Interpreting LFTs Flashcards
What pattern indicates hepatocellular damage?
ALT and AST
What pattern indicates cholestasis?
ALP, GGT and BR
What can be looked at to measure synthetic function?
Albumin
Protein
+/- platelets
What does prothrombin time measure?
Conversion of prothrombin to thrombin
Which coagulation factors ISN’T synthesised in the liver?
Factor VII
Is ALT or AST more specific for liver damage?
ALT- only produced by hepatocytes
What is an AST:ALT =1 but over 1000 indicate?
Ischaemia
What does AST:ALT >2 indicate?
Alcoholic hepatitis
What does AST:ALT <1 indicate?
Hepatocellular damage (ALT specific)
What does ALP»_space; GGT indicate?
High bone turnover
Pregnancy
What does GGT»_space; ALP indicate?
Alcohol, medications
Where is AST made?
Hepatocytes, cardiac muscle, kidney, skeletal muscle, brain, pancreas, lung, blood cells
Where is ALP made?
Biliary epithelium, bone, placenta, kidneys gut?
What are the ABCs of acute liver failure?
ABCs of Acute Liver Failure:
- Acetaminophen (paracetamol), Augmentin, Hep A, AI hepatitis
- B: hep B
- C: hep C
- D: hep D, drugs (TB drugs)
- E: esoteric causes: Wilson’s disease, Budd-Chiari syndrome
- F: acute fatty liver of pregnancy
What is the Hep B serology of a vaccinated person?
HBsAb +
No HBsAg
No HBcAb
What is the serology of someone with a past Hep B infection?
HBsAb +
HBcAb +
What is the Hep B serology of someone with an acute infection?
HBsAg +
HBcAb IgM +
What is the Hep B serology of someone with chronic infection?
HBsAg +
HBcAb IgG+
Which HepB antibody can you NOT get from vaccination?
HBcAb
Can only have HBcAb from current or previous infection
(IgM+ for acute, IgG+ for chronic)
Which Hep B antigen can you only have during infection?
HBsAg
