Chempath 25: LFTs And Cases

Question 1

Which 2 vessels supply the liver ?

Answer 1

Hepatic artery

Portal vein

Question 2

List 3 metabolic effects of Liver failure ?

Answer 2

• low plasma glucose (less glycogen stores)
• High ammonia (less metabolism of amino acids)
• Lactic acidosis (lactic acid not metabolised)

Question 3

What is the tumour marker for hepatocellular carcinoma of the liver ?

Answer 3

AFP

Question 4

Which disease is suggested by a AST:ALT ratio > 2 ?

Answer 4

Alcoholic liver disease

AST rises more than ALT in alcoholic liver disease

Question 5

What does a raised GGT level tell you ?

Answer 5

Chronic alcohol use

Or bile duct disease (if ALP and GGT is raised it means its likely not bone disease and more likely disease of the biliary tract)

Question 6

What is the best acute marker of liver function ?

Answer 6

PT

Question 7

Apart from hepatocellular carcinoma which other cancer can cause a raised AFP

Answer 7

testicular cancer

Question 8

What does an isolated raised ALT suggest ?

Answer 8

Fatty liver disease

Question 9

What does a raised bilirubin and raised ALP suggest?

Answer 9

Cholestatic liver diseases: Gall stones, PBC, PSC, Cancer

Question 10

What does a raised bilirubin and raised ALT/AST suggest ?

Answer 10

Hepatocellular disease: Acute hepatitis, chronic liver failure

Question 11

What causes an isolated raised unconjugated bilirubin ?

Answer 11

Gilbert’s syndrome

Question 12

Which drug most commonly causes drug-induced cholestasis ?

Answer 12

Augmentin (co-amoxiclav)

Question 13

What is Courvoisier’s law ?

Answer 13

In the presence of a palpable gall bladder which is non-tender and accompanied by mild painless jaundice the cause is unlikely to be gall stones