Key messages

• Traditionally, biochemical tests of liver function give relatively little information about how well the liver is performing, as they are essentially indicators of hepatic dysfunction.

• Unconjugated hyperbilirubinemia occurs when the production of bilirubin exceeds the ability of the liver to remove and conjugate it.

• Conjugated hyperbilirubinemia occurs when there is leakage of bilirubin into the blood system, at or distal to the hepatocytes, when its normal route of excretion is blocked.

• The main value of the aminotransferases is in detecting hepatocellular damage and in monitoring the patient's progress. Alanine aminotransferase has greater hepatic specificity than aspartate aminotransferase.

• Serum levels of alkaline phosphatase enzymes rise in many types of liver disease, particularly where there is intra- or extrahepatic obstruction to the flow of bile and in the presence of intrahepatic space-occupying lesions such as tumors.

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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