST, ALP and GGT,
you do notice that it in use
those big long fancy names right?
Because when we're speaking
to each other in the hospital,
That's what we call these.
00:31
Now, you need to understand
that they stand for
a very long name,
but we always use
that shortened version
when we are communicating
with each other.
00:40
These are four important enzymes
that are made in the liver
and a few other places in
your body that I'll go over
as we walk through each one.
00:49
Keep in mind an
enzyme is a protein
that helps trigger
chemical reaction
that your body
needs to function.
00:56
So we're going to
break down each one,
but what I want you to
take away from this slide
before we even move
forward is that
each one of these four important
enzymes are looked at together.
01:08
This is what helps give us
a complete clinical picture
of what's going on
with our patient.
01:14
Another thing,
look at AST and ALT,
see this makes me happy because
those normal values
are the same.
01:23
So that's a fairly
easy one to remember.
01:26
There are so many lab
values to remember,
I love it when one seems
pretty straightforward,
so I want to make sure that you focus
on memorizing those normal values
and you can use are
remembering tools,
our spaced repetition
tools to help you do that.
01:44
So let's start with AST.
01:46
Now, I'm not going to spend a
whole lot of time on this one
because I got something
better for you.
01:52
But keep in mind we're going
to take a look at this,
AST, it's an enzyme,
its normal value is 0 to
35, but this
This is the one I want you to
put a star by in your notes, ALT.
02:06
Now this one is more
specific for the,
liver.
02:10
You got it when they do just
with my nursing students,
I always say okay guys,
I know this means loser
but it also means liver.
02:17
So if I'm thinking
about AST and ALT,
alt is more specific
for the liver.
02:23
Let me help you understand why.
02:25
ALT is normally found
inside the liver cells,
but when your liver is damaged or
even inflamed you see that itís,
the ALT can be released
into your bloodstream.
02:39
That's when we got it
because this will cause your
serum ALT levels to rise.
02:45
So when someone calls and draws a
blood sample to take it to the lab,
an ALT is elevated
that means your liver
cells have been damaged.
02:56
Alt has been released
into the bloodstream
and that's why we're
able to detect a level
that's higher than
normal on lab work.
03:04
Okay now some other names is
goes by you might see it as SGPT,
or you might see it as an
alanine transaminase test.
03:12
You've got those other names,
but normally you'll hear
us refer to it as an ALT.
03:17
So just a quick review which one
is more specific for liver enzymes.
03:23
AST or ALT?
ALT, you got it,
It's the liver tests.
03:29
Now we look at all four of these
tests together to get a full picture,
but I'm going to tell you the
strengths and weaknesses of each one.
03:38
Now next up, we've got GGT.
03:40
A normal value,
there is nine to 48.
03:42
Now GGT is concentrated
in the liver.
03:46
Remember I told you these
are mostly from the liver
but they can come from
other parts on your body.
03:50
Right GGT is an
example of that one.
03:54
It's concentrated in the liver,
but it's also present in the gallbladder,
the spleen,
the pancreas and the kidneys.
04:02
So GGT blood levels are usually
high when the liver is damaged,
pair that with an ALT
level that's high.
04:10
Now we're starting to really
focus the clinical picture.
04:14
Now last up the ALP test,
this measures the amount
of alkaline phosphatase
enzyme in your bloodstream.
04:20
That's why we call
it the ALP test.
04:23
Now your liver is one of
the main sources of ALP.
04:28
But some of its also made in your
bones, in your intestines,
in your pancreas,
and your kidneys.
04:32
Don't let that get
you distracted.
04:35
So the liver is one of
the main sources of ALP
and that's really what
we're focusing on here.
04:42
Now, there is a side note,
I want to bring to your attention.
04:45
If a patient is pregnant ALP
is also made in the placenta.
04:50
So just like anything
lab values mean nothing
unless you compare them to specific
variables about your patient,
but here's kind of an overview
when you're looking at these
four important liver enzymes.
05:02
I want to look at them together
to get a full clinical picture.
05:06
Remember,
ALT is more specific than AST,
but they share the same value.
05:11
We're also going
to look at the GGT
and the ALP to get a
complete clinical picture.