61 Liver and pancreatic disease Flashcards
Which LFT is the only true test of function (as opposed to damage)?
Albumin.
Is ALT or AST more specific to the liver?
Why?
ALT more specific.
AST also found in muscle and red blood cells.
What is the tumour marker for primary hepatocellular carcinoma?
α-fetoprotein.
Which LFT’s rise in biliary tract damage? (3)
Conjugated bilirubin.
ALP and γGT.
Where is ALP synthesised? (4)
Liver.
Bone.
Intestine.
Placenta.
What can ALP be raised by in the bile tract? (4)
Cholestasis (bile blockage)
Infiltrative diseases
Space-occupying lesions (tumours)
Cirrhosis
What is γGT raised in? (8)
Structural liver damage. Alcohol. Enzyme inducers. Fatty liver. Heart failure. Prostatic disease. Pancreatic disease. Kidney damage.
What three biochemical markers of fibrosis make up the ELF score?
PIIINP.
TIMP-1.
Hyaluronic acid.
What are the hepatic causes of a raised unconjugated bilirubin? (4)
Pre-microsomal.
Microsomal.
Inherited conjugation disorders: Gilberts, Crigler-Najjar.
What are the hepatic causes of a raised conjugated bilirubin? (4)
Post-microsomal.
Intrahepatic obstruction.
Inherited excretion disorders: Dubin-Johnson, Rotor
What do 90% of people with a raised AST/ALT and a normal ALP have?
Hepatitis.
What do 90% of people with a normal AST/ALT and a raised ALP have?
Obstructive jaundice.
What is characteristically raised in alcoholic liver disease? (2)
IgA.
γGT.
What % of abnormal LFTs are caused by liver disease?
Other causes? (5)
1%
Alcohol, Gilberts, Obesity, Diabetes, Medication.
Which enzyme is faulty in inherited disorders of bilirubin conjugation?
UDP glucuronyl transferase.
