Interpreting tests Flashcards
Acute hepatitis LFT pattern
ALT/AST in the 1000s
ALP mildly raised
Chronic hepatits LFT pattern
ALT/AST in the 100s
Alcoholic LFTs pattern
Increased gGT
AST>ALT
AST/ALT mildly elevated
Increase in bilirubin
Cirrhosis LFT pattern
Liver enzymes may be normal
Albumin REDUCED
Coagulation times increased
ALT vs AST
Which is specific to liver
ALT
AST also found in heart, skeletal muscle, kidneys pancreas
What is considered a ‘marked’ increase in ALP
What is considered a moderate increase in ALP
4X increase
3X increase
Which liver enzyme mimics ALP so may be used to confirm if ALP increase is from the liver
gGT
Raised in alcohol and enzyme inducing drugs
Causes for hyperbilirubinaemia (unconjugated)
Increased red blood cell breakdown (haemolytic anaemia)
Impaired hepatic uptake (drugs, heart failure)
Impaired conjugation (Gilbert’s syndrome, physiological neonatal jaundice)
Cause of mixed hyperbilirubinaemia
hepatocellular damage
Unit of time in which albumin changes level
weeks
Causes of reduced albumin and reduced protein
cirrhosis
nephrotic syndrome
chronic inflammation
protein-losing enteropathy, alcoholism
protein malnutrition/malabsorption
Causes of reduced albumin with normal protein
Infection - Albumin is anegative acute phase protein
Causes of reduced albumin and increased protein
Myeloma
Waldenstroms
unit of time in which INR/coagulation changes in LFT
6-8 hour half life so rapid changes
Causes of non-hepatic cholestasis:
C-amoxiclav, clarithromycin, flucloxacillin, carbamazepine, chlorpromazine
sulphonlyureas
