13, 14. LFTs, what LFT abnormalities mean, patterns of abnormal LFTs in jaundice of different causes

Question 1

List the so called “liver-function tests” (6)

Answer 1

GGT (gamma glutamyl transpeptidase)
AST/ALT ratio (aspartate transaminase/alanine transaminase)
Alkaline phosphatase
Bilirubin
Albumin
PPT (prothrombin time)

Question 2

In post-hepatic jaundice, what LFTs would show an increase in level?

Answer 2

Bilirubin
GGT
Alkaline phosphatase

Question 3

What does it mean when albumin levels are low?

Answer 3

Chronic liver disease

can also be an indicator in protein deficiency/malnourishment

Question 4

What does it mean when there is an increase in PPT?

Answer 4

The synthesis impairment is short term

Question 5

What LFT shows an increase in hepatocyte damage/hepatic jaundice?

Answer 5

AST/ALT ratio

Question 6

If alkaline phosphatate is raised but all other LFTs are normal, what is the potential diagnosis?

Answer 6

Bone related disorder

Question 7

What would raised GGT potentially indicate?

Answer 7

Alcohol consumption
Liver disease (cirrhosis, hepatitis)/obstruction - ALP will also be raised
Diabetes, congestive heart failure, pancreatitis

Question 8

What marker increases depending on the degree of inflammation of the liver?

Answer 8

AST/ALT - enzymes present in hepatocytes

Present in the liver but may leak into the blood due to inflammation of the liver

Question 9

What is ALP a marker of and where is it mainly found?

Answer 9

Mainly found in bile ducts
Marker of cholestasis/obstruction
Used with GGT to confirm the raised levels are from the liver/bile ducts