Chemical Pathology 18 - LFT cases Flashcards

1
Q

What 2 LFT results are very suggestive of alcoholic liver disease?

A

AST: ALT > 2.0

High GGT

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2
Q

When is ALP most markedly elevated?

A

Bile duct damage/ obstructive jaundice

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3
Q

What is the half life of albumin?

A

20 days

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4
Q

Systematically recall some reasons why albumin may be low

A
  1. Low production (chronic liver disease/ malnutrition)
  2. Loss (gut/ kidney (nephrotic))
  3. Sepsis, “3rd sponge” - due to endothelial leaking
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5
Q

What is the best measure of acute liver function?

A

Prothrombin time

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6
Q

Recall 4 scenarios in which AFP is raised

A
  1. Pregnancy (physiolgically)
  2. Hepatocellular carcinoma
  3. Testicular cancer
  4. Hepatic damage/ regeneration
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7
Q

What are the 2 possible causes of jaundice when LFTs are normal?

A

Gilbert’s

Haemolysis

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8
Q

In a jaundiced patient with a raised ALP, what should your diagnostic approach be?

A

Do a USS
If dilated ducts: gallstones/ cancer
If undilated ducts: drugs/ PSC/PBC/ pregnancy

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9
Q

What in the LFTs would indicate that jaundice had a hepatocellular origin?

A

Raised ALT/AST as opposed to ALP

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10
Q

How can you identify obstructive jaundice clinically without measuring bilirubin?

A

Pale stool and dark urine

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11
Q

What is the ELF score, and how is it calculated?

A

Enhanced liver fibrosis score

Combines TMIP-1, P11 NP and HA in a clever algorithm

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12
Q

Which common drug is often implicated in cholestasis?

A

Augmentin (co-amoxiclav)

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13
Q

Which type of hepatitis is most common cause of acute viral illness in returning travellers?

A

Hepatitis A (water-borne)

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14
Q

What USS finding is very suggestive of liver cirrhosis?

A

Coarse liver

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15
Q

Which type of hepatitis is most likely to be transmitted by IV drug use?

A

Hep C

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