Data - Hepatobiliary

Question 1

How much do ALT and ALP rise in pathology?

Answer 1

ALT = 10 fold increase
ALP = 3 fold increase

Question 2

ALT is raised 10 fold.

ALP is raised less than 3 fold.

Answer 2

Hepatocellular injury

Question 3

ALT is raised less than 10 fold.

ALP is raised 3 fold.

Answer 3

Cholestasis

Question 4

Raised ALP and GGT?

Answer 4

Cholestasis with biliary tree involvement

Question 5

Isolated ALP?

Answer 5

Non-hepatobiliary cause
Bony metastases
Fracture
Vit D deficiency

Question 6

How to assess synthetic function of liver?

Answer 6

Serum bilirubin
Serum albumin
Serum glucose
Prothrombin time

Question 7

Raised unconjugated bilirubin?

Answer 7

Haemolysis
Impaired hepatic uptake (drugs, CCF)
Impaired conjugation (Gilbert’s)

Question 8

Raised conjugated bilirubin?

Answer 8

Hepatocellular injury

Cholestasis

Question 9

Lowered albumin?

Answer 9

Liver dysfunction - cirrhosis
Inflammatory response
Nephrotic syndrome, or other excessive loss of albumin

Question 10

Cholestasis bloods?

ALP; ALT; GGT; Bilirubin

Answer 10

ALT - Slightly raised
ALP - very raised
GGT - very raised
Bilirubin - very raised

Question 11

Acute hepatocellular injury bloods?

ALP; ALT; GGT; Bilirubin

Answer 11

ALT - Very raised
ALP - slightly raised
GGT - slightly raised
Bilirubin - slightly or very raised