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Pathology > C - LFTs > Flashcards

C - LFTs Flashcards

1
Q

7 functions of the liver

A

Intermediary metabolism
Protein synthesis
Xenobiotic metabolism
Hormone metabolism
Bile synthesis
BR metabolism and transport
Reticuloendothelial function - eg Kupffer cells

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2
Q

Examples of intermediary metabolism done in liver (3)

A

Ammonium / AAs
Lactic acid
Glycogenolysis and storage

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3
Q

2 examples of xenobiotic metabolism in liver

A

P450 enzyme system
Conjugation

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4
Q

Name the LFTs

A

AST, ALT, AFP, BR, ALP, albumin

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5
Q

Which LFTs are markers of damage

A

ALT, AST, ALP, GGT

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6
Q

Which LFTs are markers of synthetic function

A

PTT, albumin

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7
Q

Which LFT is a tumour marker

A

AFP

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8
Q

Where are AST / ALT found

A

Hepatocyte cytoplasm

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9
Q

What do AST / ALT do

A

AA metabolism

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10
Q

When are AST/ ALT released

A

Hepatocyte damage / death

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11
Q

Where else are AST and ALT found

A

Muscle
Kidney
Brain
Pancreas

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12
Q

Which enzyme is raised most in liver damage

A

ALT

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13
Q

Which enzyme is raised most in alcohol / cirrhosis

A

AST

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14
Q

What ratio of AST:ALT indicates severe liver cirrhosis

A

> 2:1

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15
Q

Where is GGT found (2)

A

Hepatocytes
Gallbladder

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16
Q

What causes raised GGT

A

Alcohol

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17
Q

When is ALP released

A

Bile duct injury
Obstructive jaundice

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18
Q

Where else is ALP found

A

Bone
SI
kidney
WBCs
Placenta

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19
Q

What does a really high ALP indicate

A

Mets
Pregnancy

20
Q

What is the half life of albumin

A

20 days

21
Q

Purpose of albumin

A

Increase oncontic pressure
Binds steroids / drugs / BR / calcium

22
Q

What does a low albumin indicate

A

Chronic liver disease
Malnutrition
Sepsis - 3rd spacing

23
Q

Half life of PTT

A

Hours

24
Q

What does deranged PTT show

A

ACUTE liver dysfunction

25
Q

What does a raised AFP indicate (3)

A

Hepatocellular carcinoma (70-80%)
Pregnancy
Testicular cancer

26
Q

What BR level would cause jaundice

A

> 20 - 30

27
Q

Which type of BR appears in urine

A

Conjugated

28
Q

Causes of high BR with normal LFTs

A

Haemolysis
Gilbert’s

29
Q

Where is the pathology if high BR with high AST/ALT

A

Hepatocellular

30
Q

Where is the cause if high BR with high ALP

A

Cholestatic

31
Q

Causes of cholestatic high BR with dilated ducts

A

Gallstones
Cancer

32
Q

Causes of cholestatic high BR with undilated ducts

A

PBC
PSC
pregnancy

33
Q

What BR product appears in urine physiologically

A

Urobillinogen

34
Q

What causes high urobilinogen in urine

A

Haemolysis
Hepatitis
Sepsis

35
Q

List other components in a liver panel (9)

A

Fasting lipids / glucose
Coeliac serology
Hepatitis serology
Alpha 1 antitrypsin
Caeraloplasmin
Liver ABs - aSMA / AMA
Igs
Ferritin
ANCA

36
Q

What is the marker for Wilson’s

A

Caeraloplasmin

37
Q

What level of caeraloplasmin indicates Wilson

A

LOW - high is normal

38
Q

Name some super specialised liver tests

A

Tumour markers
Iron studies
Liver biopsy
Viral DNA / RNA
24hr urinary copper
CT / MRCP / MRI
endoscopic USS

39
Q

When would you measure serum bile acids

A

Obstetric cholestasis

40
Q

Gold standard for diagnosing liver pathology

A

Biopsy (++ invasive and bleeding)

41
Q

Alternative to liver biopsy for assessing fibrosis

A

Fibroscan - vibrating USS

42
Q

Which ABx can cause hepatic Sx

A

Augmentin - given for UTI

43
Q

Courvoisier’s law & indication

A

Painless jaundice is pancreatic cancer

44
Q

Causes of ALT in the thousands

A

Toxins
Viral
Ischaemia

45
Q

What is a good marker of acute liver injury

A

INR

Pathology (87 decks)

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