Interpreting LFTs Flashcards
What pattern of LFTs would you see in an acute hepatitic picture?
ALT/AST in 1000s ALP mildly raised
What pattern of LFTs would you see in an chronic hepatitic picture?
ALT/AST in 100s
What pattern of LFTs do you see in cholestasis?
Raised ALP, slightly raised AST/ALT, increased bilirubin
What LFTs do you see in alcoholism?
Raised gamma GT, increased mean corpuscular volume, AST/ALT mildly elevated (AST >ALT), Increased bilirubin in acute alcholic hepatitis
What LFTs do you see in chronic liver disease?
Liver enzymes may be normal, decreased albumin, increased coagulation tests
Which liver enzymes are specific to the liver?
ALT spcific to liver
AST can come from other sources eg. heart, skeletal muscle
What are the causes of marked increase (1000s) of ast and alt?
drug induced hepatitis e.g. paracetamol
Acute viral hepatitis
Liver ischaemia
What are the causes of a modest increase in ast and alt (300-500)?
Chronic viral/alcoholic/autoimmune hepatitis
What are the causes of a mild increased in ast and alt (<300)?
Cirrhosis, NAFLD, hepatocellular carcinoma, haemachromatosis/wilsons
How can you tell if the raise in ALP is of hepatic origin?
There will also be a raised gamma gt
What are te causes of unconjugated hyperbilirubinaemia?
Increased haemolysis - haemolytic anaemia
Impaired hepatic uptake (drugs)
Impaired conjugation (Gilberts, physiological neonatal jaundice)
What are the causes of conjugated hyperbilirubinaemia?
Hepatocellular dysfunction (liver disease) Impaired hepatic secretion (cholestasis)
What is the half life of albumin?
20 days
What does decreased albumin and decreased other proteins indicate?
Advanced cirrhosis
Alcoholism
Protein malnutrition
What does decreased albumin and normal levels of other proteins indicate?
Infection as albumin is a negative acute phase protein
